This meta-analysis included 10 studies that compared the effectiveness of external fixation and open reduction with internal fixation (ORIF) using plates for patients with distal radius fractures. The pooled results demonstrated that patients who received ORIF had significantly lower disability scores than those who received external fixation. The ORIF group also had less ulnar variance and infection than the external fixation group. The two groups did not differ significantly with respect to all other clinical outcomes. Results, therefore, favour ORIF as the optimal treatment for distal radius fractures.