Abstract:[Objective] To compare the clinical results of three methods for fixation of displaced distal radius fractures. [Methods] A retrospective study was done on 115 patients who received treatment for displaced distal radial fractures in our hospital from January 2019 to May 2021. According to the doctor-patient communication, 35 patients were treated with closed reduction and external fixation with trac- tion splint (the TS group), 45 patients were with closed reduction and external fixation with plaster cast (the PC group), while the remaining 35 patients received open reduction and internal fixation (ORIF) with plate and screws. The perioperative, follow-up and imaging data of the three groups were compared. [Results] The TS, PC and ORIF group were recorded in terms of operation time [(60.7±6.1) min vs (40.4± 4.0) min vs (73.3±7.1) min, P＜0.05], treatment fee [(1 288.9±158.5) yuan vs (830.7±146.8) yuan vs (12 351.7±1 645.4) yuan, P＜0.05] and external fixation time [(7.1±0.7) weeks vs (7.1±0.7) weeks vs (1.8±1.4) weeks, P＜0.05], with statistically significant differences among them. The VAS score for pain and swelling extent of the three groups significantly improved with time after treatment (P＜0.05), which were not sta- tistically significant among the three groups at any time points accordingly (P＞0.05). All patients in the three groups were followed up for (13.6±2.1) months on a mean, and there was no significant difference in the time to resume full weight-bearing activity among the three groups (P＞0.05). During the follow-up, the TS group proved significantly superior to the PC group in term of revision surgery rate (2.9% vs 17.8%, P＜0.05). The PRWE score, Gartland-Werley score and flexion-extention ROM significantly improved in all three groups over time after operation (P＜0.05), which in ORIF group were significantly better than those in the TS group and PC group at 3 months after surgery (P＜0.05), whereas became not statistically significant among the three groups at the latest follow-up (P＞0.05). Radiographically, fracture alignment, PT, RI, and RH significantly improved in all three groups immediately after treatment and at the last follow-up compared with those preoperatively (P＜0.05). At the last follow- up, the ORIF group was ranked as the best, the TS group as the middle, while the PC group as poorest in terms of abovementioned imaging items, with statistical significances (P＜0.05). [Conclusion] All three methods are ef- fective for the treatment of displaced distal radius fractures, and each has its own advantages and disadvantages. The clinical outcome of TS is intermediate between PC and ORIF, and the treatment should be selected on a case-specific basis.