Comparison of 24-Month Outcomes After Treatment for Distal Radius Fracture

• DOI: 10.1001/jamanetworkopen.2021.12710
• Publication Date: 2021-06-17T15:01:09Z
• Authors: Kevin C. Chung; Hyungjin Myra Kim; Sunitha Malay; Melissa J. Shauver; ; Steven C Haase; Jeffrey N Lawton; John R Lien; Adeyiza O Momoh; Kagan Ozer; Erika D Sears; Jennifer F Waljee; Matthew s Brown; Hoyune E Cho; Brett F MIchelotti; Tamara D Rozental; Paul T. Appleton; Edward K Rodriguez; Laura N. Deschamps; Lindsay Mattfolk; Katiri Wagner; Philip Blazar; Brandon E Earp; Emerson Floyd; Dexter L Louie; Fraser J. Leversedge; Marc J. Richard; David S Ruch; Suzanne Finley; Cameron Howe; Maria Manson; Janna Whitfield; Bertrand Perey; Kelly Apostle; Dory Boyer; Farhad Moola; Trevor Stone; Darous Viskontas; Mauri Zomar; Karyn Moon; Raely Moon; Loree K Kalliainen; Christina M Ward; James W Fletcher; Cherrie A Heinrich; Katharine S Pico; Ashish Y. Mahajan; Brian W Hill; Sandy Vang; Dawn M Laporte; Erik A Hasenboehler; Scott D Lifchez; Greg M Osgood; Babar Shafiq; Jaimie T Shores; Vaishali Laljani; Brent H Bamberger; Timothy W Harman; David W Martineau; Carla Robinson; Brandi Palmer; Ruby Grewal; Ken A Faber; Joy C MacDermid; Kate Kelly; Katrina Munro; Joshua I Vincent; David Ring; Jesse B Jupiter; Jilian S Gruber; Abigail Finger; Rakesh K Reddy; Taylor M Pong; Emily Thornton; David G Dennison; Sanjeev Kakar; Marco Rizzo; Alexander Y Shin; Tyson L Scrabeck; Kyle Chepla; Kevin Malone; Harry A Hoyen; Blaine Todd Bafus; Roderick B Jordan; Bram Kaufman; Ali Totonchil; Dana R Hromyak; Lisa Humbert; Sandeep Sebastin; Sally Tay; Kate W Nellans; Sara L Merwin; Ethan W Blackburn; Sandra J Hanlin; Barbara Patterson; Glenn R Gaston; Christopher R Cha...; Erika G Gantt; John S Gaul; Daniel R Lewis; Bryan J Leffler; Lois K Osier; Paul C Perlik; Alan W Ward; Tod A Clark; Sheila McRae; Jennifer M Wolf; Craig M Rodner; Katy Coyle; Thomas P Lehman; Yuri C Lansinger; Gavin D O’Mahony; Kathy Carl; Janet Wells; David J Bozentka; Scott L Levin; David P Steinberg; Robert Goitz; Annamarie D Horan; Denise Knox; Kara Napolitano; Cathy A Naccarelli; Joelle Tighe; Warren C Hammert; Allison W McIntyre; Krista L Noble; Kaili Waldrick; Jeffrey B Friedrich; David Bowman; Angela Wilson; Zhongyu LI; Andrew L Koman; Benjamin R Graves; Beth P Smith; Debra Bullard
• Keywords: Distal radius fracture

<h3>Importance</h3> Distal radius fractures (DRFs) are common injuries among older adults and can result in substantial disability. Current evidence regarding long-term outcomes is scarce. <h3>Objective</h3> To compare across treatment groups at 24 months with DRFs who participated the WRIST trial. <h3>Design, Setting, Participants</h3> The Wrist Radius Injury Surgical Trial (WRIST) randomized, international, multicenter trial was conducted from April 1, 2012, through December 31, 2016. Participants were aged 60 years or isolated, unstable health systems US, Canada, Singapore. Data analysis performed March 2019 to 2021. <h3>Interventions</h3> randomized open reduction volar locking plate system (VLPS), external fixation without supplementary pinning (EFP), percutaneous (CRPP). remaining participants chose closed casting. <h3>Main Outcomes Measures</h3> primary outcome 24-month Michigan Hand Questionnaire (MHQ) summary score. Secondary scores on MHQ subdomains hand strength wrist motion. <h3>Results</h3> A total of 304 recruited for study, 187 undergo surgery, 65 VLPS, 64 EFP, 58 CRPP; 117 opted Assessments completed 182 (160 women [87.9%]; mean [SD] age, 70.1 [8.5] years). Mean 88 (95% CI, 83-92) 83 78-88) 85 79-90) CRPP, casting, no clinically meaningful difference after adjusting covariates (χ²₃ = 1.44;<i>P</i> .70). Pain also did not differ 2.64;<i>P</i> .45). changed 82 80-85) 83-88) (<i>P</i> .12) between 12 groups. rate malunion higher casting group (26 [59.1%]) than other (4 [8.0%] 8 [17.0%] 4 [9.8%] χ²₃ 43.6;<i>P</i> &lt; .001), but associated <h3>Conclusions Relevance</h3> study find patient-reported differences injury groups, little change months. These findings suggest that need necessarily be considered deciding options. Patient needs recovery goals fit relative risks benefits each type will more valuable decision-making. <h3>Trial Registration</h3> ClinicalTrials.gov Identifier:NCT01589692