461 patients with dorsally displaced distal radius fractures were randomized to undergo either volar locking-plate fixation or K-wire fixation. This study aimed to prove, through comparison, the null hypothesis that Patient-Reported Wrist Evaluation (PRWE) scores do not vary between treatments. The primary outcome of interest was PRWE results and secondary outcomes included DASH functional scores, EQ-5D quality of life scores, the incidence of complications, radiological outcomes, and economic analysis, all assessed up to 12 months postoperatively. The results of this trial indicate that no significant clinical differences were observed between either surgical intervention. When considering cost-effectiveness, K-wire fixation offered cheaper but clinical comparable results.