Volar locking plate and radial styloid plating

A significant number of distal radius fractures can be appropriately managed with a volar locking plate alone. However, fractures with a radial column/styloid fragment can prove difficult to capture with a standard volar locking plate, as the primary or secondary fracture lines would be parallel to the distal screws of most volar plates. In these situations consideration should be given for the addition of radial styloid plate. Additionally, a radial artery approach may facilitate the placement of both the styloid plate as well as a standard volar locking plate through a single approach. This hybrid construct provides a buttressing effect and the added rigidity of orthogonal fixation that some of these fractures require.