Project 173 – A Combined Randomised and Observational Study of Surgery for Fractures in the distal Radius in the Elderly (CROSSFIRE)

21 Jan 2018

Dr Jonathan Mulford – $7,469

 Distal radial fractures (wrist) are the commonest fractures seen in a hospital setting. They are particularly common in the elderly (age 60 and over) due to higher rates of falls and prevalence of osteoporosis. In Australia, it is estimated that the number of osteoporotic wrist fractures (in people aged 50 years and over) will increase over 25% from approximately 20,000 in 2013 to over 25,000 in 2022, and most of these will be aged 60 years and over. Direct costs from osteoporotic wrist fractures have been estimated to be over $130 million dollars per year in Australia. With increasing use of surgical fixation, the cost is expected to increase disproportionately.

Considerable practice variation exists in the management of distal radius fractures in the elderly. Over the last 10-20 years, the use of internal fixation for these fractures has increased more than five-fold due to the frequent loss of alignment seen with plaster fixation, despite a lack of any clear association between alignment and function in this population.

The project is part of a multi centre trial to determine what is the best and most cost-effective treatment of wrist fractures in patients over the age of 60. The study will compare operative and non-operative treatments for fractures of the wrist. Currently, both treatments are commonly used, but it is not clear which of these two common treatments is best for these fractures. We hope to learn whether or not one of these two treatments are better than the other.