Objective  To evaluate the clinical results of open reduction and internal fixation(ORIF) and external fixation(EF)for the treatment of unstable fractures in distal radius.

  Methods  From September 2005 to February 2008, 44 patients(average age:61.5 years) with unstable distal radial fractures were treated in our department by the same surgeon with either ORIF or EF. According to AO Muller classification, there were 11 cases of type A, 9 cases of type B, and 24 cases of type C. Twenty-one cases were treated with EF, while 23 cases with ORIF. The duration of operation and intra-operative blood loss were recorded. The patients were followed up 3 months, 1 year, and 2 years after surgery. Clinical and radiological outcomes, including Gartland-Wertley(GW) scores, range of motion of wrist joint, and grip strength, were measured. Complications were observed and recorded.

  Results  EF took shorter time and less blood loss than ORIF. At the 3-month follow-up, ORIF cases showed superior GW scores, volar flexion, dorsiflexion and grip strength than EF. At the 1-year follow-up, better volar flexion and grip strength were found in ORIF cases. At the 2-year follow-up, ORIF cases still showed better volar flexion than EF.

  Conclusion  In the treatment of unstable distal radial fractures, ORIF can achieve better clinical outcomes in the first 2 years, while EF offers shorter operation time and less blood loss.