Objective Manipulative reduction and HoffmannⅡ external fixation was used to treat unstable distal radius fractures, the technique and clinical effect of this operation was to be explored. Methods From June 2007 to March 2009, 27 cases of unstable distal radius fractures were treated by manipulative reduction and HoffmannⅡ external fixation, with additional K-wires used in five cases. All the cases were followed up, and were evaluated according to the Dienst functional assessment system. Some radiographic parameters were also determined in this study. Results All the patients were followed up for 6 to 18 months. 14 cases had excellent function, 10 good and 3 fair according to the Dienst functional assessment system, the excellent and good rate was 88.9%. Among them, 5 had minimal loss of reduction, 1 had pin tract infection, none had radial nerve injury or carpal tunnel syndrome. Conclusion Combined with manipulative reduction techniques, the HoffmannⅡ external fixator can be a convenient, safe, and useful tool in treating distal radius fractures.