Related Experiment Video

Updated: Jan 25, 2026

Author Spotlight: Regenerative Peripheral Nerve Interface (RPNI) Surgery in Postamputation Pain Management

Author Spotlight: Regenerative Peripheral Nerve Interface (RPNI) Surgery in Postamputation Pain Management

Published on: March 15, 2024

Volar Plate Fixation Versus Plaster Immobilization in Acceptably Reduced Extra-Articular Distal Radial Fractures: A

Marjolein A M Mulders¹, Monique M J Walenkamp¹, Susan van Dieren¹

¹Trauma Unit (M.A.M.M. and M.M.J.W.), Department of Surgery (S.v.D.), Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.

The Journal of Bone and Joint Surgery. American Volume

|May 3, 2019

Abstract

Background:

There is no consensus as to whether displaced extra-articular distal radial fractures should be treated operatively or nonoperatively. We compared the outcomes of open reduction and volar plate fixation with closed reduction and plaster immobilization in adults with an acceptably reduced extra-articular distal radial fracture.

Methods:

In this multicenter randomized controlled trial, patients 18 to 75 years old with an acceptably reduced extra-articular distal radial fracture were randomly assigned to open reduction and volar plate fixation or plaster immobilization. The primary outcome was function as measured with the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire after 12 months. Follow-up was conducted at 1, 3, and 6 weeks and at 3, 6, and 12 months. Analyses were performed according to the intention-to-treat principle.

Results:

Ninety-two patients were randomized, 48 to open reduction and volar plate fixation and 44 to plaster immobilization; 1 patient in each group was excluded for withdrawing informed consent. At all follow-up time points, operatively treated patients had significantly better functional outcomes, as indicated by significantly lower DASH scores, than patients treated nonoperatively (all p values < 0.05). Twelve nonoperatively managed patients (28%) had fracture redisplacement within 6 weeks and underwent subsequent open reduction and internal fixation, and 6 patients (14%) had a symptomatic malunion treated with corrective osteotomy.

Conclusions:

Patients with an acceptably reduced extra-articular distal radial fracture treated with open reduction and volar plate fixation have better functional outcomes after 12 months compared with nonoperatively managed patients. Additionally, 42% of nonoperatively managed patients had a subsequent surgical procedure. Open reduction and volar plate fixation should be considered for patients who experience this common injury.

Level Of Evidence:

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

More Related Videos

Author Spotlight: Advancements and Challenges in Surgical Treatments for Postamputation Pain

Author Spotlight: Advancements and Challenges in Surgical Treatments for Postamputation Pain

Published on: March 8, 2024

Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling

Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling

Published on: January 5, 2015

Related Concept Videos

Radial System Protection

Radial System Protection

Radial systems employ time-delay overcurrent relays to reduce load interruptions. When a fault occurs, the nearest breaker opens first, while upstream breakers remain closed due to longer delay settings. This approach ensures minimal disruption to the rest of the system.
In a radial system with a fault downstream of the third breaker, ideally, only the third breaker will open, isolating the fault and interrupting the load connected beyond it. The second breaker has a longer delay setting,...

Hypothesis: Accept or Fail to Reject?

Hypothesis: Accept or Fail to Reject?

The outcome of any hypothesis testing leads to rejecting or not rejecting the null hypothesis. This decision is taken based on the analysis of the data, an appropriate test statistic, an appropriate confidence level, the critical values, and P-values. However, when the evidence suggests that the null hypothesis cannot be rejected, is it right to say, 'Accept' the null hypothesis?
There are two ways to indicate that the null hypothesis is not rejected. 'Accept' the null...

Clinical Trials

Clinical Trials

Clinical trials are prospective experimental studies conducted on humans to determine the safety and efficacy of treatments, drugs, diet methods, and medical devices. Using statistics in clinical trials enables researchers to derive reasonable and accurate conclusions from the collected data, allowing them to make wise decisions in uncertain situations. In medical research, statistical methods are crucial for preventing errors and bias.
There are four phases in a clinical trial. A phase one...

Clinical Trials: Overview

Clinical Trials: Overview

Clinical development focuses on how the drug will interact with the human body and encompasses four key phases of clinical trials, each serving a specific purpose in assessing the safety and effectiveness of new drugs. These phases overlap and build upon one another. Phase I involves a small group of healthy volunteers (typically 20-80 individuals) or, in cases where significant toxicity is expected, patients with the targeted disease, such as cancer or AIDS. The volunteers are tested for...

Trial and Error and Algorithm

Trial and Error and Algorithm

A problem-solving strategy is a plan of action used to find a solution. Different strategies have distinct action plans. Trial and error involves trying different solutions until one works. For instance, to fix a broken printer, you might check ink levels, ensure the paper tray isn't jammed, and verify the printer's connection to your laptop. This method can be time-consuming but is commonly used. Thomas Edison, for example, used trial and error to find a suitable filament for the light...

Random Error

Random Error

Random or indeterminate errors originate from various uncontrollable variables, such as variations in environmental conditions, instrument imperfections, or the inherent variability of the phenomena being measured. Usually, these errors cannot be predicted, estimated, or characterized because their direction and magnitude often vary in magnitude and direction even during consecutive measurements. As a result, they are difficult to eliminate. However, the aggregate effect of these errors can be...

Articles linked to this work by shared authors, journal, and citation graph.

Persistent Radial or Midcarpal Malalignment after Corrective Osteotomy Does Not Affect Functional Outcome.

The journal of hand surgery Asian-Pacific volume·2026

[The surgical treatment of scapular fractures].

Nederlands tijdschrift voor geneeskunde·2026

Clinical practice on treatment of primary traumatic anterior shoulder dislocation: a multidisciplinary guideline.

Acta orthopaedica·2026

Surgeon Preferences and Outcome Predictions for Displaced Distal Radius Fractures in Elderly Patients: A Survey of 151 Surgeons Making 4,832 Treatment Predictions Based on Patient Profiles and Radiographs.

Journal of hand surgery global online·2026

A Survey on the Treatment of Extra-Articular Malunions of the Distal Radius.

Journal of wrist surgery·2026

Cost-effectiveness of cast treatment vs. surgery in elderly patients with substantially displaced intra-articular distal radius fractures: A trial-based economic evaluation.

PloS one·2026

See all related articles