Joint Contractures Clinical Trial
Official title:
Randomized, Double Blind, Placebo Controlled Trial of Ketotifen in Patients With Elbow Fractures or Dislocations
Injured joints, especially at the elbow, are at risk for permanent motion loss, also known as joint contractures. Joint contractures limit the function of an elbow and are a recognized complication that occurs often after a traumatic injury. The benefits of early motion after injury has helped in preventing joint contractures but there are still several patients that develop debilitating joint contractures. Current research suggests that mast cells, which are found in the joint, are key in causing joint contractures. Research has been done using a medication called Ketotifen. Ketotifen has been linked to stabilizing mast cells and preventing the joint contracture. It is hoped that short-term use of this medication after an injury will prevent the contracture from occurring.
Individuals ≥ 18 years old with isolated distal 1/3 humerus and/or proximal 1/3 ulna and/or
proximal 1/3 radius fractures and/or elbow dislocations (open fractures with or without nerve
injury may be included) and presented to Peter Lougheed Centre (PLC), Foothills Medical
Center (FMC), or South Health Campus (SHC).
Participants were required to take Ketotifen 5mg by mouth twice a day for 6 weeks or placebo
twice a day by mouth for 6 weeks. Neither the participant nor the physician knew if the
participant was taking Ketotifen or placebo. Sometimes this type of injury requires surgery.
This study invited both patients that do and do not require surgery to participate.
We took a sample of blood to measure tryptase (normally found in the body). We predicted
people with high levels of tryptase were more likely to develop stiffening in the joint.
Participants were asked to return for follow up visits 2, 6, 12, 24, and 52 weeks after
surgery or date of initial injury if surgery was not required. These visits were part of
normal care for this type of injury.
At the visit participants were asked to do the following, some of which was not part of
normal care.
At each visit: Range of motion of the elbow was assessed, DASH score was completed- form
helping the research group understand the level of disability from this injury, X-rays until
the fracture was considered healed (this was normal treatment), SF12 - questionnaire about
how the patient was feeling and coping with their injury, Additional information was
collected about how the injury was healing and weight was measured.
The participant was required to have physiotherapy which is normal treatment for this injury.
The participant was contacted by telephone at week 1, 3, 4 and 5 while taking the study
medication. During these times:
The participant was asked about:
- any problems with the study medication
- any new conditions or concerns that have developed
The participant was reminded:
- of next visit
- to continue to take study drug as instructed
During these telephone contacts, if any problems were detected that could not be rectified or
figured out during the telephone interview, then participant was asked to attend the Cast
Clinic to see their doctor in person.
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