166 patients with an intra-articular distal radius fracture were randomized to fixation with either a volar locking plate or an external fixator. Patients were followed from 6 weeks to 2 years after surgery. Results demonstrated significantly favourable results for the VLP group compared to the EF group for the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH score) and range of motion in flexion, extension, pronation, and supination from 6 weeks to 1 year. By 2 years, results generally demonstrated no significant differences between groups.