Study of displaced distal radius fractures

The Disclose trial is a randomized controlled study evaluating two common non-surgical treatments for displaced distal radius fractures in patients aged 65 years and older.

Introduction

Randomized controlled study

The DISCLOSE trial is a randomized controlled study evaluating two common non-surgical treatments for displaced distal radius fractures in patients aged 65 years and older. The study aims to determine whether a cast alone, without fracture reduction, is as effective as the standard approach involving closed reduction followed by casting.

Patients

We are recruiting patients aged 65 years or older who have sustained a low-energy, displaced distal radius fracture. Participants must be living independently and able to provide informed consent. Several exclusion criteria apply, including patients with other significant injuries, working individuals, or those with certain types of fractures.

Intervention and Control

Participants are randomly assigned to one of two groups

No reduction

A dorsal cast is applied without attempting to reposition the fracture. The cast is removed after 5 weeks, and patients are encouraged to begin hand movement and follow a standardized home exercise protocol.

Closed reduction

The fracture is reduced under local anaesthesia in the emergency department before applying the cast. As in the intervention group, the cast is removed after 5 weeks, followed by the same exercise protocol.

Patients who decline randomization are offered the option to join an observational cohort, where they receive standard care and are followed similarly to those in the trial arms.

Outcomes

Primary outcome

Wrist function at 12 months, assessed using the Patient-Rated Wrist Evaluation (PRWE) score.

Secondary outcome

  • PRWE scores at 3 months and 5 years
  • Pain (measured by visual analog scale)
  • Patient satisfaction (PASS)
  • Complications
  • Radiographic outcomes
  • Quality of life (EQ-5D-5L)
  • Physical activity (via wrist-worn accelerometers)
  • Mortality
  • Cost-effectiveness

Follow-up assessments are conducted at 3 months, 12 months, and 5 years.

Hospitals

The study is coordinated by Tampere University Hospital in Finland and conducted across multiple Scandinavian centers in Finland, Denmark, Sweden, and Estonia. This international collaboration ensures robust data and a wide range of patient perspectives across Nordic healthcare systems.

Locations
8
Countries
4
Researchers
amount