The treatment of distal radius fractures requires a meticulous reconstruction of the joint surface, as well as stable internal fixation and early functional postoperative treatment.
Extra-articular fractures require both the restoration of the volar tilt and radial length to reduce the possibility of displacement. Malalignment may result in limitations of movement, changes of load distribution, and midcarpal instability, as well as increased risk of osteoarthritis in the radiocarpal joint. Intra-articular fractures with articular displacement of more than 2 mm in the radiocarpal joint may result in osteoarthritis and functional impairment.
The distal radius and distal ulna form a three-column biomechanical construction3:

• The intermediate column is the medial part of the distal radius, with the lunate fossa and the sigmoid notch.
• The radial column is the lateral radius with the scaphoid fossa and the styloid process.
• The ulnar column is the distal ulna, the triangular fibrocartilage, and the distal radioulnar joint.
Following reduction, stabilization requires optimal fixation of the intermediate column as well as the radial column. In the case of a fractured distal ulna that compromises the distal radioulnar joint, the ulnar column should be stabilized as well.