gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Do national randomised controlled trials change international clinical practice?

Meeting Abstract

  • presenting/speaker Rosie Mc Colgan - University Hospital Galway, Galway, Ireland
  • David M. Dalton - University Hospital Galway, Galway, Ireland
  • Adrian J. Cassar-Gheiti - University Hospital Galway, Galway, Ireland
  • Michael E. O'Sullivan - University Hospital Galway, Galway, Ireland

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-905

doi: 10.3205/19ifssh0607, urn:nbn:de:0183-19ifssh06070

Published: February 6, 2020

© 2020 Mc Colgan et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives/Interrogation: The Distal Radius Acute Fracture Fixation Trial (DRAFFT) was a randomised controlled trial performed in the United Kingdom (UK). The authors concluded that there was no difference between locking plate versus Kirschner-wire (k-wire) fixation in fractures of the distal radius. This trial had a significant impact on clinical practice in the UK. The number of patients in treated with plate fixation fell from 75% to 48% before and after publication of the trial. The number of patients treated with k-wire fixation rose from 12% to 42%.

Our aim was to assess whether DRAFFT affected clinical practice in Ireland.

Methods: Data was obtained from the Hospital Inpatient Enquiry system (HIPE). It was grouped into annual intervals from 2012 until 2017. All in-patient episodes involving emergency surgery for fractures of the distal radius were included.

Results and Conclusions: In 2012, before publication of DRAFFT, 38% of patients in Ireland were treated with plate fixation versus 49% with k-wire fixation. In 2017, after publication of DRAFFT, the proportion of patients who underwent plate fixation rose to 62% with a concurrent fall in the number who underwent k-wire fixation to 30%.

It appears that surgeons in Ireland do not change their practice in response to randomised controlled trials performed in the UK. National randomised controlled trials performed in the UK have a significant impact on practice in the UK, however they do not appear to influence practice in similar international populations.