Recently, distal radius fractures are recognized as very complex injuries with a variable prognosis according to the fracture type and the treatment. Especially, there are several problems, including joint stiffness and skin necrosis due to a long term immobilization, radial shortening and collapse due to the loss of reduction in the elderly. Thus, the anatomical reduction and rigid internal fixation and early rehabilitation were recommanded. We analyzed 16 patients with distal radius fractures in the elderly, who were treated with open reduction and internal fixation with T-plate from January, 1991 to June, 1997 and were followed up for more than 12 months. The results were as follows ; 1. According to the Fernandez classification, 3 cases were type I, 3 cases were type II, 7 cases were type III, 1 case was type IV and 2 cases were type V. 2. As complications, there were 2 cases of arthritic change, 3 cases of radial shortening, and 1 case of screw loosening. 3. Anatomically satisfactory results were obtained in 75%(12 cases). 4. Functionally and clinically satisfactory results were obtained in 87%(14 cases). 5. In the treatment of distal radius fractures in the elderly, three dimensional structure and recovery of joint congruency were related to the clinical prognosis.