Patient and public involvement (PPI) in health research has gained prominence, with patients and public actively shaping research priorities, study design and knowledge translation. While the benefits and challenges of PPI are well documented, less attention has been given to the complexity of navigating multiple identities as research team members. Often, patients and public, academics and clinicians share many of the same goals and occupy overlapping roles, yet research structures rarely acknowledge or accommodate this fluidity. This commentary explores how shared identities of patients and public, academics and clinicians shape research partnerships, challenging conventional boundaries by questioning whether patients and public can also serve as academics or clinicians and vice versa.

This commentary is written from an interdisciplinary perspective, where insights are synthesised from existing literature, empirical knowledge and lived experience. The authors critically examine the intersection of patient and public, academic and clinician identities and discuss the implications for research partnerships. Recurring points of tension, including questions about the suitability of partnerships and the complexities of identity, are explored. The discussion considers how members of research teams navigate privilege and shared responsibility within collaborative settings.

Although PPI aims to foster inclusivity, research partnerships often confine patients and public, academics and clinicians to rigid titles, overlooking the multidimensional identities of those involved. To advance research, practice and advocacy, it is foundational to embrace one’s authentic self while recognising the full complexity of team members. Every individual brings a unique perspective and lived experience, and together, a research team shares the collective responsibility to produce rigorous, quality research that strengthens the body of evidence.

Distal radius fractures are the most common fractures seen in the emergency department in children in the USA. However, no established or standardised guidelines exist for the optimal management of completely displaced fractures in younger children. The proposed multicentre randomised trial will compare functional outcomes between children treated with fracture reduction under sedation versus children treated with simple immobilisation.

Participants aged 4–10 years presenting to the emergency department with 100% dorsally translated metaphyseal fractures of the radius less than 5 cm from the distal radial physis will be recruited for the study. Those patients with open fractures, other ipsilateral arm fractures (excluding ulna), pathologic fractures, bone diseases, or neuromuscular or metabolic conditions will be excluded. Participants who agree to enrol in the trial will be randomly assigned via a minimal sufficient balance algorithm to either sedated reduction or in situ immobilisation. A sample size of 167 participants per arm will provide at least 90% power to detect a difference in the primary outcome of Patient-Reported Outcomes Measurement Information System Upper Extremity computer adaptive test scores of 4 points at 1 year from treatment. Primary analyses will employ a linear mixed model to estimate the treatment effect at 1 year. Secondary outcomes include additional measures of perceived pain, complications, radiographic angulation, satisfaction and additional procedures (revisions, refractures, reductions and reoperations).

Ethical approval was obtained from the following local Institutional Review Boards: Advarra, serving as the single Institutional Review Board, approved the study (Pro00062090) in April 2022. The Hospital for Sick Children (Toronto, ON, Canada) did not rely on Advarra and received separate approval from their local Research Ethics Board (REB; REB number: 1000079992) on 19 July 2023. Results will be disseminated through publication in peer-reviewed journals and presentations at international conference meetings.

NCT05131685.