No Reduction Compared to Closed Reduction for Distal Radius Fractures in Patients Over 65 or Older
Trial Parameters
Brief Summary
DISCLOSE trial is a randomized controlled trial including 532 participants with low-energy distal radius fractures. The primary objective is to evaluate whether casting without prior closed reduction is equivalent to casting following closed reduction with respect to wrist-related pain and disability, as measured by the Patient-Rated Wrist Evaluation (PRWE) score at 12 months, in patients aged 65 years or older with a displaced distal radius fracture. * Primary endpoint will be PRWE at 12 months * Follow-up visits are scheduled at 3 and 12 months. 5-year follow-up will be considered as an exploratory endpoint
Eligibility Criteria
Inclusion Criteria: * Age 65 years or older * Independent living patients * Displaced distal radius fracture (AO/OTA 23A/23C) with 15-40 degree dorsal angulation, and/or of shortening of the radius for more than 2 mm. * Associated ulnar styloid fracture is permitted * Low energy injury, (fall from \<1 m) Exclusion Criteria: * Patient unable to provide consent * Patients who are actively working in a paid position * Volar angulation, partial articular fractures (AO/OTA 23B) * Concomitant fracture of the ulna proximal to the base of the styloid process * Associated fracture or dislocation in any other body part that would affect the use of the injured distal radius * Distal radius fractures in both arms * Open injury, Gustilo 2 or higher * No bony contact between the main fragments * High energy injuries