{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T09:30:59Z","timestamp":1761989459700,"version":"3.37.3"},"reference-count":22,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,1,28]]},"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Optimal management of distal radius fractures in adults remains controversial. Previous evidence and current clinical guidelines tell us that, if a closed reduction of a dorsally displaced fracture is possible, Kirschner wires (K-wires) are the preferred form of surgical fixation. However, the question remains whether there is any need to perform surgical fixation following a successful closed reduction, or is a simple plaster cast as effective? This is the protocol for a randomised controlled trial of manipulation and surgical fixation with K-wires versus manipulation and casting in the treatment of dorsally displaced distal radius fractures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and analysis<\/jats:title><jats:p>Adult patients with an acute dorsally displaced fracture of the distal radius are potentially eligible to take part. Prior to surgery, baseline demographic data, radiographs, data on pain\/function using the Patient-Rated Wrist Evaluation Score (PRWE) and health-related quality of life (HRQoL) using the EuroQoL 5-dimension 5-level (EQ-5D-5L) will be collected. A randomisation sequence, stratified by centre, intra-articular extension of the fracture and age, will be administered via a secure web-based service. Each patient will be randomly allocated to either \u2018manipulation and surgical fixation with K-wires\u2019 or \u2018manipulation and plaster casting\u2019. A clinical assessment, radiographs and records of early complications will be recorded at 6 weeks. PRWE and HRQoL outcome data will be collected at 3, 6 and 12 months post-randomisation. Further information will be requested with regard to healthcare resource use and any complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Ethics and Dissemination<\/jats:title><jats:p>The National Research Ethic Committee approved this study on 6 October 2016 (16\/SC\/0462).<\/jats:p><jats:p>The National Institute for Health Research Health Technology Assessment monograph and a manuscript to a peer-reviewed journal will be submitted on completion of the trial. The results of this trial will substantially inform clinical practice on the clinical and cost-effectiveness of the treatment of this injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"ISRCTN11980540\" ext-link-type=\"isrctn\" specific-use=\"clinicaltrial pre-results\">ISRCTN11980540<\/jats:ext-link>; Pre-results.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2018-028474","type":"journal-article","created":{"date-parts":[[2020,5,7]],"date-time":"2020-05-07T22:46:45Z","timestamp":1588891605000},"page":"e028474","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Surgical fixation with K-wires versus plaster casting in the treatment of dorsally displaced distal radius fractures: protocol for Distal Radius Acute Fracture Fixation Trial 2 (DRAFFT 2)"],"prefix":"10.1136","volume":"9","clinical-trial-number":[{"clinical-trial-number":"isrctn11980540","registry":"10.18810\/isrctn","type":"preResults"}],"author":[{"given":"Juul","family":"Achten","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Sones","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Dias","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Hedley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan A","family":"Cook","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melina","family":"Dritsaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"May Ee","family":"Png","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0239-7278","authenticated-orcid":false,"given":"Alastair","family":"Gray","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah E","family":"Lamb","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew L","family":"Costa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,3,23]]},"reference":[{"key":"2024052012471958000_9.3.e028474.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(98)00167-X"},{"key":"2024052012471958000_9.3.e028474.2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.00020"},{"key":"2024052012471958000_9.3.e028474.3","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-4-27"},{"key":"2024052012471958000_9.3.e028474.4","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.g4807","article-title":"Percutaneous fixation with kirschner wires versus volar locking plate fixation in adults with dorsally displaced fracture of distal radius: randomised controlled trial","volume":"349","author":"Costa","year":"2014","journal-title":"BMJ"},{"key":"2024052012471958000_9.3.e028474.5","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.O.00565"},{"key":"2024052012471958000_9.3.e028474.6","unstructured":"NICE. 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