Distal radius fractures are among the most prevalent fractures. They are treated via a variety of methods, but the best treatment has not been defined yet. This study was performed to compare the results of open reduction and internal fixation with locking plates versus the pin and plaster method. In this prospective study, 100 patients aged 30 to 60 years with Fernandez type III were selected randomly from August 2016 to August 2018 at Department of Orthopaedics, GMC Srinagar after obtaining informed consent. They were treated with pin and plaster fixation (n = 50) or internal fixation with the volar locking plate (n = 50). Both groups were compared at the one year follow up. Demographic features and standard radiographic indices were recorded and MAYO Wrist Score was used for outcome. Pain (P = 0.564) was not significantly different between the groups. In the plating group mean MAYO score (P<
0.001) was more than pin and plaster group. The rate of acceptable results of radiographic indices (P<
0.001), grip strength (P<
0.001) and range of motion in supination-pronation (P<
0.001) in plating method were better than the pin and plaster method.
Conclusion: In treatment of intra-articular distal radius fractures in middle-aged Patients internal fixation with locking plates may be prefered to pin and plaster as the treatment of choice.