Database of Atypical and Rare Fractures and Injuries (DARFI)

Research summary

1. Study Objectives The main aim of DARFI is to: - Establish a national collaborative database platform for the study of atypical and rare fractures. - Create a shared platform linking Major Trauma Centres,Trauma Units and District General Hospitals across the UK. - Enable high-quality,large-scale research on rare fracture types that would be impossible to study meaningfully at single centres. - Identify patterns,predictors of poor outcomes,and factors influencing treatment choices (e.g. when early surgery is required or when conservative treatment may be equally effective). 2. Principal Questions / Hypotheses While DARFI is an observational,data-collection platform rather than a single hypothesis-driven trial,it aims to address broad,ongoing research questions such as: - What are the epidemiological characteristics (frequency,demographics,mechanisms) of rare and atypical fractures across the UK? - What treatment strategies (operative vs non-operative) lead to better short-,medium-,and long-term outcomes? - What risk factors or patient features predict poor recovery,complications,or mortality in these rare fracture types? - Can national-level data reveal patterns or clusters that may inform prevention,diagnosis,and clinical guidelines? 3. Methodology Summary - Study Design: Cohort database study (retrospective data collection). - Setting: All participating NHS Major Trauma Centres,Trauma Units and District General Hospitals across the UK. - Participants: Patients with rare or atypical fractures and injuries - Sampling: Convenience sampling — all eligible cases with complete data entered by participating centres. - Data Collection: Pseudonymised patient data uploaded to a secure REDCap database hosted by Liverpool University Hospitals NHS Foundation Trust (LUHFT). Data collected includes demographics,injury type,mechanism,management,comorbidities,imaging,and outcomes. Follow-up data (up to 5 years) will capture short-,medium-,and long-term results (e.g. complications,failure,readmission,mortality). - Data Management: Each Trust pseudonymises data locally before upload. Only anonymised data are shared with research teams. Oversight by the National Atypical and Rare Fractures Research Database Committee. - Analysis: Primarily descriptive and comparative statistics using SPSS (e.g. t-tests,Mann–Whitney U tests,regression models). Univariate and multivariate analyses to identify predictors of outcomes. p < 0.05 considered statistically significant. - Duration: Initial 5-year period with the option for renewal.

Principal Investigator

Sarah Lancaster

Contact us

Email: Kathryn.Lewis@ouh.nhs.uk

IRAS number

331288