Objective To compare the clinical efficacy of different surgical methods in the treatment of comminuted distal radius fracture. Methods A total of 210 patients with distal radius fractures in our department from January 2012 to December 2016 were divided into group A

B

C according to fracture displacement type and degree of comminuted fracture;58 cases in group A were treated with open reduction and single plate fixation via dorsal approach

69 cases in group B were treated with open reduction and double plate fixation via dorsal approach

and 83 cases in group C were treated with open reduction and single plate fixation via volar approach.The differences of reduction effect

soft tissue condition

clinical healing time

complications and wrist joint function of the three groups were compared. Results There was no statistical difference in radius height

palm inclination and ulnar deviation between three groups（P>0.05）.No statistical difference was found in clinical healing time（P>0.05）.The tendon irritation signs of group A was significantly higher than those of group B and group C

the differences were significant（P<0.05）.After 9 months of operation

DASH upper limb function questionnaire and PRWE score were used to evaluate the wrist joint function of three groups from different directions.There were statistical differences between group A and other two groups in scoring. Conclusion The volar approach can be applied to most distal radial intraarticular fractures.It has advantages in fracture reduction

plate placement and tendon injury avoidance

but there is a risk of median nerve and radial artery injury

which requires certain surgical techniques.Dorsal approach with double plate fixation can provide stability of the double column and can directly look at the joint surface.It has certain advantages for the treatment and reduction of severe crushing of the dorsal joint surface

but there is a risk of extensor tendon irritation.Dorsal single plate fixation has no advantages in fixation strength

longterm function and the prevention and treatment of complications.At the same time

there are individual differences in the choice of surgical methods

which should be determined in combination with the degree of fracture comminution

type of displacement

skin and soft tissue conditions in the operative area

as well as the patient′s requirements on wrist function and other aspects.