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van Veelen NM, van de Wall BJ, Hoepelman RJ, IJpma FF, Link BC, Babst R, Groenwold RH, van der Velde D, Diwersi N, van Heijl M, Houwert RM, Beeres FJ
Let’s Agree to Disagree on Operative Versus Nonoperative Treatment for Distal Radius Fractures in Older People: Protocol for a Prospective International Multicenter Cohort Study
Let’s Agree to Disagree on Operative versus Nonoperative (LADON) Treatment for Distal Radius Fractures in the Elderly: The Study Protocol for a Prospective International Multicenter Cohort Study.
Nicole Maria van Veelen;
Bryan JM van de Wall;
Ruben J. Hoepelman;
Frank FA IJpma;
Björn-Christian Link;
Reto Babst;
Rolf HH Groenwold;
Detlef van der Velde;
Nadine Diwersi;
Mark van Heijl;
R Marijn Houwert;
Frank JP Beeres
ABSTRACT
Background:
Distal radius fractures are the most frequently encountered fractures in western societies, typically affecting patients over the age of 50. Although this is such a common injury, the best treatment for these fractures in elderly patients is still under debate.
Objective:
The aim of this prospective study is to compare the outcome of operatively and non-operatively treated distal radius fractures in the older population. Only patients with distal radius fractures for which equipoise regarding the optimal treatment exists will be included.
Methods:
This prospective international multicenter observational cohort study will be designed as a natural experiment. Patients ≥65 years old with an acute distal radius fracture will be considered for inclusion. Treatment allocation will occur based on the local preferences of the treating hospital either in Switzerland or the Netherlands. Patients will be identified after treatment has been initiated. Based on the radiographs and baseline information of the patient, an expert panel of six certified trauma surgeons from two regions will provide their treatment recommendation. Only patients for which the experts disagree on treatment recommendations will ultimately be included in the study. The primary outcome will be the Patient-rated Wrist Evaluation (PRWE) score measured at 12 weeks. Secondary outcomes will include the Physical Activity Score for the Elderly, EuroQoL questionnaire, pain, the living situation, range of motion, complications, and radiological outcomes.
Results:
not applicable
Conclusions:
Although many trials on this topic have previously been published, there remains and ongoing debate regarding the optimal treatment for distal radius fractures in elderly patients. This observational study, which will use a fairly new methodological study design, will provide further information on treatment outcomes for those elderly patients with distal radius fractures for which to date equipoise exists regarding the optimal treatment. Clinical Trial: clinicaltrials.gov NCT05631314
Citation
Please cite as:
van Veelen NM, van de Wall BJ, Hoepelman RJ, IJpma FF, Link BC, Babst R, Groenwold RH, van der Velde D, Diwersi N, van Heijl M, Houwert RM, Beeres FJ
Let’s Agree to Disagree on Operative Versus Nonoperative Treatment for Distal Radius Fractures in Older People: Protocol for a Prospective International Multicenter Cohort Study