40 patients with unstable wrist fracture to be treated with external fixators were randomized for the use of titanium pins (TI) or Hydroxyapatite-coated titanium pins (HA). Clinical evaluation of pin site with regard to erythema, drainage, pain value and radiological assessment for loosening at T1 (mean, 9 days), T2 (mean, 43 days), and T3 (mean, 56 days) was conducted. In the case of infection, a detailed follow up with the specifics of antibiotic and any surgical procedure was recorded. The results from this study indicated that there were no significant differences in terms of these outcomes. However, there was a trend towards superior bone anchorage in the HA group, which also had a tendency to an increased susceptibility of minor pin-track infections.