Displaced, unstable intra-articular distal radius fractures are usually treated with reduction and fixation to allow early motion and minimize the potential for development of posttraumatic arthritis. The dorsal surgical approach allows direct visualization of the articular surface to ensure an anatomic reduction. Low profile, locked plates have minimized the unacceptable complication rates previously associated with dorsal plates. This study reviews the historical perspective, indications, technique, complications, and rehabilitation for dorsal, locked plate fixation of intra-articular distal radius fractures. The authors report a strategy for simplifying the fixation of these fractures.