Objective To evaluate the clinical efficacy of minimally invasive percutaneous plate osteosynthesis （MIPPO） combined with an internal fixation locking system in patients suffering from type C distal radius fractures. Methods This study involved 80 patients with distal radius fractures admitted between July 2024 and January 2025. These patients were randomly assigned to either a control group or an observation group, with 40 patients in each group. The control group underwent the Henry approach to the distal radius, while the observation group received the MIPPO approach. Both groups were treated with internal fixation using the palmar multi-axial locking system. Comparisons were made between the two groups regarding operation duration, blood loss, and complication incidence. Additionally, comparisons included postoperative pain （visual analogue scale, VAS）, carpal function （Gartland-Werley score） at 2, 4, 8, and 12 weeks post-surgery, as well as fracture healing time, upper limb function （DASH score）, and wrist mobility at the final follow-up. Results The observation group demonstrated significantly shorter operation time （t=47.131; P<0.001） and reduced blood loss （t=13.09; P<0.001） compared to the control group. The complication rate was also lower in the observation group, though not statistically significant （χ²=3.105; P=0.078）. At 2 weeks and 4 weeks postoperatively, the VAS scores of the observation group were significantly lower than those of the control group （t=-4.852, -4.733; P<0.001）; there was no significant difference in the VAS scores of the two groups at 12 weeks and 24 weeks postoperatively （t=-1.826, 1.043; P=0.073, 0.301）. At 2 weeks （t=-3.642; P=0.001）, 4 weeks （t=-5.195; P<0.001）, and 8 weeks （t=-5.240; P<0.001） postoperatively, the Gartland-Werley scores of the observation group were higher than those of the control group, and the Gartland-Werley scores of the two groups were not significantly different at 12 weeks postoperatively （t=-0.375; P=0.709）. At the final follow-up, fracture healing time （t=0.793; P=0.431）, DASH score （t=1.171; P=0.246）, and wrist mobility in terms of flexion （t=1.386; P=0.171）, extension （t=-0.631; P=0.531）, radial deviation （t=-1.377; P=0.174）, and ulnar deviation （t=-1.53; P=0.131） showed no significant differences between the two groups. Conclusion Treating distal radius fracture with the MIPPO approach combined with an internal fixation locking system results in short operation time, reduced bleeding, few complications, little postoperative pain, and good wrist function recovery. MIPPO combined internal fixation locking system proves highly valuable in enhancing short-term surgical results and functional recovery for patients with distal radius fracture.