[Objective] To investigate the efficacy of Kirschner needle combined with external fixation frame in the treatment of extremely distal radius fracture. [Methods] The clinical data of 9 patients with extremely distal radius fracture treated by surgery from January 2018 to January 2020 were collected. During surgery, the palmar approach, the dorsal approach, or the combined approach was used to reveal the very distal radius fracture, and the fracture was fixed percutaneously with a Kirschner needle, and the wrist joint was stretched and fixed by a single-arm external fixation frame on the dorsal side of the wrist. The wrist rehabilitation function training was removed 6 weeks after surgery, and the Kirschner needle was removed 8 weeks after surgery. Postoperative follow-up was followed for more than 12 months, and the recovery of postoperative imaging indexes, fracture reduction, fracture healing and wrist range of motion were evaluated, and the MAYO wrist function score and upper limb function survey scale (DASH) were evaluated. [Results] All 9 patients were followed up with a mean follow-up time of (14.44±2.19) months. All cases had no complications such as bone nonunion, carpal tunnel syndrome, tendon irritation, and tendon rupture. Postoperative fractures healed effectively, except for 1 case where fracture reduction was lost, but no reoperation was required. None of the 9 patients developed significant pain. MAYO wrist function score is 75~95 points, with an average score of (87.78±7.12). DASH upper limb function survey scale score was 0.83~8.33 points, with an average score of (3.14±2.69). [Conclusion] Kirschner needle combined with external fixation frame is a reliable and effective treatment for the treatment of extremely distal radius fractures.