Two hundred eleven patients with displaced distal radius fractures were randomized to receive standard closed reduction (n=105) or point-of-care ultrasound (PoCUS) - guided reduction (n=106). The primary outcome was the proportion of patients requiring more than one reduction attempt. Secondary outcomes included adequacy of alignment on radiographs, time to complete reduction, and the need for operative repair at discharge. Outcomes were assessed at the time of ED management and discharge. Overall, the study found that more than one reduction attempt was required in 12% of the standard group versus 6% of the PoCUS group, but this was not statistically significant. PoCUS reductions took slightly longer, and rates of operative repair were similar (16% vs 20%). The study suggests that PoCUS does not significantly improve first-attempt success in distal radius fracture reductions.