We reviewed the results of the treatment of giant-cell tumors of the distal part of the radius in twenty-three patients, to identify criteria that could assist in the selection of the most effective option for treatment or reconstruction. The treatment was chosen on the basis of the preoperative roentgenographic assessment of the extent of the tumor. Seven patients, who had received previous treatment elsewhere, were referred to us because of a local recurrence. An extended curettage followed by packing of the cavity with cement was effective in preserving the normal function of the extremity and in eradicating the lesion in five patients who had a lesion that was intraosseous or that involved minimum cortical perforation. Of the eighteen remaining patients, who had extraosseous extension of the tumor, seventeen had a resection of the distal part of the radius and one had a below-the-elbow amputation. After resection of the involved segment of bone, the best functional result was seen in the patients who had been managed with a radiocarpal arthrodesis and use of an intercalary bone graft that was stabilized with a long plate. At the most recent follow-up examination (range, two to nineteen years after the curettage or resection), there had been no local recurrences.