Internal fixation and comparisons of different fixation methods for treating distal radial fractures in adults

Objectives: To evaluate the effectiveness of internal fixation for fractures of the distal radius in skeletally mature people. Additionally, to evaluate the relative effectiveness of different surgical methods of treating these fractures. More specifically, the authors compare the effectiveness of: • internal fixation versus conservative treatment; • different methods of internal fixation, including different techniques associated with inserting implants, different implants, and different types and durations of immobilisation after internal fixation; • different fixation methods (percutaneous pinning, external fixation, internal fixation); and different combinations of surgical methods; • different techniques (e.g. use of arthroscopy) and approaches (e.g. surgical repair of the triangular fibrocartilagenous complex (fibrous tissue which binds together the distal ends of the radius and ulnar) not already covered. The authors consider these outcomes primarily in terms of patient-assessed functional outcome and satisfaction, and other measures of function and impairment, pain and discomfort, the incidence of complications, anatomical deformity and use of resources. If data allows it, the authors intend to study the outcomes in different age groups and for different types of fractures, especially whether they are extra-articular or intra-articular.