Abstract: OBJECTIVE Through meta analysis to compare the effect of external fixation support versus small splint fixation in unstable distal radius fractures regarding clinical results， radiological outcomes and postoperative complications. METHODS Cochrane Library， MEDLINE， EMbase， CBM and the relevant English and Chinese orthopedic journals were searched for the randomized controlled trials of external fixation support versus small splint fixation in unstable distal radius fractures. Then the researchers analyzed wrist functions， radiological outcomes and complications though meta analysis. RESULTS A total of 8 RCTs with a total of 713 participants were included. The results of Meta-analyses showed that compared with small splint fixation fixation， wrist functionsRR=1.25， P<0.01 and radiological outcomesRR=1.24， P<0.01 were superior in the external fixation support group， meanwhile， the loss of volar tilt angleMD=4.85，P<0.01 and ulnar inclination angleMD=3.20， P<0.01 were smaller and the length of radial shorteningMD=-3.42， P<0.01 was shorter after six months follow-up. And external fixation support fixation led to significantly fewer total complicationsRR=0.62， P<0.01. CONCLUSION External fixation support is a better alternative to small splint fixation for unstable distal radius fractures. However， more high quality， large scale and multicentric randomized controlled trials are required for more accurate conclusion.