[Objective] To compare the clinical outcomes of internal fixation with volar locking plate (VLP) versus external fixator com- bined with percutaneous Kirshner wire for unstable distal radius fractures (UDRF) . [Methods] A retrospective study was performed on 73 patients who underwent surgical treatment for UDRF in our hospital from January 2018 to January 2020. According to the results of preoper- ative doctor-patient communication, 41 patients received VLP internal fixation (the IF group) , while the remaining 32 patients were treated with external fixator combined with percutaneous Kirshner wire (the EF group) . The perioperative, follow-up and imaging data were com- pared between the two groups. [Results] All the patients in both groups had operation performed smoothly. Although the IF group consumed significantly longer operation time than the EF group (P＜0.05) , the former proved significantly superior to the latter in terms of times of in- traoperative fluoroscopy and VAS scores in the early stage (P＜0.05) . The total incidence of postoperative complications was 7.3% in the IF group, whereas 25.0% in the EF group, which was statistically significant (P＜0.05) . All patients in both groups were followed up for (15.3± 2.1) months on an average, and the IF group returned to full weight-bearing activity significantly earlier than the EF group (P＜0.05) . In ad- dition, the IF group proved considerably superior to the EF group in terms of Cooney score, flexion-dorsiflexion range of motion (ROM) , ul- nar-radial deviation ROM, and forearm pronation/supination ROM postoperatively (P＜0.05) . Radiographically, the IF group proved signifi- cantly superior to the EF group in terms of palmar tilt (PT) , radial inclination (RI) , radial length (RL) , and joint congruence grade immedi- ately after surgery and at last follow-up (P＜0.05) , moreover, the former got fracture healing on images significantly earlier than the latter (P＜0.05) . [Conclusion] Compared with external fixator combined with Kirschner wire, the VLP internal fixation has fewer early adverse re- actions, better functional recovery, and is more conducive to fracture healing.