Evidence map›Paper›PMID 35549696›Full record

Trial reportBMC musculoskeletal disorders2022

Non-operative treatment or volar locking plate fixation for dorsally displaced distal radius fractures in patients over 70 years - a three year follow-up of a randomized controlled trial.

Hanna Südow, Sara Severin, Maria Wilcke, Jenny Saving, Olof Sköldenberg, Cecilia Mellstrand Navarro

2 registry-linked trialsOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC musculoskeletal disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 18 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 4 pooled it
6.1field-weighted citation impact, top 3% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT01268397 naunknown statusnot on this map

Unstable Dorsally Displaced Fractures of the Distal Radius in the Elderly. A Randomized Comparison Between Operative Fixation and Plaster Cast Treatment.

TypeinterventionalSponsorDanderyd HospitalRan2009 to 2019Enrolled80ConditionsFracture of the Distal Radius, Wrist FractureArmsopen reduction and internal fixation with a volar plate, closed reduction and plaster treatment
NCT02154620 nacompletednot on this map

Dorsally Displaced Distal Radius Fractures in Patients Over 70 Years - Volar Plate or Plaster - A Prospective Randomized Trial

TypeinterventionalSponsorKarolinska InstitutetRan2013 to 2018Enrolled130ConditionsDistal Radius FractureArmsVolar plate, Synthes TCP volar plate
3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 4 syntheses or guidelines pooled it, 29 citations in OpenAlex.

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  8. Outcomes of Distal Radius Fractures: A Comparison Between Fellowship-Trained Trauma and Hand Orthopaedic Surgeons.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Hanna SüdowDepartment of Clinical Science and Education, Karolinska Institute, Södersjukhuset, SE-118 83, Stockholm, Sweden. hanna.sudow@ki.se.
Sara SeverinKarolinska Institute, Department of Clinical Science, Danderyd Hospital, Stockholm, Sweden.
Maria WilckeDepartment of Clinical Science and Education, Karolinska Institute, Södersjukhuset, SE-118 83, Stockholm, Sweden.
Jenny SavingDepartment of Clinical Science and Education, Karolinska Institute, Södersjukhuset, SE-118 83, Stockholm, Sweden.
Olof SköldenbergKarolinska Institute, Department of Clinical Science, Danderyd Hospital, Stockholm, Sweden.
Cecilia Mellstrand NavarroDepartment of Clinical Science and Education, Karolinska Institute, Södersjukhuset, SE-118 83, Stockholm, Sweden.
Karolinska Institutet · SEStockholm South General Hospital · SE

Funding

Regional Agreement on Medical Training and Clinical Research between the Stockholm County Council and Karolinska Institute (ALF) 20190193the Swedish Research Council K2014-99X-22493-01-3
6 · The paper itself

Abstract

backgroundSurgical treatment of displaced distal radius fractures (DRF) in older patients has increased, despite lacking evidence of its superiority over non-operative treatment. How treatment choice affects these patients after the initial 12-month period remains unknown. This study presents a clinical and radiographic follow up at an average of 3 years after treatment in the context of a randomized clinical trial comparing outcomes in patients aged ≥70 years, with a dorsally displaced distal radius fracture treated either surgically with volar locking plate or non-operatively.

methodsBetween 2009 and 2017, 140 patients aged ≥70 years with dorsally displaced DRF were randomized to surgery with volar locking plate (VLP) or non-operative treatment. At an average of 3 years after inclusion the participants were invited to an additional follow-up. The primary outcome was Patient Rated Wrist Evaluation (PRWE). Secondary outcomes included additional Patient Reported Outcome Measures (PROM), grip strength, range of motion, complications and radiological results.

resultsSixty six patients were available for a 3 year follow-up, 33 in the non-operatively treated group and 33 in the VLP-group. The mean age at injury was 77 years. At 3 years the median PRWE was better (0 points) in the VLP-group than in the non-operative treatment group (9 points) p-value: 0.027. No statistically significant difference was found in Disabilities of the Arm, Hand, and Shoulder (DASH), EuroQol 5 Dimensions (EQ-5D) or grip strength. Total arc of range of motion was larger in the operatively treated group. No significant difference in osteoarthritis was found. Both groups had regained grip strength. The complication rate was similar. Outcomes improved from the 1 year to the 3 year follow-up.

conclusionsSurgery with volar locking plate gave less long-term disability compared to non-operative treatment for severely displaced distal radius fractures in patients aged ≥70 years. Our findings were statistically significant but in the lower range of clinical importance.

trial registrationThe study was registered at : NCT02154620 03/06/2014 and NCT01268397 30/12/2010. Ethical approval was obtained from Ethical Committee in Stockholm, Sweden (2009/37-31/3, 2013/105-31/2, 2014/1041-32, 2017/611-32).

Indexed as

Radius FracturesAgedBone PlatesFollow-Up StudiesFracture Fixation, InternalHumansRange of Motion, ArticularTreatment OutcomeAgedDistal radius fractureFracture fixationGeriatric fractureNon-operative treatmentQuality of lifeVolar locking plate

Identifiers

PMID35549696
PMCPMC9097389
OpenAlexW4280600987

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

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.