$wrist distal radius fracture$

$wrist distal radius fracture$

Wrist distal radius fracture registration#
Wrist distal radius fracture trial#

To derive level 1 evidence for DRF treatment, we conducted the Wrist and Radius Injury Surgical Trial (WRIST). In this era of value-based care and shared decision-making, long-term outcomes help to guide surgeons, patients, and their families through understanding the benefits and risks of each treatment. 8 - 16 Long-term outcomes on injuries in older adults are especially germane because today’s older generation is living longer and leading more active lives than previous generations. Few studies followed older adults longer than 12 months, and those that did only reported results from the final assessment intermediate outcomes to track the trajectory of recovery were missing. Literature is sparse regarding long-term, posttreatment DRF outcomes in older populations. This is particularly true for older adults, who resist being randomized and may experience barriers to follow-up such as lack of transportation. 3 The lack of evidence for comparative efficacy stems from the difficulty in conducting clinical trials when the treatment options are so disparate that recruiting a sufficient sample size can be difficult. 1 Despite more than 200 years of experience in treating this injury since it was first described by Colles 2 in 1812, the American Academy of Orthopaedic Surgeons guidelines published in 2009 indicated that there is insufficient evidence to justify any particular DRF treatment over another for older adults.

$wrist distal radius fracture$

More than 85 000 Medicare beneficiaries sustain distal radius fracture (DRF) annually.

Wrist distal radius fracture registration#

Trial Registration Identifier: NCT01589692 Patient needs and recovery goals that fit to relative risks and benefits of each treatment type will be more valuable in treatment decision-making. These findings suggest that long-term outcomes need not necessarily be considered in deciding between treatment options. The rate of malunion was higher in the casting group (26 participants ) than in the other groups (4 participants for VLPS, 8 participants for EFP, and 4 participants for CRPP χ 2 3 = 43.6 P < .001), but malunion was not associated with the 24-month outcome difference across groups.Ĭonclusions and Relevance The study did not find clinically meaningful patient-reported outcome differences 24 months after injury across treatment groups, with little change between 12 and 24 months. Pain scores also did not differ across groups at 24 months (χ 2 3 = 2.64 P = .45). Mean MHQ summary scores at 24 months were 88 (95% CI, 83-92) for VLPS, 83 (95% CI, 78-88) for EFP, 85 (95% CI, 79-90) for CRPP, and 85 (95% CI, 79-90) for casting, with no clinically meaningful difference across groups after adjusting for covariates (χ 2 3 = 1.44 P = .70). Assessments were completed at 24 months for 182 participants (160 women mean age, 70.1 years). Results A total of 304 adults were recruited for the study, and 187 were randomized to undergo surgery, 65 to VLPS, 64 to EFP, and 58 to CRPP 117 participants opted for closed reduction and casting. Secondary outcomes were scores on the MHQ subdomains hand strength and wrist motion. Main Outcomes and Measures The primary outcome was the 24-month Michigan Hand Outcomes Questionnaire (MHQ) summary score. The remaining participants chose closed reduction and casting. Interventions Participants were randomized to open reduction and volar locking plate system (VLPS), external fixation with or without supplementary pinning (EFP), and percutaneous pinning (CRPP). Data analysis was performed from March 2019 to March 2021. Participants were adults aged 60 years or older with isolated, unstable DRFs at 24 health systems in the US, Canada, and Singapore. Objective To compare outcomes across treatment groups at 24 months among adults with DRFs who participated in the WRIST trial.ĭesign, Setting, and Participants The Wrist and Radius Injury Surgical Trial (WRIST) randomized, international, multicenter trial was conducted from April 1, 2012, through December 31, 2016. Current evidence regarding long-term outcomes in older adults is scarce. Importance Distal radius fractures (DRFs) are common injuries among older adults and can result in substantial disability. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.

$wrist distal radius fracture$