Objective: Evaluate the efficacy, safety and economy of small splints and plate in the treatment of distal radius fractures (DRFs). Methods: Seven electronic databases, including PubMed, EMBASE, Cochrane Library, sinomed, CNKI, VIP and Wanfang, were searched for the original study. Literature was screened according to the inclusion and exclusion criteria, and the methodological quality of the included studies was evaluated by Cochrane risk bias assessment tool. The software Revman 5.4 was used for data analysis. Results: A total of 19 studies were included in the study. The clinical effective rate of the plate group [RR=0.96,95％CI(0.93,0.99),P=0.007], Radial inclination [MD= -1.85,95％CI(-2.93, -0.77), P=0.0008], Ulnar inclination [MD= -2.49,95％CI(-3.95, -1.04),P=0.0007], relative height of radius [MD= -1.63,95％CI(-2.40, -0.86),P<0.0001] were better than those in small splints group. There was no significant difference in fracture healing time [MD= -4.39, 95％CI(-9.07, 0.28), P=0.07] and complications [RR=1.57,95％CI(0.98,2.52), P=0.06] between the two groups. In terms of treatment cost[MD= -2.83,95％CI(-3.37, -2.30), P<0.00001], the small splint group was better than the plate treatment group. Conclusion: Compared with small splints therapy, plate internal fixation has advantages in clinical effective rate and imaging scores. There is no significant difference in fracture healing time and complications between the two groups. In terms of treatment cost, small splint therapy is better than plate therapy. Clinical treatment should be selected and formulated according to the individual situation, demands and clinical practice of patients.