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DRAFT-CASP: Distal Radius Acute Fracture Trial – Cast versus Splint; 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

Funder NIHR (part of DHSC)
Recipient organisation University of Oxford
Funding £1.7M
Period May 2022 — Feb 2028

In plain English

AI plain-English summary

Every year, more than 100,000 people in the UK break their wrist, and the standard treatment—a heavy, non-removable plaster cast—may be overkill for fractures that do not need to be manually realigned. This matters because wearing a cast for weeks is inconvenient and can stiffen the wrist, yet doctors lack high-quality evidence that a cast is actually better than a simple removable splint for these common, stable fractures. The trial will directly compare the two approaches in terms of wrist function, pain, complications, and cost. If the removable splint proves as effective as the cast, it could become the new standard of care. That would mean patients can shower normally, remove the splint for gentle movement, and potentially return to daily activities sooner. It would also reduce the burden on fracture clinics, which currently spend time removing and reapplying casts, and lower NHS costs for materials and follow-up appointments. The trial’s economic evaluation will make the financial case explicit for health service commissioners.

View original technical description
Background. There are over 100,000 fractures of the wrist (distal radius) in the UK each year; 6% of all women will have sustained such a fracture by the age of 80 and 9% by the age of 90. As the population continues to age, an increasing burden for health and social care is expected. Aim. To compare the clinical and cost-effectiveness of a standard care cast versus removable splint for adults with a distal radius fracture that does not require manipulation. Study design. A multi-centre, randomised non-inferiority trial with internal pilot and embedded process and economic evaluations. Patients. 1894 adults with an acute fracture of the distal radius that does not require manipulation. Patients presenting more than two weeks after injury; with an open fracture; or with evidence that they would be unable to complete follow-up questionnaires will be excluded. Comparison. Standard care plaster cast. Intervention. A removable splint applied from below the elbow to the knuckles. Primary outcome: the Patient Reported Wrist Evaluation at 3 months post randomisation. Secondary outcomes. Wrist function at other time-points, pain scores daily for the first two weeks, health-related quality of life, complications and resource use assessed up to 1 year.

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Related Research

Grants with similar aims, by meaning.

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
Distal Radius Acute Fracture Trial 3 – Cast versus Splint (DRAFT3-CASP): a randomised non-inferiority trial comparingclinical and cost-effectiveness of a standard care cast versus removable splint for adults with a distal radius fracturethat does not require manipulation
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
DRAFFT 2: Distal Radius Acute Fracture Fixation Trial - A Randomised Controlled Trial of Manipulation and surgical fixation with K-wires versus Manipulation and Casting in the Treatment of Adult Patients with a Dorsally Displaced Fracture of the Distal Radius
A multi-centre randomised controlled trial evaluating cast treatment versus surgical fixation on wrist function for fractures of the scaphoid wrist in adults

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