5. Key characteristics of participants, fractures and interventions.

Study ID	Participants	Fracture type and classification	Timing/ common interventions/ duration	Intervention	Control
Cassidy 2003	323; 84% female; mean age 64 years.	Unstable and / or displaced unilateral distal radius fracture resulting from a low energy impact. Extra‐articular (AO type: A2.1, A2.2, A3.1, A3.2, A3.3) or intra‐articular (C1.1, C1.2, C1.3, C2.1, C2.2).	Before 5 days from injury. Closed reduction. Optional use of K‐wires for fracture stabilisation. Duration of immobilisation differed in the two groups.	Bone substitute. Norian SRS (calcium‐phosphate bone cement) injected percutaneously or through small incision into cavity (after clean‐up). Below‐elbow plaster cast for 2 weeks. Wrist and forearm exercises started at 2 weeks. Removable splint for 4 weeks.	Closed reduction and cast (108 people) or external fixator (54 people) for 6 to 8 weeks. Wrist and forearm exercises started after this.
Jeyam 2002	21; all female; mean age 73 years.	Displaced distal radius fracture. Melone type 1 or 2a fractures: intra‐articular.	Recruitment criteria within 7 days of injury. Closed reduction. Short‐arm cast for 4 weeks.	Bone substitute. Hydroxyapatite bone cement inserted through small dorsal incision after clean‐up. Short‐arm cast for 4 weeks.	Kapandji's intrafocal pinning (2 or 3 K‐wires inserted at fracture site). Short‐arm cast for 4 weeks. K‐wires removed at 6 weeks.
Kopylov 1999	40; 90% female; mean age 67 years.	Redisplaced unstable distal radial fracture (20 degrees dorsal angulation or 2+ mm axial compression or 2+ mm incongruity in radiocarpal or distal radio‐ulnar joints). Extra‐articular and intra‐articular.	After 7‐10 days from initial reduction. Closed reduction in both groups. Duration of immobilisation differed in the two groups.	Bone substitute. Fracture exposed through < 5 cm dorsal incision. After clean‐up, Norian skeletal repair system (SRS) ‐ bone cement ‐ injected to fill defect. Short arm dorsal splint for 2 weeks, then wrist mobilisation.	Hoffman external fixator 5 weeks. Two pins inserted into 2nd metacarpal and 2 into radial shaft. Wrist mobilised after 5 weeks.
Kopylov 2002	20; all female; mean age 66 years.	Redisplaced distal radial fracture (20 degrees dorsal angulation or 2+ mm axial shortening or 2+ mm incongruity in radio‐carpal or distal radio‐ulnar joints). Extra‐articular and intra‐articular.	After 7‐10 days from initial reduction. Plaster cast immobilisation for 1 week, then removable splint up to 3 weeks.	Bone substitute. Closed reduction and fracture exposed through < 5 cm dorsal incision. After open reduction, as required, clean‐up, Norian skeletal repair system (SRS) ‐ bone cement ‐ injected to fill defect. Short arm dorsal splint for 1 week, then wrist mobilisation and instruction.	No change of cast or re‐reduction. Short arm dorsal splint for 1 week, then wrist mobilisation and instruction.
McQueen 1996	120; 89% female; mean age 63 years.	Redisplaced (>10 degrees dorsal angulation or > 3 mm radial shortening). AO types A and C (extra‐articular and intra‐articular).	Within 2 weeks from injury. Open reduction for graft group and closed reduction for plaster cast and external fixation groups. Immobilisation for 6 weeks.	Bone graft. Open reduction and bone graft (from iliac crest) held by 1 Kirschner wire, then forearm cast for 6 weeks	(1) Closed reduction and plaster cast for 6 weeks. or (2) Open incisions for pin insertion. Bridging of radiocarpal joint. Pennig external fixator for 6 weeks. Ball joint released for limited wrist motion in 30 patients at 3 weeks.
Rajan 2006	93; 81% female; mean age 61 years.	Unstable fracture either primarily or redisplaced. Instability defined if at least 2 criteria met: dorsal angulation > 20 degrees, loss of radial length > 10 mm, intra‐articular extension of fracture, severe dorsal metaphyseal comminution, radioulnar separation. AO types A3, C2 and C3 (extra‐ and intra‐articular)	Primary or secondary fixation at mean 5.5 days from injury. Open reduction and dorsal plate fixation. Dorsal splint then full forearm cast for 4 weeks.	Bone graft Allogenic bone‐graft substitute (Tutoplast cancellous chips). Dorsal splint, then circular forearm cast for 4 weeks.	Bone graft Autogenic bone‐graft (from iliac crest ). Dorsal splint, then circular forearm cast for 4 weeks.
Sanchez‐Sotelo 2000	110; 88% female; mean age 66 years.	AO: A3 (extra‐articular) or C2 (intra‐articular) distal radius fractures.	Soon after injury. Closed reduction. Duration of immobilisation differed in the two groups.	Bone substitute. Debris etc removed through 1 cm incision and Norian SRS (calcium‐phosphate bone cement) injected into cavity. Below‐elbow cast for 2 weeks.	Below‐elbow cast for 6 weeks.
Schmalholz 1989	49; all female; mean age 68 years.	Redisplaced closed unstable extra‐articular distal radial fracture (dorsal angulation 30+ degrees and / or axial compression 5 mm) following second closed manipulation.	Varied, 8 to 24 days after initial closed reduction for trial entry. Open reduction at 14‐24 days post fracture for bone cement group and closed reduction 15‐24 days from plaster cast group. Duration of immobilisation differed in the two groups.	Bone substitute. Open reduction and methylmethacrylate cement used to fill dorsal bone deficiency. Dorsal plaster for 2 weeks.	Closed reduction and below‐elbow plaster cast: for 4 weeks.
Schmalhotz 1990	50; 96% female; median age 66‐67 years.	Redisplaced closed unstable distal radial fracture (dorsal angulation 30+ degrees and / or axial compression 5 mm) following second closed manipulation. Frykman type I and II fractures: extra‐articular.	Varied, 14 to 18 days post injury. Open reduction for graft group and closed reduction for external fixator group. Duration of immobilisation differed in the two groups.	Bone substitute. Open reduction and methylmethacrylate cement used to fill dorsal bone deficiency. Dorsal plaster for 2 weeks.	External fixation ‐ 2 pins in 2nd metacarpal and 2 in radial shaft) ‐ with one bar Hoffman fixator for 33 to 40 days (5‐6 weeks).
Widman 2002	48; 69% female; mean age 51.5 years.	Severely displaced and comminuted distal radial fracture, Older type 3 (radial styloid process shortened > 4 mm distal to ulna) or type 4 (marked comminution and radial styloid process shortened to level of ulna or less). Older types 3 & 4; AO types A2, A3, C1, C2, C3 (extra‐articular and intra‐articular).	After treatment at A&E department. Closed and open reduction under general anesthesia for bone graft group and closed reduction under regional anaesthesia for control group. Duration of immobilisation differed in the two groups.	Bone graft. External fixation (using a half‐frame Hoffman external fixator: 2 pins in 2nd metacarpal and 2 in radial shaft) and cancellous bone graft (from iliac crest) inserted through 3‐4 cm dorsal incision into fracture cavity. External fixator for 3 weeks, then plaster cast, allowing volar flexion but limited extension, for 3 weeks.	External fixation alone. Removed after 6 weeks.