Prof. Matthew Costa Professor of Orthopaedic Trauma University of Oxford Honorary Consultant Trauma Surgeon, John Radcliffe Hospital, Oxford

20 Jan Wrist Fractures: Study Compares Casting to Surgical Fixation

Posted at 17:11h in Author Interviews, BMJ, Orthopedics by

MedicalResearch.com Interview with:

Prof. Matthew Costa Professor of Orthopaedic Trauma University of Oxford Honorary Consultant Trauma Surgeon, John Radcliffe Hospital, Oxford

Prof. Costa

Prof. Matthew Costa
Professor of Orthopaedic Trauma
University of Oxford
Honorary Consultant Trauma Surgeon,
John Radcliffe Hospital, Oxford 

MedicalResearch.com: What is the background for this study?

Response: Fixation with metal implants provides reliable functional outcomes for patients after a manipulation of a displaced fracture of the distal radius, but such surgery carries risk for the patient and is expensive.

A moulded plaster cast is a safer and cheaper intervention but may not provide the same functional outcome.
It is not known which of these treatments is superior.

MedicalResearch.com: What are the main findings?

Response: Surgical fixation with K-wires did not improve patients’ wrist function at one year compared with casting following manipulation of a fracture of the distal radius.

However, one in eight patients treated with a moulded cast required later surgery for loss of fracture position in the first six weeks after their injury.

MedicalResearch.com: What further research on this topic do you recommend?

  • What is the optimal technique for immobilisation of a dorsally displaced distal radius fracture that does not require manipulation to achieve reduction?
  • What is the optimal techniques for immobilisation of a dorsally displaced distal radius fracture following a manipulation of the fracture?
  • What is the optimal technique for providing pain relief to patients who require a reduction of a dorsally displaced distal radius fracture?
  • What is the optimal regime for rehabilitation of the patient after immobilisation of their wrist for a fracture of the distal radius? 

No disclosures

Citation:

Costa M L, Achten J, Ooms A, Png M E, Cook J A, Lamb S E et al. Surgical fixation with K-wires versus casting in adults with fracture of distal radius: DRAFFT2 multicentre randomised clinical trial BMJ 2022; 376 :e068041 doi:10.1136/bmj-2021-068041

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Last Updated on January 20, 2022 by Marie Benz MD FAAD

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