目的　探讨不同内固定方法治疗不稳定型桡骨远端骨折的临床疗效。 方法　2004年1月至2009年1月，我院对50例不稳定型桡骨远端骨折患者采用克氏针或钢板内固定，必要时行自体髂骨植骨治疗。术后通过随访，并对随访资料进行分析、研究。  结果　腕关节功能按Sarmiento标准进行评定，结果优26例、良13例、可7例、差3例，失访1例，优良率达到79.6%，其中15例开放损伤患者中，1例行食指固有伸肌腱转位重建拇长伸肌腱术，2例皮肤缺损者经期游离植皮后伤口愈合，13例伤口I期愈合。  结论　针对不稳定型桡骨远端骨折不同情况，采取不同的内固定方式，方能提供稳定的固定，尽可能减少并发症，取得良好临床疗效。

Objective　To explore therapeutic effects of different internal fixations on treating the unstable distal radial fracture.　Methods　From Jan. 2004 to Jan. 2009，50 cases suffering from the unstable distal radial fracture were treated with Kirschner wire or plate fixation, combined with bone graft or not. Patients were followed-up and the data were collected.　Results　Wrist function was evaluated according to the Sarmiento standards. The results were excellent in 26 cases, good in 13 cases, better in 7 cases, poor in 3 cases, and the excellent rate was about 79.6% (1 case lost). For 15 cases of open injury, 1 case combined with disconnection of long thumb extensor tendon had a transposition reconstruction surgery of inherent long thumb extensor tendon, 2 cases with skin defect recovered after skin graft, and 13 cases received I healing. Conclusions　In order to provide stable fixation, reduce complications and achieve good clinical efficacy, different fixation methods should be taken to treat unstable distal radius fractures in various situations.