One hundred and twenty patients with dorsally-displaced, unstable, extra-articular distal radius fractures were randomized to receive fracture fixation using a volar locking plate (n=60) or a dorsal locking nail-plate (n=60). The primary outcome of interest was the Quick Disability of the Arm, Shoulder, and Hand (QuickDASH) score. Secondary outcomes of interest included the Patient-Rated Wrist Evaluation (PRWE), EuroQoL 5 Dimensions (EQ-5D) index and Visual Analog Scale (VAS) scores, pain medication use, range of motion, grip strength, and radiographic outcomes. Outcomes were assessed up to 1 year post-operation. Results demonstrated significantly favourable QuickDASH and PRWE scores in the volar plate up to 1 year post-operation, however these differences were not clinically important. Lower need for pain medication and greater grip strength were observed in the volar plating group in the first 6 weeks post-operation.