Are the fancy locking plates for distal radius fractures nothing more than orthopaedic bling?

Shinier is not always better. The image is CC by Dennis Skley.

Shinier is not always better. The image is CC by Dennis Skley.

Costa et. al. performed recently a multi-center study including 18 trauma centers throughout the United Kingdom. They randomized patients with distal radius fractures to volar locking plates or Kirschner wires. They managed to randomize 461 patients and follow-up 90% after 1 year using self-reported scores. They could not find any difference after 1 year regarding their primary outcome, PRWE-score (−1.3 points, 95% CI -4.5 to 1.8). This was well below their stipulated minimally clinically important difference of 6 points. Could this be the end of the volar locking plate era? Continue reading