Sixty-two patients with comminuted, intra-articular distal radius fractures were randomized to receive surgical intervention with a variable angle volar plate (n=31) or external fixator with or without K-wire augmentation (n=31). The outcomes of interest included grip strength, range of motion, Disability of the Arm, Shoulder and Hand (DASH) score, patient rated wrist evaluation (PRWE) score, and complications. Outcomes were assessed at 6 weeks, 3 months, 6 months, and 1 year post-operation. Results demonstrated significantly superior range of motion, PRWE scores, DASH scores and grip strength in the volar plating group in the first 6 months post-operation. 1 year post-operation, flexion, extension, and grip strength were superior in the volar plating group. 4 cases of adverse events in the volar plating group and 6 cases of adverse events in the external fixator group were observed.