Abstract: Objective　To investigate the characteristics and differences of two kinds of die-punch fractures of the distal radius on imageology.　Methods　Images and clinical data of 498 cases with die-punch fractures of the distal radius from January 2007 to January 2016 were studied. According to the “three-column theory” and the location of fractures involved, die-punch fractures were divided into a single-column fracture and a double-column fracture. The differences in incidence, age, gender, treatment method and functional recovery between the two kinds of die-punch fractures were compared.　Results　The incidence, mean age and excellent and good rate of functional recovery of single-column fractures were 15.66%, 35.42 years old and 96.15% respectively, while as 84.34%, 54.69 years old and 80.00% respectively for double column die-punch fractures, showing significant differences between the two groups (P=0.000); the male or female ratio was 48/30, the operation or conservation ratio was 62/16 of single-column die-punch fractures, while as 223/197 as the male or female ratio and 344/76 as the operation or conservation ratio for double-column die-punch fractures, respectively, showing no significant differences between two groups (P=0.169 and P= 0.613 respectively).　Conclusions　Die-punch fractures of the distal radius are fractures resulting from an axial load through the lunate to the lunate fossa. However, due to different nature and size of violence, different position of wrist when injured and different bony quality of patient, resulting single-column and double-column die-punch fractures, which making significant difference in category and classification, degree of severity, occurrence mechanism, violence nature and level, incidence, age and prognosis of the fractures. 

Key words:  , Fracture of distal radius, 　Die-punch fracture, 　Three column theory