Usually, the closed or percutaneous reduction is suitable for group C1 fractures in which the skeletal lesion has simple intra-articular components, with no metaphyseal comminution and at least two fragments. For percutaneous reduction, manipulation of the cartilage-bearing fragments is done under fluoroscopic guidance using an awl or a periosteal elevator through a small skin incision with minimum soft-tissue dissection and percutaneous pinning can be used to stabilize them. External fixation is the method of choice for the group C2 fracture with a simple intra-articular component and extensive metaphyseal comminution in order to control radial shortening and metaphyseal angulation. And in case, restoration of articular congruity cannot be done with ligamentotaxis in such condition following application of the external fixator, and a percutaneous and/or limited open reduction together with 40⁰–60⁰ bone grafting is suggested. In this situation, usually, a small dorsal approach between the third and fourth dorsal compartments is applied. Then the articular fragments are elevated against the carpus and stabilized using percutaneous pins. Autogenous bone grafting can provide additional mechanical support to the small cartilage-bearing fragments and increases the stability of the construct and facilitates the healing of bone so it is strongly advocated. After all, this fixator can be removed at 5 weeks. For group C3 fractures extensile open reduction and bone grafting is highly indicated if the fracture is with increasing articular disruption of more than two fragments and if the fracture does not respond to ligamentotaxis as it sometimes does not allow disimpaction of the central articular fragments and sometimes reduction of severely rotated palmar ulnar lip fragments cannot be done. Treatment of The fractures of this group is a challenge because of the inherent instability and irreducibility, the high amount of metaphyseal comminution, the severity of the articular disruption, major bone loss of the distal forearm may be due to open wounds, gunshot wound, or crush injuries, their association with carpal disruption and the distal ulna fractures or Ipsilateral fractures of the upper extremity. A palmar and a dorsal approach both can be needed in case of severely displaced four-part fractures However, the palmar ulnar fragments should be stabilized first so that the mechanical continuity of the palmar cortex can be restored using a palmar buttressing which provides a solid base for the reduction of the dorsoulnar and radial styloid fragments, combining ligamentotaxis using a simple external fixator frame and limited dorsal open reduction through the bone graft of iliac. Plate fixation can only be used in place of external fixation in the following conditions: If exact reduction of bony cortex opposite the plate; if the solid purchase of the screws in the distal fragments; ability to achieve primary soft-tissue coverage of the implants and if associated primary bone grafting of defects or comminuted areas. A p-shaped low-profile plate is preferable for dorsal plate fixation as the use of both smaller screws or pins is allowed by the transverse limb of the plate. To provide a condylar plate effect, these can be threaded to the plate holes. This feature helps in the independent fixation of articular fragments whereas the metaphyseal fracture is bridged by the two longitudinal limbs of the plate. Indirect reduction techniques are suggested for the application of the plate. Longitudinal intraoperative sterile finger trap traction can be used to achieve it using a fracture distractor, or a temporary external fixator for the wrist. Grafting of fracture and application of plating is performed following temporary fixation of the fragments using K-wire and controlled reduction with intra-operative fluoroscopy The plate must be covered with an extensor retinaculum flap in order to prevent irritation of tendons in the second and third compartments.Microlock locking hand plates are used for exceptional fractures of the hand. It allows free choice for the placement of screws.