152 patients with extra-articular distal radius fractures were randomized to have their fracture fixated using either an intramedullary nail, or a volar plate fixation technique. The purpose of this study was to compare the two methods with respect to functional and radiological outcomes. Results at the 2-year follow-up assessment indicated that patients in both groups exhibited similar pain, function, ulnar variance and volar tilt, and fracture union rates of 100%. Both treatment methods also appeared to be safe, as the incidence of complications was relatively low in both groups. There was a tendency for intramedullary nail fixation to yield less soft-tissue-related complications; however, there was a risk for articular surface screw penetration in this group.