Fractures of the distal radius are common injuries, with an annual incidence of 27 per 10,000 per year. As many as two-thirds of these fractures are displaced, necessitating reduction to restore wrist function and avoid neurovascular compromise. When adequate reduction cannot be achieved by closed reduction alone, closed reduction and percutaneous pinning versus open reduction and internal fixation is considered. Here we present the case of a middle aged female presenting with a dorsally displaced and angulated fracture of the distal radius after a fall on the outstretched hand. The fracture was treated by open reduction and internal fixation with a volar locking plate. We outline the natural history, preoperative care, intraoperative technique, and postoperative considerations of distal radial fractures.