Trends in the management of fractures of the distal radius in Ireland: did the Distal Radius Acute Fracture Fixation Trial (DRAFFT) change practice?

Bone Joint J. 2019 Dec;101-B(12):1550-1556. doi: 10.1302/0301-620X.101B12.BJJ-2018-1615.R3.

Abstract

Aims: The aim of this study was to examine trends in the management of fractures of the distal radius in Ireland over a ten-year period, and to determine if there were any changes in response to the English Distal Radius Acute Fracture Fixation Trial (DRAFFT).

Patients and methods: Data was grouped into annual intervals from 2008 to 2017. All adult inpatient episodes that involved emergency surgery for fractures of the distal radius were included.

Results: In 2008 Kirschner-wire (K-wire) fixation accounted for 59% of operations for fractures of the distal radius, and plate fixation for 21%. In 2017, the rate of K-wire fixation had fallen to 30%, and the proportion of patients who underwent plate fixation had risen to 62%.

Conclusion: There is an increasing trend towards open reduction and internal fixation for fractures of the distal radius in Ireland. This has been accompanied by a decrease in popularity for K-wire fixation. DRAFFT did not appear to influence trends in the management of fractures of the distal radius in Ireland. Cite this article: Bone Joint J 2019;101-B:1550-1556.

Keywords: Distal radius fracture; Evidence-based medicine; Randomized controlled trial; Trauma.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Plates
  • Bone Wires
  • Female
  • Fracture Fixation, Internal / instrumentation
  • Fracture Fixation, Internal / methods
  • Fracture Fixation, Internal / trends*
  • Humans
  • Ireland
  • Linear Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Practice Patterns, Physicians' / trends*
  • Pragmatic Clinical Trials as Topic
  • Radius Fractures / surgery*
  • Young Adult