OBJECTIVE: The aim of this systematic review was to determine the extent to which sex and gender are considered in the design and reporting of DRF rehabilitation RCTs. DATA SOURCE: PubMed, Embase, CINAHL and Pedro databases were searched in March 2022, and an updated search was conducted in July 2023. STUDY SELECTION: All RCTs with a rehabilitation intervention and any comparison were included. DATA EXTRACTION: We extracted information on the study characteristics and sex and gender reporting in the articles. We extracted whether the studies complied with the SAGER guidelines and a reporting tool for sex and gender. DATA SYNTHESIS: A total of 77 studies were included in this review. All studies were published between 1987 and 2021. Two were in children, and the rest were in adults. This systematic review found that sex and gender were adequately considered in only six of the 77 RCTs investigating rehabilitation interventions post-DRF. Three of those studies were published before the SAGER guidelines were published in 2016, and three were published after 2016. CONCLUSION: Overall, sex and gender were inadequately defined, and poorly addressed in the study design, conduct, and interpretation. Unfortunately, there was no evidence of improvement after 2016 when the SAGER guidelines became available.