Both the radiocarpal and distal radioulnar joints are often affected in “distal radius fractures”. The incidence of this injury increases markedly among women over the age of 40. Bearing the wide variety of distal radius fractures in mind, a fixation system should be used which permits trans- and extraarticular application and subsequent reduction by means of distraction, as well as wrist mobilization and corrective osteotomies. It is important that both reduction and position of the carpal bones can be checked. This is possible using the double ball joint configuration with carpal height dimensioning. The possibility of extraarticular fixation should always be considered. AO group A.2 and A.3 fractures with sufficiently large fragments are suitable for this procedure. In other cases, transarticular application is advised. Complementary measures are justified in the case where two or more cortices in AP and lateral X-rays are destroyed. They are also used to stabilize the joint surface. Large bone defects should be filled with corticospongeous material.