Key PointsQuestionWhat are the treatment outcomes for distal radius fractures in older adults in the short-term (≤3 months) and intermediate-term (>3 months to 1 year) postoperative periods?FindingsIn this systematic review and network meta-analysis of 23 randomized clinical trials including 3054 participants, distal radius fracture treatment with open reduction and internal fixation with volar locking plate was associated with clinically and statistically significant improvements in short-term patient-reported outcomes assessed with the Disabilities of the Hand and Shoulder Questionnaire and Patient-Rated Wrist Evaluation.MeaningThe findings of this study suggest that open reduction and internal fixation with volar locking plate may achieve greater patient-reported quality of life in the early postoperative recovery period compared with casting alone.