Background: Distal radius fractures in the elderly population are very common injuries, and unique management issues in the treatment of these fractures. Distal radius fractures in osteoporotic bone have greatly diminished stability. There are often bone impaction and fracture fragmentation. Objective: To evaluate clinical and radiological outcomes of management of patients with extra-articular distal radius fractures in elderly by comparison between K-wire fixation vs. volar plate. Patients and Methods: Our study made a comparison between 2 types of Operative management of fracture K-wire and volar plate. At the Department of Orthopaedic Surgery, Al-Azhar University Hospitals, 20 patients with extra-articular distal radius fracture, with ages ranged above 60 years old. Ten patients treated by K-wire and casting for 6 weeks, then removal of k-wire and started Range of Motion (ROM) from 6-8 weeks, An Other group of Ten patients were management by Volar locked Plate with below elbow slab for 2 weeks, then removal of slab and start ROM. During the follow up period, clinical evaluation revealed significant improvement in pain, movement and grip strength. The functional outcome by Quick DASH Score and MAYO Score. Results: In K-wire group, the mean age was 65.40 and high incident in female (60.0%). K-wire was removed after 6-8 weeks, and all patients were followed up of functional outcome for 6 months. The result of 3months were Q-DASH score (35.64) and MAYO score (69.00). After 6 months were Q-DASH score (17.00) and MAYO score (82.00). the complications of K-wire in this study were pin tract infection (40%) loosening (20%) and Complex regional pain syndrome (CRPS) (20%). In Volar Plate group the mean age was 65.20, and high incident in male (80.0%). and suture removal after 2 weeks and started Rang of Motion (ROM), All patients were followed up of functional outcome for 6 months. The result of 3 months Q-DASH score (17.12) and MAYO score (85.00), and after 6 months Q-DASH score (10.90) and MAYO score (91.00). The complications were ugly scar (20%) and CRPS (20%). Conclusion: Volar plates were more rigged fixation and highly united rate than k-wire. It's allowed early ROM and quickly returns to functional. On follow up for more time, no real difference of functional outcome between the two methods of management.