|ABSTRACT Objective For patients with die-punc fractures of the distal radius, open reduction therapy assisted by wrist arthroscopy was adopted to evaluate the treatment and analyze the effect, so as to provide corresponding reference for clinical practice and improve the level of diagnosis and treatment. Methods Clinical data of 50 patients diagnosed as distal radial die-punch fractures admitted to our hospital from December 2015 to May 2017 were retrospectively analyzed, including 31 males and 19 females. Age range: 20-45 years old, mean (34.12 2.56) years old. All patients adopt wrist arthroscopy assisted by the volar approach open reduction surgery, volar plate fixation to analyze the effects of the treatment, compared before and after the treatment of each part of the wrist joint (the back stretch, palm, feet wide, radial deviation, pronation and supination) range and function of wrist joint (pain, functional status, activity, grip strength, back stretch/palm flexion mobility). Results All 50 patients were followed up for 18 months. DR tomography showed that all fractures healed without shortening of radial axis. Wound infection occurred in 3 cases, all of them disappeared after treatment, and no other serious complications occurred. According to Cooney wrist function scale, the excellent and good rate was 94.00% (46/50). In terms of wrist range of motion, such as dorsiflexion, palmar flexion, ulnar deviation, radial deviation, pronation, and pronation, the postoperative 18 months was significantly greater than that before and after the surgery, with statistically significant differences (P<0.05). In terms of pain, functional status, range of motion, range of dorsiflexion/palmar flexion, handgrip strength and other wrist joint functions, the postoperative 18 months were all higher than that before the operation, and the difference was statistically significant (P<0.05).Conclusion Carpal arthroscope-assisted open reduction for the treatment of die-punch fractures of the distal radius can better restore the formation of the articular surface, which is conducive to the rapid recovery of the function of the wrist, with high safety and is worth promoting.