40 patients with a distal radius malunion were randomized to either 3-dimensional (3D) or 2-dimensional (2D) preoperative planning for corrective osteotomy. The primary outcome was the change in patient-reported disability on the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire over 12-month follow-up; secondary measures included visual analog scales for pain and satisfaction, the Patient-Rated Wrist Evaluation, and radiographic assessment of deformity correction. No significant differences between groups were noted in the changes of the DASH, PRWE, VAS pain, or VAS satisfaction after 3, 6 or 12 months.