目的：探讨应用扩展的桡侧腕屈肌入路治疗复杂的桡骨远端关节内骨折的手术方法和效果。方法： 回顾性分析自2012年10月至2015年3月北京积水潭医院应用扩展的桡侧腕屈肌入路治疗的38例新鲜桡骨远端关节内骨折患者，其中男性25例，女性13例，平均年龄（52.76±8.62）岁（32~64岁）。患者受伤至手术时间平均（5.42±1.91） d（3~10 d），左侧17例，右侧21例。根据X线片、CT影像进行分型，所有患者均为国际内固定研究学会（Association for the Study of Internal Fixation，AO/ASIF）C3型桡骨远端骨折。分别在术后1、2、3、6、12个月对患者进行随访，随访内容包括正、侧位X线片，腕关节背伸、掌屈、桡偏、尺偏活动度，前臂旋转活动度，握力，并且在术后6、12个月随访时采用改良的GarlandWerley评分法和PRWE（patient rated wrist evaluation）评分法评定疗效。结果： 所有患者骨折愈合良好，随访时间均超过12个月，术后平均随访时间（16.37±2.85）个月（12~22个月）。术后6个月改良的Garland-Werley评分5.37±2.82，优良率84.21%，术后12个月改良的Garland-Werley评分 5.03±2.60，优良率86.84%。术后6个月PRWE评分15.82±8.38，术后12个月PRWE评分12.17±7.58。结论： 应用扩展的桡侧腕屈肌入路能够有效地治疗复杂的桡骨远端关节内骨折，并且可以避免掌背侧联合入路的缺点。

Objective： To discuss the effect of treatment of complicated intra-articular distal radius fractures with extended flexor carpi radialis approach. Methods: A retrospective analysis of 38 cases with fresh complicated intra-articular distal radius fractures treated by using extended flexor carpi radialis approach in our hospital from October 2012 to March 2015, with 25 males and 13 females. The average age was (52.76±8.62) years (32-64 years). The average time to surgery was (5.42±1.91) d (3-10 d), with left wrist 17 cases and right wrist 21 cases. All the patients were with C3 distal radius fractures according to Association for the Study of Internal Fixation (AO/ASIF) classification. The follow-up was conducted 1, 2, 3, 6, and 12 months after operation, including AP and lateral X-ray, wrist extension and flexion, radial deviation and ulnar deviation, forearm pronation and supination, and grip strength. At the end of 6 and 12 months after operation, all the patients were evaluated by using the mo-dified Garland-Werley score and patient rated wrist evaluation (PRWE). Results: All the patients got good bone union, and their follow-up time was more than 12 months. The average follow-up time was (16.37±2.85) months (12-22 months). The score of modified Garland-Werley evaluation 6 months post-operation was 5.37±2.82, excellent and good rate was 84.21%, the score of modified Garland-Werley evaluation 12 months post-operation was 5.03±2.60, excellent and good rate was 86.84%. The score of PRWE 6 months post-operation was 15.82±8.38, the score of PRWE 12 months post-operation was 12.17±7.58. Conclusion: The extended flexor carpi radialis approach is effective for the treatment of complicated intra-articular distal radius fractures and can avoid the complications of volar and dorsal combination approach.