Abstract:[Objective]: To compare the clinical efficacy of combined external fixator and volar locking plate internal fixation for the treatment of senile osteoporotic distal radius fractures.[Methods]: A retrospective analysis of 68 elderly patients with osteoporotic distal radius fractures from January 2013 to January 2018 was performed. Among them, 38 patients were treated with closed manipulative combined external fixation(EF group). Open reduction and locking plate internal fixation for another 30 patients (IF group). To compare the operation time and hospitalization time of the two groups，and the comparison of changes in palmar tilt angle, ulnar inclination and radial styloid process height at 3, 6, and 12 months after operation. The wrist joint mobility and Gartland-Werley function score of the wrist joint were observed 6 months after operation.[Results]: All the 68 cases were followed up. The follow-up time was 14.37±1.85 months in the external fixation group and 14.70±1.53 months in the internal fixation group. Compared with the volar locking plate internal fixation, the operation time and hospitalization time of the external fixation group were significantly shortened. There was no significant difference between the two groups in terms of palmar tilt angle, ulnar inclination, wrist joint mobility and Gartland-Werley function score (P >0.05), but the height of the radial styloid process of the two groups was statistically significant (P <0.05).[Conclusion]: Combined external fixation for the treatment of senile osteoporotic distal radius fractures is simple and reliable, and can simultaneously restore the functional and anatomical angles, especially for the recovery of the radial styloid process height .