OBJECTIVE: To investigate the operative indication and clinical efficacy of combination of external fixator and volar approach fixation in treating distal radius fracture. METHODS: From March 2000 to March 2005, 28 patients with distal radius fracture were treated with combination of external fixator and volar approach fixation. Dorsal external fixator was used to maintain wrist in functional position, combinated volar plate or Kirschner wire fixation after reduction was achieved. Bone graft was necessary if there were severe comminuted cortical bone or compress of cancellous bone. Of 28 patients, there were 21 males and 7 females, aging from 18-54 years with a median age of 41 years. The locations were the left side in 4 cases and the right side in 24 cases. According to typing criterion for AO, 18 cases were classified as C2 and 10 cases as C3. One case was accompanied with dislocation of lunate bone. RESULTS: Among 28 patients, 24 were followed up for an average of 8.5 months. The anatomical relationship of their wrist joint were re-established and retained. Overall good to excellent results were achieved in 87%, excellent in 16 cases, good in 5 cases and fair in 3 cases. CONCLUSION: A combination of external fixator and volar approach fixation is an effective method of treating fractures of the distal radius, because distal radius fracture is unstable or difficult to close reduction. Volar fixation can avoid operative complication, and external fixator can obtain satisfactory reduction and function.