Intrafocal pinning of distal radius fractures was described first by Kapandji in 1976. The technique has been used widely in Europe but remains relatively unknown in the United States. It is indicated in unstable distal radius fractures without significant intra-articular displacement. This article provides a review of the European experience, a description of the surgical technique, and an analysis of our own clinical series. Intrafocal pinning works best in patients less than 65 years of age, for the fracture patterns described previously. It provides the surgeon with a simple and effective, minimally invasive method of improving alignment and stability of unstable fractures.