Twenty-six studies including 1946 patients were included in this meta-analysis comparing percutaneous pinning and plaster casting for the treatment of distal radius fracture. Additionally, variations of the percutaneous pinning procedure, including various pinning devices and post-operative rehabilitation programs, were reviewed. The primary outcomes of interest were patient-reported functional outcomes and the risk of complications. Radiographic, economic, grip strength, range of motion, pain, patient satisfaction and physician-reported outcomes could not be pooled due to incomplete data, lack of reporting or uncertainties in the data. Results of the study found that the risk of fracture redisplacement requiring secondary treatment and the risk of finger stiffness was significantly lower in the percutaneous pinning group compared to the plaster cast group. The risk of a fair to poor composite functional grading score was significantly lower in the percutaneous pinning group. Significant differences in wire displacement were observed between Kapandji and Py's isoelastic percutaneous pinning methods, in favour of Py's pinning. No significant differences in the risk of complications were observed between percutaneous wire patients who received early mobilization and later mobilization post-surgery.