Abstract:[Objective] To evaluate the clinical efficacy of closed reduction and fixation with external fixator combined with Kirschnerwire for unstable distal radius fractures. [Methods] From March 2019 to September 2021, a total of 30 patients received closed reductionand fixation with external fixator combined with Kirschner wire for unstable distal radius fractures, and the clinical and imaging data of thepatients were evaluated. [Results] All the patients were operated smoothly without serious complications, with operation time of (73.8±6.9)minutes, perioperative blood loss of (46.4±9.6) ml, and frame removal time of (7.8±0.9) weeks. With time from the point preoperatively, im-mediately postoperatively to that at the last follow-up, VAS score significantly reduced [(8.1±0.6), (6.1±0.9), (3.3±0.3), P＜0.001]. At the lastfollow-up, the Cooney score, palmar flexion-dorsal extension, radio-ulnar deviation, and pronation-supination ROMs were significantly im-proved (P＜0.05). In term of imaging, compared with those preoperatively, the volar tilt (VT) [(4.7±1.9)°, (13.2±0.7)°, (12.8±0.5)°, P＜0.001],radial inclination (RI) [(7.0±1.0)°, (22.8±0.8)°, (21.8±0.6)°, P＜0.001] and radial styloid height (RH) [(5.8±1.0) mm, (11.4±0.6) mm, (9.2±0.5) mm, P＜0.001] were significantly increased immediately postoperatively and at the latest follow up. However, the RH was significantlylost at the last follow-up compared with immediately after surgery (P＜0.05). [Conclusion] For unstable distal radius fractures, closed reduc-tion and internal fixation with external fixator combined with Kirschner wire can obtain satisfactory clinical consequences, despite of loss ofradius styloid height in some extent latterly, which can be used as one of the surgical methods chosen by clinicians.