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However, in certain complex fracture patterns, volar plating alone may not provide sufficient stability. In such cases, alternative fixation strategies\u2014such as dorsal plating, fragment-specific fixation, or spanning constructs\u2014may be necessary. Understanding the biomechanical challenges and appropriate surgical solutions is key to optimizing outcomes in distal radius fractures beyond standard volar fixation. This review highlights fracture types where volar fixation may be insufficient and presents alternative strategies tailored to each fracture pattern.<\/jats:p>","DOI":"10.1177\/15589447251397019","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T11:04:50Z","timestamp":1765883090000},"page":"1242-1249","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["When Is a Volar Plate Not Enough? 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