Does additional radial column plating improve clinical and radiological outcomes in distal radius fractures with radial styloid involvement or severe comminution?

This study compares the clinical and radiological outcomes of volar plating alone and combined volar and radial column plating in the management of Arbeitsgemeinschaft für Osteosynthesefragen (AO) type C2–C3 distal radius fractures. This retrospective cohort study included 80 patients with AO type C2–C3 distal radius fractures who were treated with either single volar plating (n = 50) or combined volar and radial column plating (n = 30). The patients were followed up for a minimum of 2 years. Outcome measures included the Patient-Rated Wrist Evaluation score, wrist range of motion, radiological parameters (radial height, inclination, volar tilt, ulnar variance), and pinch strength. Patients treated with dual plating demonstrated significantly better Patient-Rated Wrist Evaluation scores at all follow-up points ( P < .05) as well as improved radial height, inclination, volar tilt, wrist flexion, and grip strength. Pronation values were more favorable in the single-plating group across all follow-up time points, while supination values differed only at the 6-month assessment; overall function and radiological alignment otherwise appeared more favorable in the dual-plating group. In AO type C distal radius fractures with radial styloid involvement or severe comminution, dual plate fixation demonstrated improved functional recovery and maintenance of radiographic alignment. Supplementary radial column fixation may therefore represent an effective treatment strategy for these challenging fracture patterns, warranting further prospective investigation.