Non-surgical casting versus surgical reduction for children with severely displaced distal radial fractures (the CRAFFT Study): a multicentre, randomised, controlled non-inferiority trial and economic evaluation.

تم تحديد هذه الدراسة على أنها ذات تأثير كبير محتمل. يقدّر مقياس التأثير العالي الذي يعتمد على الذكاء الاصطناعي من OE التأثير المحتمل لورقة بحثية ما من خلال دمج إشارات من كل من المجلة التي نُشرت فيها والمحتوى العلمي للمقالة نفسها. تم تطوير نموذج OE High Impact باستخدام أحدث تقنيات معالجة اللغة الطبيعية، ويتنبأ نموذج OE High Impact بدقة أكبر بأداء الاقتباس المستقبلي للدراسة أكثر من معامل تأثير المجلة وحده. وهذا يتيح التعرف المبكر على الأبحاث ذات المغزى السريري ويساعد القراء على التركيز على المقالات التي من المرجح أن تشكل الممارسة المستقبلية.

ملخص الدراسة

750 children aged 4–10 years with severely displaced distal radial fractures were randomized to receive non-surgical casting or surgical reduction. The primary outcome of interest was upper limb function at 3 months, measured using the Patient Reported Outcomes Measurement Information System (PROMIS) Upper Extremity Score for Children. Secondary outcomes included pain, health-related quality of life, cosmetic appearance, complications, unplanned surgery, and health-care costs. Outcomes were assessed at 6 weeks and 3, 6, and 12 months. Overall, the results revealed that surgical reduction provided a small improvement in upper limb function at 3 months, and non-inferiority of casting was not established against the prespecified margin. However, functional differences were no longer evident at 6 or 12 months, while casting was associated with fewer early complications and substantially lower costs. These findings suggested that non-surgical casting could be considered as an initial treatment strategy for most children with severely displaced distal radial fractures.