Current Issue May 2012 | Vol. 28, No. 2

Current Topic

May 2012
Current Concepts in the Treatment of Distal Radius FracturesKevin C. Chung, MD, MS, Guest Editor
In this era of evidence-based medicine, long cherished beliefs and myths are constantly challenged by critically examining available data to form a scientific basis for treatment selection. Despite over 200 years of treating distal radius fractures, and many thousands of publications on this topic, surgeons and patients alike are still vexed that we have not arrived at a consensus regarding the most optimal treatment option for a particular injury type and for a unique patient characteristic. This Hand Clinics volume strives to synthesize the best available evidence by providing a comprehensive analysis of the current treatments for distal radius fractures. The majority of the authors for this volume hail from the Wrist and Radius Injury Surgical Trial (WRIST) study group. This group is the largest collaboration of hand surgeons in the world, consisting of 19 sites and over 50 hand surgeons who will be participating in this clinical trial. For the first time, the WRIST study group will randomize patients over 60 years of age into K-wire fixation, external fixation, or volar locking plating fixation to identify the most optimal treatment for this prevalent injury. At the same time, an observational group of subjects with similar fracture types will be treated with casting to exam the outcomes of casting treatment and compare them to the outcomes of surgical treatment. This ambitious 5-year study supported by the National Institutes of Health is entitled, "A Clinical Trial for the Surgical Treatment of Distal Radius Fractures in the Elderly." This project is currently underway and should provide robust level 1 data that will help to guide future treatment decisions for distal radius fractures.