Trial reportEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2026
Costs and health-related quality of life of non-operative and surgical treatment modalities for displaced distal radius fractures: a comprehensive overview based on the CAST study.
Trial report in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThe aim of this study was to provide a comprehensive overview of costs and health-related quality of life (HRQoL) associated with three treatment modalities for common displaced distal radius fractures (DRFs): (1) non-operative treatment, (2) direct plate fixation and (3) delayed plate fixation in case of fracture redisplacement during follow-up.
methodsA cost and HRQoL analysis was performed based on data collected during the CAST study, a multicenter cluster-randomized controlled trial including adult patients with a displaced DRF, randomized between immobilization with a plaster splint or circumferential cast. Included patients were prospectively followed for one year. Operatively treated patients also continued questionnaire follow-up. From a societal perspective, healthcare costs, patient and family costs, and indirect (i.e. productivity) costs were collected. Patients completed questionnaires on HRQoL (EQ-5D-5 L), healthcare consumption and work productivity.
resultsIn total, 693 patients were included in this study (non-operative: 402, direct plate fixation: 165, delayed plate fixation: 126). The estimated mean total costs per patient were €2,212 for non-operative treatment, €4,339 for direct plate fixation and €4,393 for delayed plate fixation HRQoL improved between 3 and 12 months but did not reach pre-injury HRQoL in all groups.
conclusionsThis study provides a descriptive overview of societal costs of displaced DRF treatment. Non-operative treatment is least costly. The cost differences between direct and delayed plate fixation is €58 in favor of direct plate fixation. Starting with non-operative treatment and later deciding whether to proceed with operative treatment based on alignment changes during follow-up, could reasonably be considered as a treatment option. HRQoL improved in all groups.
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