6/28/23, 1:19 AM DRAFFT2 Pathway Feedback Search Clinical Topics Home Studies DRAFFT2 DRAFFT2 Disease Distal radius fracture Trial question Is surgical fixation with K-wires superior to casting in patients with dorsally-displaced distal radius fracture? Study design Multi-center Open label RCT Population Characteristics of study participants 83.0% female N = 500 17.0% male 500 patients (417 female, 83 male) Inclusion criteria: adult patients with a dorsally-displaced distal radius fracture that needed manipulation Key exclusion criteria: injury > 2 weeks old; fracture extending > 3 cm from radiocarpal joint; open fracture with Gustilo and Anderson grading > 1; inability to reduce the joint surface of fracture by closed manipulation Interventions N=245 K-wire fixation (manipulation and surgical fixation with K-wires plus cast) N=255 cast (manipulation and moulded cast only) https://web.pathway.md/studies/rechT1KZdDfygzNjA 1/2 6/28/23, 1:19 AM DRAFFT2 Pathway Primary outcome Patient Rated Wrist Evaluation score at 12 months 21.2 21.2 20.7 15.9 10.6 5.3 No significant difference 0.0 K-wire fixation Cast No significant difference in Patient Rated Wrist Evaluation score at 12 months (20.7 vs. 21.2; MD -0.34, 95% CI -4.33 to 3.66) Secondary outcomes No significant difference in Patient Rated Wrist Evaluation at 6 months (27.6 vs. 28.4; MD -0.32, 95% CI -4.26 to 3.62) No significant difference in the mean score of EuroQol-5D at 12 months (0.78 vs. 0.81; AD -0.03, 95% CI -0.07 to 0.02) No significant difference in the mean score of EuroQol VAS at 12 months (80.42 vs. 81.11; AD -0.51, 95% CI -4.3 to 3.29) Safety outcomes No significant differences in blood clots, complex regional pain syndrome. Significant difference in surgery for loss of fracture reduction in the first 6 weeks (0.4% vs. 13%). Conclusion In adult patients with a dorsally-displaced distal radius fracture that needed manipulation, K-wire fixation was not superior to cast with respect to Patient Rated Wrist Evaluation score at 12 months. Reference Matthew L Costa, Juul Achten, Alexander Ooms et al. Surgical fixation with K-wires versus casting in adults with fracture of distal radius: DRAFFT2 multicentre randomised clinical trial. BMJ. 2022 Jan 19;376:e068041. Open reference URL https://web.pathway.md/studies/rechT1KZdDfygzNjA 2/2