The DRAFFT trial is a landmark multicentre RCT comparing Kirschner wire fixation to volar locking plate fixation for surgically treated dorsally displaced distal radius fractures. It enrolled 461 adults across 18 UK trauma centres and followed them for 12 months using the Patient Rated Wrist Evaluation as the primary outcome.
For years, volar locking plates rapidly displaced Kirschner wires as the dominant fixation method for distal radius fractures, driven by biomechanical superiority and early small-trial data suggesting faster functional recovery. The DRAFFT trial is the evidence that challenged this trend head-on.
When you see a dorsally displaced distal radius fracture requiring surgical fixation that can be reduced by indirect means, this paper tells you that Kirschner wire fixation is a fully acceptable choice. It is faster, requires less antibiotic prophylaxis, and produces equivalent 12-month wrist function and quality of life.
The key clinical caveat: these results apply only to fractures reducible without direct joint exposure. Fractures with irreducible articular displacement were excluded and remain a separate decision. Counsel patients preoperatively that regardless of fixation method, wrist function at one year will likely remain about 15% below their pre-injury baseline.
Percutaneous Fixation with Kirschner Wires versus Volar Locking Plate Fixation in Adults with Dorsally Displaced Fracture of Distal Radius: Randomised Controlled Trial
Radiological Assessment of Osteo-Arthrosis.
Mesenchymal Stem Cells.
Traumatic Arthritis of the Hip after Dislocation and Acetabular Fractures: Treatment by Mold Arthroplasty. an End-Result Study Using a New Method of Result Evaluation.
Bone: Formation by Autoinduction.
Treatment of Deep Cartilage Defects in the Knee with Autologous Chondrocyte Transplantation.
Interrater Reliability of a Modified Ashworth Scale of Muscle Spasticity
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Comparison of Upper Gastrointestinal Toxicity of Rofecoxib and Naproxen in Patients with Rheumatoid Arthritis. Vigor Study Group.
Magnetic Resonance Classification of Lumbar Intervertebral Disc Degeneration.
Novel Regulators of Bone Formation: Molecular Clones and Activities.
The Diagnosis of Osteoporosis.
"modes of Failure" of Cemented Stem-Type Femoral Components: a Radiographic Analysis of Loosening.
Biomechanical Measures of Neuromuscular Control and Valgus Loading of the Knee Predict Anterior Cruciate Ligament Injury Risk in Female Athletes: a Prospective Study.
Femoroacetabular Impingement: a Cause for Osteoarthritis of the Hip.
Prevention of Infection in the Treatment of One Thousand and Twenty-Five Open Fractures of Long Bones: Retrospective and Prospective Analyses.
The Variation in Isometric Tension with Sarcomere Length in Vertebrate Muscle Fibres.
Osteoarthritis: a Disease of the Joint as an Organ.
Radiological Demarcation of Cemented Sockets in Total Hip Replacement.
Ectopic Ossification Following Total Hip Replacement. Incidence and a Method of Classification.
The Operation of the Century: Total Hip Replacement.
Fatty Muscle Degeneration in Cuff Ruptures. Pre- and Postoperative Evaluation by CT Scan.
Osseointegrated Titanium Implants. Requirements for Ensuring a Long-Lasting, Direct Bone-To-Implant Anchorage in Man.
The Etiology of Chondromalacia Patellae.
Fracture and Dislocation Classification Compendium-2018.
The Three Column Spine and Its Significance in the Classification of Acute Thoracolumbar Spinal Injuries.
Dislocations after Total Hip-Replacement Arthroplasties.
Patient Satisfaction after Total Knee Arthroplasty: Who Is Satisfied and Who Is Not?
Problems in the Management of Type III (severe) Open Fractures: a New Classification of Type III Open Fractures.
The Value of Postural Reduction in the Initial Management of Closed Injuries of the Spine with Paraplegia and Tetraplegia. I.
Vacuum-Assisted Closure: a New Method for Wound Control and Treatment: Animal Studies and Basic Foundation.
