Trial reportPlastic and reconstructive surgery2020
The Wrist and Radius Injury Surgical Trial: 12-Month Outcomes from a Multicenter International Randomized Clinical Trial.
Trial report in Plastic and reconstructive surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 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
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 58 citations in OpenAlex.
- Surgical Treatment of Periarticular Distal Radius Fracture in Elderly: A Systematic Review.Medicina (Kaunas, Lithuania) · 2024Pooled it
- Efficacy of cast immobilization versus surgical treatment for distal radius fractures in adults: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2023Pooled it
- Trial
- Comparison of Distal Radius Fracture Outcomes in Older Adults Stratified by Chronologic vs Physiologic Age Managed With Casting vs Surgery.JAMA network open · 2023Trial
- Comparison of 24-Month Outcomes After Treatment for Distal Radius Fracture: The WRIST Randomized Clinical Trial.JAMA network open · 2021Trial
- Outcomes of Distal Radial Fractures in Geriatric Patients Following Volar Locked versus Dorsal Bridge Plating.Journal of wrist surgery · 2026Article
- Emergency Medicine Management of Distal Radius and Ulna Fractures: Narrative Review.The western journal of emergency medicine · 2026Review
- Article
- Non-Surgically Treated Distal Radius Fractures in the Adult Population: A Systematic Review and Meta-analysis.Hand (New York, N.Y.) · 2026Review
- Second Metacarpal Index as a Predictor of Secondary Displacement in Conservatively Treated Distal Radius Fractures.Medicina (Kaunas, Lithuania) · 2026Article
- Predictors of Extended Length of Stay Following Open Reduction and Internal Fixation for Distal Radius Fractures.Journal of wrist surgery · 2025Article
- Review
- Surgical vs. Conservative Treatment of Distal Radius Fractures in the Elderly: A Systematic Review and Meta-Analysis.Cureus · 2024Review
- Volar Locking Plate versus Closed Reduction and Immobilization for Distal Radius Fracture in the Elderly: Systematic Review and Meta-Analysis of Randomized Controlled Trials.Journal of wrist surgery · 2024Article
- Complications after volar plate synthesis for distal radius fractures.EFORT open reviews · 2024Article
- Is fracture management merely a physical process? Exploring the psychological effects of internal and external fixation.Journal of orthopaedic surgery and research · 2024Article
- Article
- Sick leave length and the costs of operatively and conservatively treated distal radius fractures in the working age population: a retrospective cohort study.BMC musculoskeletal disorders · 2023Article
- Association of Open Reduction and Internal Fixation With Volar Locking Plate for Distal Radius Fractures With Patient-Reported Outcomes in Older Adults: A Network Meta-analysis.JAMA network open · 2023Article
- A Cost-Effectiveness Analysis of the Various Treatment Options for Distal Radius Fractures.Journal of hand surgery global online · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundOptimal treatment for distal radius fractures in older adults remains uncertain. No randomized trials comparing the most frequently used treatments in this population have been conducted. Surgical treatment rates vary widely, and the sustained benefits of surgery are uncertain.
methodsThe Wrist and Radius Injury Surgical Trial, a randomized, multicenter trial, enrolled 304 adults aged 60 years and older with isolated, unstable distal radius fractures at 24 institutions. Patients who wanted surgery (n = 187) were randomized to internal fixation, external fixation, or percutaneous pinning; patients who preferred conservative management (n = 117) received casting. The primary outcome was the 12-month Michigan Hand Outcomes Questionnaire (MHQ) summary score.
resultsAt 12 months, there were no differences by treatment in primary outcome. Twelve-month MHQ summary scores differed between internal fixation and external fixation by 3 points (97.5 percent CI, 6.0 to 11.5) and between internal fixation and pinning by -0.14 (97.5 percent CI, -9.2 to 8.9). However, at 6 weeks, the mean MHQ summary score for internal fixation was greater than for external fixation by 19 (p < 0.001), pinning by 11 (p < 0.001), and casting by 7 (p = 0.03). Internal fixation participants demonstrated significantly better radiologic alignment throughout the follow-up period. Malunion was experienced by 48 percent of casting participants.
conclusionsRecovery was fastest for internal fixation and slowest for external fixation according to most measures, but by 12 months there were no meaningful differences in outcomes. Casting participants experienced satisfactory results despite loss of radiologic alignment. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
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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.