Discussion
fracture, fractures, Colles’ fractures, pain
DISEASE, SECONDARY
In this randomized, controlled, multicenter study, we found a small, imprecise but consistent, difference between groups in all primary and secondary functional results (PRWE, 15D QD, and VAS) favoring FC. The primary outcome, PRWE at 24 months, showed a difference of 5.37 points. However, this did not reach the predetermined MCID of 11 points. Surprisingly, the fracture being in the dominant or non-dominant hand did not seem to influence PRWE at 24 months or predict outcome in the cumulative probability model. Overall, the rate of operative treatment, physical therapy and additional visits to the outpatient clinic, and additional imaging and other examinations was higher in the VFUDC group. This caused the mean cost of treatment to be substantially higher in the VFUDC group than in the FC group. The increase in QALY was produced with lower costs compared to VFUDC. In other words, VFUDC produces inferior QALYs at a higher cost. It should also be noted that QALYs tend to measure the cost burden of the overall course of the illness/treatment and may not therefore be fully applicable in assessing the individual burden of disease, especially in the early phases of the treatment. In our study, not only were the overall costs of visits and treatment higher, but patients in the VFUDC group more often reported feeling pain (26% vs 9%, p = 0 .04) and stiffness (9% vs 0%, p = 0.06) to yes/no questions compared to the FC group at 3 months, Raittio et al. [Current protocols concerning the non-operative treatment of DRF seem to vary greatly between countries, hospitals, and even surgeons. Different casting methods and positions have been used based on fracture morphology, and some authors have also advocated different approaches, for example, Colles’ fractures compared to Smith fractures, van Leeuwen et al. [Most patients 65 years and older with a DRF are suitable for non-operative treatment and the functional results of operative and non-operative treatment are similar in the older population, Stephens et al. [According to a Finnish study, the incidence rate of distal radius fracture among individuals aged 60 years and older in Oulu, Finland, was 585 per 100 000 people per year, Flinkkilä et al. [