Although fractures of the distal radius are common, an optimal treatment has not been delineated, especially in unstable fractures. Over the past few years, the importance of alignment correction, preservation of normal radial length, and reconstruction of congruity of both the radiocarpal and radioulnar joints have been emphasized. Authors reviewed 23 cases of unstable intra-articular fractures of the distal radius treated with small external fixator to improve anatomical and functional result. External skeletal fixation, combined with internal fixation when necessary, was thought to be a useful method for the treatment of unstable intra-articular fractures of the distal radius.