Casting without prior reduction versus closed reduction for displaced wrist (distal radius) fractures in people 65 and older

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This randomized controlled trial enrolls 532 patients aged 65 or older with low-energy displaced distal radius fractures and compares two approaches: immediate casting without attempting a closed reduction versus closed reduction under local anaesthetic followed by casting. Both groups receive a dorsal cast for five weeks, identical post-cast advice, and follow-up visits at 3 and 12 months, with the Patient-Rated Wrist Evaluation (PRWE) score at 12 months as the primary endpoint. No radiographs are taken during the casting period and an observational arm is offered for patients who decline randomization but consent to follow-up. The trial is run across multiple hospitals in Finland, Denmark, and Estonia with standardized treatment and outcome measurement protocols.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Age 65 years or older
* Independent living patients
* Displaced distal radius fracture (AO/OTA 23A/23C) with 15-40 degree dorsal angulation, and/or of shortening of the radius for more than 2 mm.
* Associated ulnar styloid fracture is permitted
* Low energy injury, (fall from \<1 m)

Exclusion Criteria:

* Patient unable to provide consent
* Patients who are actively working in a paid position
* Volar angulation, partial articular fractures (AO/OTA 23B)
* Concomitant fracture of the ulna proximal to the base of the styloid process
* Associated fracture or dislocation in any other body part that would affect the use of the injured distal radius
* Distal radius fractures in both arms
* Open injury, Gustilo 2 or higher
* No bony contact between the main fragments
* High energy injuries

Where it's running

• Viborg regional Hospital
  Viborg, Denmark Recruiting
• Tartu University Hospital
  Tartu, Estonia Recruiting
• Tampere University Hospital
  Tampere, Pirkanmaa, Finland Recruiting
• Helsinki University Hospital
  Helsinki, Uusimaa, Finland Recruiting
• Kanta-Häme Central Hospital
  Hämeenlinna, Finland Recruiting
• Kuopio University Hospital
  Kuopio, Finland Recruiting

Study contacts

• Principal investigator: Laura Kärnä, MD — Tampere University Hospital
• Study coordinator: Laura Kärnä, MD
• Email: laura.karna@pirha.fi
• Phone: +3583311611

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

• Optimal Duration of Mechanical Traction for Displaced Distal Radius Fractures

  This study tests whether 1 minute of mechanical traction can align a displaced distal radius as well as 5 or 10 minutes in adults who come to the emergency department.

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• Riddle-based distraction during casting in children

  This study tests whether a riddle-based distraction technique can reduce pain, fear, and anxiety in kids aged 6–12 during cast application.

  Recruiting Artvin Coruh University · Kilis, Central · NCT07845136

• ESWT added to rehabilitation for CRPS-I after a distal radius fracture

  This trial tests whether adding extracorporeal shock wave therapy to standard rehab helps adults with CRPS-I after a distal radius fracture.

  Recruiting Kanuni Sultan Suleyman Training and Research Hospital · Istanbul, Istanbul · NCT07807852

• Wrist Injury Strengthening Exercise added to usual care for improving pain and function after a wrist fracture

  This trial tests whether a therapist-guided strengthening program helps people 50 and older recover better from a wrist fracture than standard self-management advice.

  Recruiting University of Aarhus · Aarhus N · NCT07538323

• Home-use photobiomodulation (light) therapy to help recovery after distal radius (wrist) fracture surgery

  This test will see if a home-use light therapy device plus twice-daily home exercises helps adults 18–65 recover wrist function after surgical repair of a distal radius fracture.

  Recruiting University of Nove de Julho · São Paulo · NCT07426926

• Fear of movement and recovery after a non-surgical broken wrist

  This project will see if fear of movement (kinesiophobia) predicts recovery in people treated without surgery for a broken wrist.

  Recruiting Pamukkale University · Denizli and 1 other locations · NCT07291505

How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.