Background: Distal radius fractures (DRFs) are mainly treated by surgery; however, there is no strong evidence to establish the superiority of one modality over another. Aim: To determine the most efficient surgical procedure in terms of restoring anatomical angles in DRFs. Methods: This retrospective study was conducted at King Abdulaziz University Hospital, Jeddah between 2010 and 2016. It involved 31 patients with DRF treated surgically. All patients were assessed pre-and post-operatively to measure radial height (RH), radial inclination (RI),ulnar variance (UV) and volar tilt (VT) on posteroanterior and lateral radiographs. The Shapiro-Wilk test was performed to determine the normality of measurements. Results: Pre-operative variables, including (RH), (RI), (VT), and (UV), were not significantly different among patients in all treatment groups. In group 1 (closed reduction with K-wire, external fixation, or both), all the pre- and post-treatment variables were significantly different (p < 0.05), except (UV) (p = 0.867). Conversely, the difference between pre- and post-measurement variables in group 2 (open reduction with plate and screw) was significantly high (p < 0.05). Further, group 3 (open reduction with K-wire plus plate and screws) and group 4 (open reduction with K-wire plus plate and screws in combination with external fixation) showed no significant difference (p > 0.05). Conclusion: Open reduction with plate and screws was highly effective in the management of DRFs. However, additional studies are needed to establish an effective management for these fractures.