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Peri-Operative

Radiological Outcomes Of Wire Fixation Vs Moulded Cast For Dorsally Displaced Distal Radius Fracture

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PERI-OPERATIVE

Radiological Outcomes Of Wire Fixation Vs Moulded Cast For Dorsally Displaced Distal Radius Fracture .

Radiological outcomes following surgical fixation with wires versus moulded cast for patients with a dorsally displaced fracture of the distal radius: a radiographic analysis from the DRAFFT2 trial.

Bone Jt Open . 2024 Feb 13;5(2):132-138.

Contributing Authors

CE Plant A Ooms JA Cook ML Costa M Dritsaki H Dakin J Jones A McKee K Smith M Hamadto S Gwilym T Chesser J Candal-Couto C Hing D Giddin P Johnston A Ullah J Williams W Eardley M Srinivasan S Sampalli M Farrar C Roberts K Mohanty I MacLeod P Sarda A Elseehy N Rossiter D Warwick C Peach D MacKay R Benson A Watts J Young F Shah S Lipscombe A Ng CP Charalambous B Sheriden K Theivendran P Sanjay R Nanda A Bateman M Butler O Keast-Butler A McAndrew W Chevannes P Kankanalu A Wijendra A Fontalis H Afifi MC Killen R Higgin W Wignadasan K Wong C Gibson H Beale B Jennings J Kennedy M Williamson D Rasidovic L Jenner JB Tadros S Milner J Duncan S Kerr L Nordin M Weston O Payton T Oni C Zhao S Gill M Iqbal K Aneiba D Pillai L Hughes J Crosby M Whitehouse T Corbett A Iqbal S Buchan L Beddard V Vardhan B Beamish M Jones J Holley R Morrell R Lerner K Draper

Five hundred patients with dorsally displaced distal radius fractures requiring closed manipulation were randomized to receive either surgical fixation with Kirschner wires (n=245) or treatment with a moulded cast (n=255). The primary outcome of interest was dorsal angulation on radiographs at six weeks post-manipulation. Secondary outcomes included radial shortening (ulnar variance), and patient-reported outcomes assessed by the PRWE, EQ-5D-5L, and EQ-VAS at three, six, and twelve months. Overall, the results of the study revealed that wire fixation led to significantly less dorsal angulation at six weeks (adjusted mean difference -4.13°, p < 0.001), but there were no differences in radial shortening or any patient-reported outcomes. This suggests that although wire fixation yields better radiological alignment, this does not translate into improved clinical outcomes within one year.

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