114 patients, over the age of 18, with unstable distal radius fractures were randomized into one of two treatment groups to compare the efficacy of a plate fixation, using volar locking plates, or external fixation using adjuvant pins. Patients in the plate fixation group showed comparable results to the external fixation group in terms of Quick DASH score and VAS pain scores. Further assessment found significantly improved results for Mayo wrist score, supination, and ulnar variance for those who received treatment with volar locking plates, when compared to the external fixation group. The rates of complications were similar between groups, however it should be noted that 15% of patients in the plating group required plate removal.