The Library

UK DRAFFT : a randomised controlled trial of percutaneous fixation with kirschner wires versus volar locking-plate fixation in the treatment of adult patients with a dorsally displaced fracture of the distal radius

Tools

Costa, Matthew L., Achten, Juul, Parsons, Nicholas R., Rangan, Amar, Edlin, Richard P., Brown, Jaclyn and Lamb, S. E. (Sallie E.). (2011) UK DRAFFT : a randomised controlled trial of percutaneous fixation with kirschner wires versus volar locking-plate fixation in the treatment of adult patients with a dorsally displaced fracture of the distal radius. BMC Musculoskeletal Disorders, Vol.12 (No.1). p. 201. ISSN 1471-2474

Preview

Text
WRAP_Lamb_1471-2474-12-201.pdf - Published Version
Download (253Kb)

Official URL: http://dx.doi.org/10.1186/1471-2474-12-201

Abstract

Background: Fractures of the distal radius are extremely common injuries in adults. However, the optimal
management remains controversial. In general, fractures of the distal radius are treated non-operatively if the bone
fragments can be held in anatomical alignment by a plaster cast or orthotic. However, if this is not possible, then
operative fixation is required. There are several operative options but the two most common in the UK, are
Kirschner-wire fixation (K-wires) and volar plate fixation using fixed-angle screws (locking-plates). The primary aim of
this trial is to determine if there is a difference in the Patient-Reported Wrist Evaluation one year following K-wire
fixation versus locking-plate fixation for adult patients with a dorsally-displaced fracture of the distal radius.
Methods/design: All adult patients with an acute, dorsally-displaced fracture of the distal radius, requiring
operative fixation are potentially eligible to take part in this study. A total of 390 consenting patients will be
randomly allocated to either K-wire fixation or locking-plate fixation. The surgery will be performed in trauma units
across the UK using the preferred technique of the treating surgeon. Data regarding wrist function, quality of life,
complications and costs will be collected at six weeks and three, six and twelve months following the injury. The
primary outcome measure will be wrist function with a parallel economic analysis.
Discussion: This pragmatic, multi-centre trial is due to deliver results in December 2013.

Item Type:

Journal Article

Subjects:

R Medicine > RD Surgery

Divisions:

Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School
Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit

Library of Congress Subject Headings (LCSH):

Wrist -- Fractures -- Treatment, Bone wiring (Orthopedics), Bone screws (Orthopedics)

Journal or Publication Title:

BMC Musculoskeletal Disorders

Publisher:

BioMed Central Ltd.

ISSN:

1471-2474

Official Date:

13 September 2011

Dates:

Date	Event
13 September 2011	Published

Volume:

Vol.12

Number:

No.1

Page Range:

p. 201

Identifier:

10.1186/1471-2474-12-201

Status:

Peer Reviewed

Publication Status:

Published

Access rights to Published version:

Open Access

Funder:

National Institute for Health Research (Great Britain) (NIHR)

Grant number:

HTA08/116/97 (NIHR)

References:

1. Barrett JA, Baron JA, Karagas MR, Beach ML: Fracture risk in the U.S.
Medicare population. J Clin Epidemiol 1999, 52(3):243-9.
2. Chen NC, Jupiter JB: Management of distal radial fractures. J Bone Joint
Surg Am 2007, 89(9):2051-62.
3. Kakarlapudi TK, Santini A, Shahane SA, Douglas D: The cost of treatment of
distal radial fractures. Injury 2000, 31(4):229-32.
4. Mah ET, Atkinson RN: Percutaneous Kirschner wire stabilisation following
closed reduction of Colles’ fractures. J Hand Surg Br 1992, 17(1):55-62.
5. Willis AA, Kutsumi K, Zobitz ME, Cooney WP: Internal fixation of dorsally
displaced fractures of the distal part of the radius. A biomechanical
analysis of volar plate fracture stability. J Bone Joint Surg Am 2006,
88(11):2411-7.
6. Arora R, Lutz M, Hennerbichler A, Krappinger D, Espen D, Gabl M:
Complications following internal fixation of unstable distal radius
fracture with a palmar locking-plate. J Orthop Trauma 2007, 21(5):316-22.
7. Handoll HH, Madhok R: From evidence to best practice in the
management of fractures of the distal radius in adults: working towards
a research agenda. BMC Musculoskelet Disord 2003, 4:27.
8. MacDermid JC, Turgeon T, Richards RS, Beadle M, Roth JH: Patient rating of
wrist pain and disability: a reliable and valid measurement tool. J Orthop
Trauma 1998, 12(8):577-86.
9. MacDermid JC, Richards RS, Donner A, Bellamy N, Roth JH: Responsiveness
of the short form-36, disability of the arm, shoulder, and hand
questionnaire, patient-rated wrist evaluation, and physical impairment
measurements in evaluating recovery after a distal radius fracture. J
Hand Surg Am 2000, 25(2):330-40.
10. Hudak PL, Amadio PC, Bombardier C: Development of an upper extremity
outcome measure: the DASH (disabilities of the arm, shoulder and
hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am
J Ind Med 1996, 29(6):602-8.
11. Brooks R: EuroQol: the current state of play. Health Policy 1996,
37(1):53-72.
12. Netten A: Unit cost of health and social care personal social services
research unit. Canterbury: University of Kent; 1996.
13. Self-reports of health care utilisation: can a questionnaire replace a
diary?. 16th Annual meeting of the international society for health
technology assessment in health care The Hague, The Netherlands; 2000.
14. MacDermid JC, Roth JH, Richards RS: Pain and disability reported in the
year following a distal radius fracture: a cohort study. BMC Musculoskelet
Disord 2003, 4:24.
15. Downing ND, Karantana A: A revolution in the management of fractures
of the distal radius? J Bone Joint Surg Br 2008, 90(10):1271-5.
16. Berntsen GK, Fonnebo V, Tollan A, Sogaard AJ, Magnus JH: Forearm bone
mineral density by age in 7,620 men and women: the Tromso study, a
population-based study. Am J Epidemiol 2001, 153(5):465-73.
17. NICE: Guide to the methods of technology appraisal. London; 2008.