A System for the Functional Evaluation of Reconstructive Procedures after Surgical Treatment of Tumors of the Musculoskeletal System.
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Hip Morphology Influences the Pattern of Damage to the Acetabular Cartilage: Femoroacetabular Impingement as a Cause of Early Osteoarthritis of the Hip.
Porosity of 3D Biomaterial Scaffolds and Osteogenesis.
A Report: the Definition and Classification of Cerebral Palsy April 2006.
Clinician's Guide to Prevention and Treatment of Osteoporosis.
Prevention of Venous Thromboembolism
The Development of Assessment of Spondyloarthritis International Society Classification Criteria for Axial Spondyloarthritis (part II): Validation and Final Selection
Radiation Exposure from CT Scans in Childhood and Subsequent Risk of Leukaemia and Brain Tumours: a Retrospective Cohort Study.
Epidemiology of Adult Fractures: a Review.
Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017.
Osteoblastic Cells Regulate the Haematopoietic Stem Cell Niche.
A Joint Coordinate System for the Clinical Description of Three-Dimensional Motions: Application to the Knee.
Consensus Statement on Concussion in Sport-The 5th International Conference on Concussion in Sport Held in Berlin, October 2016.
Oarsi Guidelines for the Non-Surgical Management of Knee Osteoarthritis.
Estimating the Prevalence of Limb Loss in the United States: 2005 to 2050.
Metastasis to Bone: Causes, Consequences and Therapeutic Opportunities.
Role of Proinflammatory Cytokines in the Pathophysiology of Osteoarthritis.
The Basic Science of Articular Cartilage: Structure, Composition, and Function.
Osteoporosis: Now and the Future.
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Fracture and Dislocation Classification Compendium - 2007: Orthopaedic Trauma Association Classification, Database and Outcomes Committee.
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Effect of Calcium and Vitamin D Supplementation on Bone Density in Men and Women 65 Years of Age or Older
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Diagnosis and Management of Prosthetic Joint Infection: Clinical Practice Guidelines by the Infectious Diseases Society of America.
The Amazing Osteocyte.
Osteosarcoma Incidence and Survival Rates from 1973 to 2004: Data from the Surveillance, Epidemiology, and End Results Program.
Projected Volume of Primary Total Joint Arthroplasty in the U.s., 2014 to 2030.
The 2018 Definition of Periprosthetic Hip and Knee Infection: an Evidence-Based and Validated Criteria.
Bone Quality--The Material and Structural Basis of Bone Strength and Fragility.
Prevalence of Muscular Dystrophies: a Systematic Literature Review.
Mechanisms of Bone Metastasis.
The Compressive Behavior of Bone as a Two-Phase Porous Structure.
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Morbidity at Bone Graft Donor Sites.
Articular Cartilage Repair: Basic Science and Clinical Progress. a Review of the Current Status and Prospects.
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Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures
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The Oswestry Disability Index.
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Rating Systems in the Evaluation of Knee Ligament Injuries.
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Delirium in Older Persons.Citation only
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The DRAFFT trial is a landmark multicentre RCT comparing Kirschner wire fixation to volar locking plate fixation for surgically treated dorsally displaced distal radius fractures. It enrolled 461 adults across 18 UK trauma centres and followed them for 12 months using the Patient Rated Wrist Evaluation as the primary outcome.
For years, volar locking plates rapidly displaced Kirschner wires as the dominant fixation method for distal radius fractures, driven by biomechanical superiority and early small-trial data suggesting faster functional recovery. The DRAFFT trial is the evidence that challenged this trend head-on.
When you see a dorsally displaced distal radius fracture requiring surgical fixation that can be reduced by indirect means, this paper tells you that Kirschner wire fixation is a fully acceptable choice. It is faster, requires less antibiotic prophylaxis, and produces equivalent 12-month wrist function and quality of life.
The key clinical caveat: these results apply only to fractures reducible without direct joint exposure. Fractures with irreducible articular displacement were excluded and remain a separate decision. Counsel patients preoperatively that regardless of fixation method, wrist function at one year will likely remain about 15% below their pre-injury baseline.