Abstract： Objective： To observe the clinical effect of Guba Prescription combined with external small splint immobilization with fourteen bone-setting manipulation on senile type A extended distal radius fracture （Colles fracture） . Methods：A total of 78 senile patients with type A Colles fractures treated in the Orthopedics Department of Foshan Hospital of Traditional Chinese Medicine from January to December 202 were retrospectively selected and divided into the observation group and the control group，with 9 cases in each group，according to different treatment methods. The control group received external small splint immobilization with fourteen bone-setting manipulation，and the observation group received additional treatment with Guba Prescription on the basis of the control group. The clinical efficacy of the two groups was evaluated， and the imaging parameters， fracture healing cycle， wrist Cooney scores， and incidence of complications were compared between the two groups. Results： The excellent and good rate was 92.1%（ 6/9） in the observation group，which was higher than that of 74.6%（ 29/9） in the control group，with the difference being significant （P＜0.05）. The palm inclination angle，ulnar deviation angle，and radius height in the two groups immediately after reduction and after four weeks of treatment were increased when compared with those before reduction， with the difference being significant （P＜0.05）. After treatment， the pain scores， wrist range of motion scores，functional status scores，and total scores of the Cooney scores in the observation group were higher than those in the control group，with the differences being significant （P＜0.05）. The fracture healing time in the observation group was shorter than that in the control group， with the difference being significant （P＜0.05）. The incidence of complications was 5.1% （2/9） in the observation group，which was lower than that of 20.51% （8/9） in the control group， with the difference being significant （P＜0.05）. Conclusion： Guba Prescription combined with external fixation treatment with fourteen bone-setting manipulation has a significant effect in treating senile type A Colles fractures，which can improve the wrist joint function of patients，shorten the clinical healing cycle of fractures，reduce the risk of complications，and thus improve the quality of life of patients.