Trial reportBMJ (Clinical research ed.)2014
Percutaneous fixation with Kirschner wires versus volar locking plate fixation in adults with dorsally displaced fracture of distal radius: randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
79 citing papers in PubMed, 7 syntheses or guidelines pooled it, 209 citations in OpenAlex.
- A review of trauma and orthopaedic randomised clinical trials published in high-impact general medical journals.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2022Pooled it
- What Is the Relative Effectiveness of the Various Surgical Treatment Options for Distal Radius Fractures? A Systematic Review and Network Meta-analysis of Randomized Controlled Trials.Clinical orthopaedics and related research · 2021Pooled it
- Percutaneous pinning for treating distal radial fractures in adults.The Cochrane database of systematic reviews · 2020Pooled it
- Impact of surgical intervention trials on healthcare: A systematic review of assessment methods, healthcare outcomes, and determinants.PloS one · 2020Pooled it
- Pooled it
- Are Volar Locking Plates Superior to Percutaneous K-wires for Distal Radius Fractures? A Meta-analysis.Clinical orthopaedics and related research · 2015Pooled it
- Meta-analysis for dorsally displaced distal radius fracture fixation: volar locking plate versus percutaneous Kirschner wires.Journal of orthopaedic surgery and research · 2015Pooled it
- Does the pronator-sparing approach improve functional outcome, compared to a standard volar approach, in volar plating of distal radius fractures? A prospective, randomized controlled trial.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2023Trial
- Moulded cast compared with K-wire fixation after manipulation of an acute dorsally displaced distal radius fracture: the DRAFFT 2 RCT.Health technology assessment (Winchester, England) · 2022Trial
- Surgical fixation with K-wires versus casting in adults with fracture of distal radius: DRAFFT2 multicentre randomised clinical trial.BMJ (Clinical research ed.) · 2022Trial
- Percutaneous fixation with Kirschner wires versus volar locking-plate fixation in adults with dorsally displaced fracture of distal radius: five-year follow-up of a randomized controlled trial.The bone & joint journal · 2019Trial
- Early palmar plate fixation of distal radius fractures may benefit patients aged 50 years or older: a randomized trial comparing 2 different treatment protocols.Acta orthopaedica · 2019Trial
- Internal plate fixation versus plaster in displaced complete articular distal radius fractures, a randomised controlled trial.BMC musculoskeletal disorders · 2016Trial
- The treatment of displaced intra-articular distal radius fractures in elderly patients.Deutsches Arzteblatt international · 2014Trial
- ESTES recommendations regarding distal radius fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Review
- Comparison of Kirschner wire versus volar locking plate fixation for distal radius fractures: clinical and functional outcomes.Acta orthopaedica et traumatologica turcica · 2026Article
- Article
- Identifying Volar Locking Plates on Plain Radiographs: Can Artificial Intelligence Models 'Beat' Clinicians?Cureus · 2025Article
- K-wires as a valid alternative to dual and single headless cannulated compression screw fixation of chauffeur fractures: a biomechanical comparison.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Article
19 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
Abstract
objectivesTo compare the clinical effectiveness of Kirschner wire fixation with locking plate fixation for patients with a dorsally displaced fracture of the distal radius.
designA multicentre two arm parallel group assessor blind randomised controlled trial with 1:1 treatment allocation.
setting18 trauma centres in the United Kingdom.
participants461 adults with a dorsally displaced fracture of the distal radius within 3 cm of the radiocarpal joint that required surgical fixation. Patients were excluded if the surgeon thought that the surface of the wrist joint was so badly displaced it required open reduction.
interventionsKirschner wire fixation: wires are passed through the skin over the dorsal aspect of the distal radius and into the bone to hold the fracture in the correct anatomical position. Locking plate fixation: a locking plate is applied through an incision over the volar (palm) aspect of the wrist and secured to the bone with fixed angle locking screws.
main outcome measuresPRIMARY OUTCOME MEASURE: validated patient rated wrist evaluation (PRWE). This rates wrist function in two (equally weighted) sections concerning the patient's experience of pain and disability to give a score out of 100. SECONDARY OUTCOMES: disabilities of arm, shoulder, and hand (DASH) score, the EuroQol (EQ-5D), and complications related to the surgery.
resultsThe baseline characteristics of the two groups were well balanced, and over 90% of patients completed follow-up. The wrist function of both groups of patients improved by 12 months. There was no clinically relevant difference in the patient rated wrist score at three, six, or 12 months (difference in favour of the plate group was -1.3, 95% confidence interval -4.5 to 1.8; P=0.40). Nor was there a clinically relevant difference in health related quality of life or the number of complications in each group.
conclusionsContrary to the existing literature, and against the rapidly increasing use of locking plate fixation, this trial found no difference in functional outcome in patients with dorsally displaced fractures of the distal radius treated with Kirschner wires or volar locking plates. Kirschner wire fixation, however, is cheaper and quicker to perform.
trial registrationCurrent Controlled Trials ISCRTN 31379280. UKCRN 8956.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.