Sixty patients with distal radial fractures treated using anterior locking plate fixation were randomized to receive either concomitant endoscopic carpal tunnel release (CTR) (n=30) or no release (n=30). The primary outcome was the Patient-Rated Wrist Evaluation (PRWE) score. Secondary outcomes included QuickDASH, EQ-5D-5L, Boston Carpal Tunnel Questionnaire, pain numerical rating scale, grip strength, and finger-to-palm distance. Outcomes were assessed at 2 weeks, 6 weeks, 3 months, 6 months, and 12 months. Overall, the results of the study revealed no significant differences in functional outcomes, quality of life, or carpal tunnel symptoms between groups. However, patients with AO type C fractures showed less finger stiffness in the carpal tunnel release (CTR) group during early follow-up. These findings suggest that routine endoscopic CTR does not significantly improve outcomes in all patients but may reduce finger stiffness in more severe fracture subtypes.