Distal Radius Acute Fracture Trial 3 – Cast versus Splint (DRAFT3-CASP): a randomised non-inferiority trial comparing clinical and cost-effectiveness of a standard care cast versus removable splint for adults with a distal radius fracture that does not require manipulation

Recently, there has been some evidence that a removable wrist splint may provide the patient with the same support as a cast while their fracture heals. A splint can be removed by the patient themselves thereby avoiding additional visits to the hospital. This could be more convenient for patients and save money for the NHS. This study will compare wrist function and pain in patients with a fracture of the distal radius treated with usual care in a cast with standard follow-up versus a removable wrist splint with discharge from the emergency department. 1894 adult patients with a fracture of their distal radius will be invited to take part from hospitals across the UK. Half of these people will be treated in a cast and half in a removable splint. All of the patients will be given the same information and advice about their injury and their recovery. Which treatment a person gets will be decided by a computer to ensure a fair comparison. Everyone has an equal chance of getting either treatment. During the first two weeks, we will monitor the patients’ pain and after three, six and twelve months everyone will receive a questionnaire. The questions will ask about what activities they are able to do, their quality of life, any problems they might have and any costs that have been incurred because of the injury.