One hundred ten patients with distal radius fractures were randomized to receive either topology-optimized splint immobilization (n=54) or cast immobilization (n=56) after closed manual reduction. The primary outcome of interest was the Gartland-Werley (G-W) wrist score at 6 weeks. Secondary outcomes included radiographic parameters, visual analog scale (VAS) scores, swelling degree grades, and complication rates. Outcomes were assessed for up to 12 weeks. Overall, the results of the study revealed that the splint group had significantly better wrist function at 6 weeks and fewer complications, such as shoulder-elbow pain and skin irritation. By 12 weeks, no significant differences were observed between the groups. The findings suggest that topology-optimized splints provide early functional benefits and reduce complications compared to traditional casts.