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Do large pragmatic randomised trials change clinical practice? Assessing the impact of the Distal Radius Acute Fracture Fixation Trial (DRAFFT)

Lookup NU author(s): Dr Simon Jameson, Michael Reed


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AimsOur aim, using English Hospital Episode Statistics data before during and after the Distal Radius Acute Fracture Fixation Trial (DRAFFT), was to assess whether the results of the trial affected clinical practice.Patients and MethodsData were grouped into six month intervals from July 2005 to December 2014. All patient episodes in the National Health Service involving emergency surgery for an isolated distal radial fracture were included.ResultsClinical practice in England had not changed in the five years before DRAFFT: 75% of patients were treated with plate fixation versus 12% with Kirschner (K)-wires. After the publication of the trial, the proportion of patients having K-wire fixation rose to 42% with a concurrent fall in the proportion having fixation with a plate to 48%. The proportion of 'other' procedures stayed the same.Take home message. It appears that surgeons in the United Kingdom do change their practice in response to large, pragmatic, multicentre clinical trials in musculoskeletal trauma.

Publication metadata

Author(s): Costa ML, Jameson SS, Reed MR

Publication type: Article

Publication status: Published

Journal: Bone and Joint Journal

Year: 2016

Volume: 98B

Issue: 3

Pages: 410-413

Print publication date: 01/03/2016

Online publication date: 26/02/2016

Acceptance date: 12/11/2015

ISSN (print): 2049-4394

ISSN (electronic): 2049-4408

Publisher: The British Editorial Society of Bone & Joint Surgery


DOI: 10.1302/0301-620X.98B3.36730

PubMed id: 26920968


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