Outcome Reporting in Distal Radius Fracture Research: A Systematic Review Across Treatment Modalities

Abstract

Distal radius fractures (DRFs) are among the most common adult fractures, yet outcome reporting across studies remains inconsistent. Variability in assessed domains, measurement tools, and follow-up timing limits evidence synthesis and hinders standardized, patient-centered care. We systematically reviewed 179 English-language clinical studies evaluating DRF management across 5 treatment categories: casting, surgical intervention, physical therapy, pharmacotherapy, and operative versus nonoperative comparison. Data were extracted on study characteristics, outcome domains, measurement tools, and timing, and risk of bias was assessed using RoB 2.0 for randomized trials and MINORS (Methodological Index for Non-Randomized Studies) for nonrandomized studies. Patient-reported outcome measures were most frequent, with Disabilities of the Arm, Shoulder, and Hand (DASH/QuickDASH; n = 110) and Patient-Rated Wrist Evaluation (PRWE; n = 71) most common. Functional outcomes such as grip strength (n = 124) and range of motion (n = 140) were widely reported, particularly in therapy studies, while radiographic outcomes predominated in surgical and casting studies. Sixty percent of studies reported outcomes at 12 months or longer, and most exhibited low risk of bias. This review highlights heterogeneity in outcome reporting for DRF management, supporting development of a core outcome set and integration of longitudinal, real-world monitoring approaches such as digital phenotyping. This review demonstrates that outcome reporting in DRF studies remains fragmented, with variability in domains, instruments, and follow-up timing. Such heterogeneity prevents meaningful comparison across studies, reduces the feasibility of meta-analysis, and hampers the development of best-practice guidelines. A standardized core outcome set would address these limitations by ensuring consistent minimum reporting, while emerging methods such as digital phenotyping could complement traditional measures and provide continuous, patient-centered monitoring in future research.