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.
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.