Objective To observe the clinical effects of two approaches on unstable distal radius fracture （UDRF）. Methods From January 2016 through December 2020, 120 patients with UDRF were selected. Among them, 60 cases （group A） received open reduction and steel plate internal fixation, and another 60 cases （group B） received closed reduction and external fixation. After 3 months of follow-up, fracture healing time, complications, wrist joint function recovery （assessed by Gartland and Werley, GW, scoring system）, and treatment cost were compared between the two groups. Results The fracture healing time of group A was significantly longer than that of group B （t=4.065 4, P=0.000 1）. There was no statistical difference in the total incidence rate of complications between the two groups （χ²=0.138 9, P=0.709 4）. After 3 months of operation, the excellent and good rate of GW score in group A was slightly higher than that in group B, without statistical difference （χ²=0.890 5, P=0.345 3）. The treatment cost of group A was significantly higher than that of group B （t=5.896 6, P<0.001）. Conclusion Both of the selected two methods can achieve satisfactory short-term effect on UDRF, but closed reduction and external fixation features lower treatment cost and shorter fracture healing time.