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Dislocations clinical trials

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NCT ID: NCT00993954 Completed - Clinical trials for Radial Head Subluxation

Nurse Reduction of Pulled Elbow

Start date: October 2009
Phase: N/A
Study type: Interventional

Radial head subluxation, also known as pulled elbow or nursemaid's elbow, is one of the most common upper extremity injuries in young children and a common reason for an emergency department visit.1 The injury typically occurs when a forceful longitudinal traction is applied to an extended and pronated forearm.2 Children with radial head subluxation are usually easily recognized by their clinical presentation and rapidly treated by a simple reduction technique involving either hyperpronation or supination and flexion of the injured arm.3-7 Despite the relative ease of diagnosis and treatment, children with radial head subluxation often wait several hours in a pediatric emergency department for a reduction that takes only a few minutes.8 Such visits have direct health care costs and involve time and stress for the child and their family. While many factors are associated with parental and patient satisfaction in the emergency department, it appears that that early treatment or intervention and shorter waiting times correlate with patient and parent satisfaction.9,10 As well, patient satisfaction appears to be the same or better when emergency department care for minor injuries is provided by nurse practitioners compared to physicians.11-13 Increasingly nurse initiated treatments and the use of medical directives and clinical pathways are becoming a focus in providing health care.14-17 While radial head subluxation treatment is an appropriate area to consider management by emergency department nurses, no studies have examined their role in the management of this common injury. Our study's objective was to examine whether triage nurses, trained in the use of a medical directive that taught recognition and treatment of radial head subluxation, could successfully reduce radial head subluxation at a rate similar to physicians. Given the practical constraints at the time of emergency department triage, this study was designed as a cluster randomized trial where the unit of randomization was a day and the patients on any given day were assigned to the nurse or physician arm for the entire day.

NCT ID: NCT00985023 Completed - Clinical trials for Unstable Lisfranc Fracture-dislocations of the Midfoot

A Comparison of Stainless Steel and Bioabsorbable Screw Fixation of Lisfranc Foot Injuries

Lisfranc
Start date: August 2008
Phase: Phase 4
Study type: Interventional

The Lisfranc ligaments are a group of ligaments that connect the bones of the middle portion of the foot to each other. The Lisfranc ligaments allow for a normal and stable range of motion and shape to the foot. In certain foot fractures where the Lisfranc ligaments are damaged, the constraint and stability it had given to the middle of the foot is lost. Attempted activity at the foot will result in pain and abnormal motion. If injury to the Lisfranc ligaments is left untreated, the eventual end result is foot arthritis and deformity. The current standard orthopaedic treatment of foot fractures with Lisfranc ligament injuries is surgery. The foot fractures are fixed with metal screws. The Lisfranc ligaments are fixed by compressing the space between the middle bones of the foot with steel screws. These screws allow for ligament healing. As the ligaments heal, the patient should not resume activity with the fixed foot too soon as the screw may break. Upon breakage, the ligament repair may fail and the screw is now difficult to surgically remove. Regardless of breakage, a second surgical procedure is often recommended to remove the steel screw 6 months after foot surgery. This allows for a complete return of normal foot range of motion, but at the cost of a second surgical procedure. The investigators hypothesize that absorbable screw fixation of the Lisfranc ligaments does not yield significant differences in postoperative foot stability, ligament function, and symptoms when compared to steel screw fixation. In addition, absorbable screw fixation of the Lisfranc ligaments offers the advantage that a second surgical procedure to remove the screw is not necessary.

NCT ID: NCT00840593 Completed - Clinical trials for Surgical Procedures, Operative

A Prospective, Randomised Long-term Follow-up of Operative Versus Non-operative Treatment of Gr. 3 Acromioclavicular Dislocation

Start date: February 2009
Phase: N/A
Study type: Interventional

The purpose of this study is to compare the long-term clinical and radiological results of operative and conservative treatment of Tossy type 3 acromio-clavicular dislocation.

