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.