63 patients with a distal radius fracture and undergoing closed reduction prior to plaster orthosis application were randomized to reduction either with or without the aid of mini-C-am fluoroscopy guidance. Patients were assessed postreduction for reduction quality on radiograph, number of manipulations attempts, and subjective difficulty with reduction as rated by the treating resident. Radiographic results demonstrated no significant differences between groups in radial height, radial inclination, ulnar variance, or volar tilt. Subjective difficultly and number of manipulations attempted were both significantly increased in the mini-C-arm group compared to the standard group.