135 patients, aged 18 to 73 years, with displaced distal radial fractures were randomized to evaluate the efficacy of volar locking plate fixation against closed reduction and percutaneous wire fixation over 12 months. Patients were administered the Hand Health Profile section of the Patient Evaluation Measure (PEM), the QuickDASH, the EuroQol-5D (EQ-5D; quality of life) and were assessed for range of motion and grip strength. The evidence presented in this study demonstrated that volar locking plate fixation for distal radial fracture resulted in faster early postoperative recovery of function but this advantage was no longer apparent by 12 weeks. Volar locking plates achieved superior anatomical reduction and grip strength, but this did not translate to a statistically significant difference in function at 12 weeks or at 12 months.