Clinical Audit – Timing of Surgery for Distal Radius Fractures
Background
Why this project was needed
Distal radius (DR) fractures are the most common upper limb trauma presentation. BOAST/NICE guidelines specify clear operative timing standards: intra-articular fractures requiring surgery should be operated on within 72 hours of injury; extra-articular fractures requiring surgery should be operated on within one week. Where operative management is required following re-displacement after manipulation, surgery should also be undertaken within 72 hours. Adherence to these timing standards is important for optimising fracture reduction, soft tissue management, and patient outcomes. This audit was conducted at Princess Royal University Hospital (PRUH), part of King's College Hospital NHS Foundation Trust, to evaluate local compliance.
Aims
What the project set out to achieve
To evaluate adherence to BOAST/NICE timing guidelines for surgical management of distal radius fractures at PRUH.
Objectives
Specific measurable steps
- Identify all surgically treated distal radius fractures over the audit period (March–August 2025).
- Classify fractures as intra-articular or extra-articular.
- Record date of injury and date of surgery for each case.
- Calculate the proportion of cases meeting BOAST guideline timing criteria.
- Analyse cases failing to meet guidelines to identify causes of delay.
- Identify cases where delay was due to late presentation versus system factors.
Discussion
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