Volar Locking-Plate and Kirschner-Wire Fixation Did Not Differ in Terms of Functional Outcomes After Dorsally Displaced Distal Radial Fracture

Costa ML, Achten J, Parsons NR, Rangan A, Griffin D, Tubeuf S, Lamb SE; DRAFFT Study Group. Percutaneous Fixation with Kirschner Wires Versus Volar Locking Plate Fixation in Adults with Dorsally Displaced Fracture of Distal Radius: Randomised Controlled Trial. BMJ. 2014 Aug 5;349:g4807. ### Question: In patients with a dorsally displaced fracture of the distal part of the radius, how does volar locking-plate fixation compare with Kirschner-wire fixation? ### Design: Randomized (allocation concealed), blinded (data collectors and outcome assessors), controlled trial with twelve months of follow-up (Distal Radius Acute Fracture Fixation Trial [DRAFFT]). ### Setting: 18 centers in the United Kingdom. ### Patients: 461 patients ≥18 years of age (mean age, 59 years; 84% women) who had a dorsally displaced fracture of the distal part of the radius within 3 cm of the radiocarpal joint in the past 2 weeks. Exclusion criteria were a fracture extending >3 cm from the radiocarpal joint, open fracture, inability of the fracture to be reduced with indirect techniques, or contraindication to anesthesia. 416 patients (90%) completed follow-up. ### Intervention: Patients were allocated to volar locking-plate fixation (n = 231) or Kirschner-wire fixation (n = 230). Locking-plate fixation involved an incision over the volar …