A combined randomised and observational study of surgery for fractures in the distal radius in the elderly (CROSSFIRE) - a study protocol

Harris, Ian A, Naylor, Justine M, Lawson, Andrew, Buchbinder, Rachelle, Ivers, Rebecca, Balogh, Zsolt, Smith, Paul, Mittal, Rajat, Xuan, Wei, Howard, Kirsten, Vafa, Arezoo, Yates, Piers, Rieger, Bertram, Smith, Geoff, Elkinson, Ilia, Kim, Woosung, Chehade, Mellick, Sungaran, Jai, Latendresse, Kim, Wong, James, Viswanathan, Sameer, Richardson, Martin, Shrestha, Kush, Drobetz, Herwig, Tran, Phong, Loveridge, Jeremy, Page, Richard, Hau, Raphael, Bingham, Roger, Mulford, Jonathan and Incoll, Ian 2017, A combined randomised and observational study of surgery for fractures in the distal radius in the elderly (CROSSFIRE) - a study protocol, BMJ open, vol. 7, no. 6, pp. 1-7, doi: 10.1136/bmjopen-2017-016100.

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Title A combined randomised and observational study of surgery for fractures in the distal radius in the elderly (CROSSFIRE) - a study protocol
Author(s) Harris, Ian A
Naylor, Justine M
Lawson, Andrew
Buchbinder, Rachelle
Ivers, Rebecca
Balogh, Zsolt
Smith, Paul
Mittal, Rajat
Xuan, Wei
Howard, Kirsten
Vafa, Arezoo
Yates, Piers
Rieger, Bertram
Smith, Geoff
Elkinson, Ilia
Kim, Woosung
Chehade, Mellick
Sungaran, Jai
Latendresse, Kim
Wong, James
Viswanathan, Sameer
Richardson, Martin
Shrestha, Kush
Drobetz, Herwig
Tran, Phong
Loveridge, Jeremy
Page, RichardORCID iD for Page, Richard orcid.org/0000-0002-2225-7144
Hau, Raphael
Bingham, Roger
Mulford, Jonathan
Incoll, Ian
Journal name BMJ open
Volume number 7
Issue number 6
Article ID e016100
Start page 1
End page 7
Total pages 7
Publisher BMJ Publishing Group
Place of publication London, Eng.
Publication date 2017-06-01
ISSN 2044-6055
Keyword(s) aged
fracture fixation
patient reported outcome
radius fractures
Summary Fractures of the distal radius are common and occur in all age groups. The incidence is high in older populations due to osteoporosis and increased falls risk. Considerable practice variation exists in the management of distal radius fractures in older patients ranging from closed reduction with cast immobilisation to open reduction with plate fixation. Plating is currently the most common surgical treatment. While there is evidence showing no significant advantage for some forms of surgical fixation over conservative treatment, and no difference between different surgical techniques, there is a lack of evidence comparing two of the most common treatments used: closed reduction and casting versus plating. Surgical management involves significant costs and risks compared with conservative management. High-level evidence is required to address practice variation, justify costs and to provide the best clinical outcomes for patients.Methods and analysis This pragmatic, multicentre randomised comparative effectiveness trial aims to determine whether plating leads to better pain and function and is more cost-effective than closed reduction and casting of displaced distal radius fractures in adults aged 60 years and older. The trial will compare the two techniques but will also follow consenting patients who are unwilling to be randomised in a separate, observational cohort. Inclusion of non-randomised patients addresses selection bias, provides practice and outcome insights about standard care, and improves the generalisability of the results from the randomised trial.Ethics and dissemination CROSSFIRE(Combined Randomised and Observational Study of Surgery for Fractures In the distal Radius in the Elderly) was reviewed and approved by The Hunter New England HREC (HNEHREC Reference No: 16/02/17/3.04). The results of the trial will be published in a peer-reviewed journal and will be disseminated via various forms of media. Results will be incorporated in clinical recommendations and practice guidelines produced by professional bodies.Registration CROSSFIRE has been registered with the Australian and New Zealand Clinical Trials Registry (ANZCTR: ACTRN12616000969460).
Language eng
DOI 10.1136/bmjopen-2017-016100
Field of Research 110399 Clinical Sciences not elsewhere classified
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2017, The Authors
Persistent URL http://hdl.handle.net/10536/DRO/DU:30098546

Document type: Journal Article
Collection: School of Medicine
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