Objective To determine the preliminary clinical effect of AO multiple-angle locking plate on the treatment for the distal radius type C fractures in elderly people. Methods Between March 2011 and February 2014, a total of 47 elderly patients who sustained distal radius type C fractures were admitted in our department and received open reduction and AO multiple-angle locking plate. They were 15 males and 32 females, with an average age of 67.5 years: 20 patients with type C1 fractures, 16 with C2 and 11 with C3. Disabilities of Arm, Shoulder, and Hand (DASH) and Gartland and Werley scoring system were used for clinical functional assessment of the grip strength and wrist motion range. Results Within the 47 patients, 43 were followed up for 6 to 12 (mean 8.3) months and got fully healed finally, with an average healing time of 7 weeks. Forty-two patients had excellent functional assessment and no complication occurred during the follow-up periods. Conclusion Open reduction and AO multiple-angle locking plate are effective approaches for osteoporotic unstable distal radius fractures for the elderly patients.