50 patients with unstable, irreducible, or comminuted distal radial fractures were randomized to either receive open reduction with internal fixation (ORIF) or closed reduction with bridging external fixation. The purpose of this trial was to compare grip strength and range of motion over a medium-term follow-up. The 1 year results indicated that there was a significant difference in grip strength and ROM between groups favoring ORIF. However, this difference was not maintained at 5 years with both groups approaching the normal grip strength and ROM values of the uninjured side.