PURPOSE: To evaluate the effectiveness of operative treatment in distal radius fracture with distal radioulnar joint injury. MATERIAL AND METHOD: From January 1992 to January 2000, 66 cases of distal radius fracture with distal radioulnar joint injury who had been treated with conservative or operative methods were analyzed the final state of radius articular surface and distal radioulnar joint. RESULT: In operatively treated cases(42 cases), the average of volar tilt was 3.74 degrees, ulnar inclination 21.9 degrees, radial length 9.74mm. In conservatively treated cases(24 cases), The average of volar tilt was 1.75 degrees, ulnar inclination 15.1 degrees, radial length 7.67mm. The state of distal radioulnar joints were as follows; In operatively treated cases, anatomical reduction 37(88%), joint widening 5, In conservatively treated cases, anatomical reduction 17(70%), joint widening or ulnar impingement syndrome 7. CONCLUSION: In treatment of distal radius fracture with distal radioulnar injury, operative treatment is probably more effective in restoration of radius articular surface and distal radioulnar joint healing.