NCT ID: NCT00743873 Completed - Patella-Dislocation Clinical Trials

Platelet-rich Plasma (PRP) Treatment for Medial Retinaculum Tear Post Medial Patellar Dislocation

Start date: January 2008
Phase: Phase 2/Phase 3
Study type: Interventional

To check the influence of injected platelet-rich plasma (PRP) on the healing of medial retinaculum and the redaction in recurrent dislocation of the patella.

NCT ID: NCT00738127 Completed - Pain Clinical Trials

Safety Study of Surgical Technique to Treat Acute Dorsal Trans-Scaphoid Perilunate Dislocations

ADTPD
Start date: October 1992
Phase: N/A
Study type: Interventional

The purpose of this study is to determine a surgical technique is effective in the treatment of acute dorsal trans-scaphoid perilunate dislocations.

NCT ID: NCT00628836 Completed - Clinical trials for Shoulder Dislocation

Treatment of Shoulder Subluxation in Chronic Stroke Patients

Start date: June 2001
Phase: Phase 1
Study type: Interventional

The study looks at treatments for reversing chronic shoulder subluxation after a stroke. It compares electrical stimulation with surface electrodes (stimulation through the skin) with intra-muscular stimulation (from inside the muscle)using an implanted micro-stimulator (BION). Subjects are put either in a surface stimulation or a BION® group. In the BION® group, two BION®s are implanted in the shoulder, the medial deltoid and supraspinatus muscles. Treatment consists of a baseline of 6 weeks, and 6 weeks of therapy, consisting of 2 sessions per day for 10 to 30 minutes each time. This is followed by 6 weeks without therapy. If testing shows that after 6 weeks of therapy there is no reversal of subluxation, more intense therapy is carried out for another 6 weeks. Treatment is similar in the surface electrode group, but surface electrodes deliver the stimulation instead of BION®s. A total of 30 subjects is expected to complete the study.

NCT ID: NCT00582517 Completed - Knee Dislocation Clinical Trials

Compass Hinge Stabilization of Knee Dislocations: A Randomized Trial

CKH
Start date: August 2000
Phase: N/A
Study type: Interventional

The purpose of this project is to evaluate the effect of the Compass™ Universal Hinge external fixator on the outcome of patients following acute dislocation of the knee

NCT ID: NCT00551668 Completed - Clinical trials for Patellar Dislocation

A Prospective, Randomized Study of Operative and Nonoperative Treatment for Primary Traumatic Patellar Dislocation

Start date: January 1998
Phase: N/A
Study type: Interventional

The objective of this prospective, randomized cohort study was to evaluate the clinical results between operative and nonoperative treatment of primary patellar dislocation.

NCT ID: NCT00288847 Completed - Patella-Dislocation Clinical Trials

Functional Surface Electromyogram of Knee Extensors in Healthy Humans and Patients With Patella-dislocation.

Start date: November 2005
Phase: N/A
Study type: Observational

The activation of the knee extensors in adults after patella dislocation. The kneecap can dislocate due to an accident or also only due to an interior turn in the stretched knee joint out of its sliding bearing. E. Arendt (Arendt 2002) wrote an overview work, in which possible causes and working methods to the patella dislocation are discussed. Despite almost one hundred quotations the authors are not able find the causes and the possible treatment concepts. The study will examined healthy adults (25 female and 25 men) and 25 patients with patella dislocation by a routine applied clinical gait analysis and surface EMG (after the European SENIAM guidelines) iin the Laboratory for Gait Analysis Basel of the Children's University Hospital Basel. The combination of gait analysis and the surface EMG with Wavelet analysis may objectify possible reasons for a patella dislocation

NCT ID: NCT00251264 Completed - Clinical trials for Shoulder Dislocation

Arthroscopic Versus Open Stabilization for Traumatic Shoulder Instability

Start date: November 2001
Phase: N/A
Study type: Interventional

The purpose of this study is to compare arthroscopic and open shoulder stabilization procedures by measuring the disease-specific quality of life outcome in patients with traumatic unidirectional anterior instability of the shoulder at 2 and 5 years. Hypothesis: There is no difference in disease-specific quality of life outcomes in patients with traumatic unidirectional anterior shoulder instability, undergoing an arthroscopic versus an open stabilization procedure.