Fractures of the distal third of the radial shaft are difficult to treat successfully by means of closed reduction. The early treatment of choice is open operation, anatomical reduction with rigid and secure internal fixation. Resection of the distal portion of the ulna and bone-grafting should be seriously considered in fractures brought to operation three to four weeks after fracture. Restoration of good function in fractures treated late appears to be most successfully accomplished by means of intramedullary fixation combined with bone-grafting of the radius and resection of the distal portion of the ulna.