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Clinical Trial Details — Status: Terminated

Administrative data

NCT number NCT02051933
Other study ID # 03-12-19B
Secondary ID
Status Terminated
Phase N/A
First received
Last updated
Start date January 2013
Est. completion date May 2016

Study information

Verified date February 2022
Source Wake Forest University Health Sciences
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of this study is to determine if botulinum toxin type A (Botox) injections, at the time of surgery for pilon fractures, will improve ankle range-of-motion and functionality.


Description:

To determine if the use of Botulinum toxin A intramuscular injections of the gastrocsoleus complex in patients with operatively treated tibial plafond fractures will result in: 1. increased ankle dorsiflexion when compared to controls 2. increased ankle functionality as measured by the FAAM, and quality of life as measured by the SF-36, when compared to controls 3. a higher proportion of patients achieving at least 10 degrees of dorsiflexion when compared to controls


Recruitment information / eligibility

Status Terminated
Enrollment 10
Est. completion date May 2016
Est. primary completion date March 2016
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Patients 18 and older with a tibial plafond fracture to be treated by a staged protocol involving primary external fixation and definitive fixation within 3 weeks from the injury. (Non-definitive, interval procedures such as repeat irrigation and debridement and fibular fixation are allowed.) Exclusion Criteria: - Younger than 18 years of age - Significant traumatic brain injury or cognitive disability that would interfere with post-operative rehabilitation and study questionnaires - Nerve, vascular, or tendon injury of the lower leg: injury to the tibial or peroneal motor nerves, injury to the posterior tibial artery requiring repair, or laceration of tendons that are involved in plantar flexion or dorsiflexion of the ankle which require repair - History of prior lower extremity fracture to the tibia or ankle of the affected limb. - Incarcerated patients. - Patients unable or unwilling to return for follow-up examination. - Pregnant or lactating patients. - History of disease affecting the neuromuscular junction (ex: myasthenia gravis). - Use of aminoglycoside antibiotics at the time of definitive fixation. - Ipsilateral foot injury that will impair dorsiflexion exercises: Lisfranc injuries, fractures or dislocations of the talus, calcaneus, navicular, cuboid, cuneiforms, or metatarsals (phalanx fractures or dislocations will not be excluded). - Patients receiving Botulinum Toxin A for other reasons. - Patients with a known hypersensitivity to Botulinum toxin A. - Gustilo Anderson type III B and C. - Patients with a weight greater than 115 kg - to ensure proper injection locations

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Botulinum toxin type A
At the time of definitive fixation, the hospital's investigational pharmacy will provide four syringes containing 0.5mL Botulinum toxin type A. The dose of botulinum toxin will be calculated based on the patient's weight in kilograms, such that a total dose of 200U of Botox will be used for a 70kg individual. The dosage will scale linearly in proportion to the patient's body weight, such that each kilogram change results in a 3U change in Botox (rounded to the nearest 30U interval change from 200U, with a maximum of 300U). 45-55 kg: 140U 55-65 kg: 170U 65-75 kg: 200U 75-85 kg: 230U 85-95 kg: 260U 95-105 kg: 290U 105-115 kg: 300U
sodium chloride
At the time of definitive fixation, the hospital's investigational pharmacy will provide four syringes containing 0.5mL 0.9% sodium chloride solution . The dose of 0.9% sodium chloride will be calculated based on the patient's weight in kilograms, such that a total dose of 200U of Placebo will be used for a 70kg individual. The dosage will scale linearly in proportion to the patient's body weight, such that each kilogram change results in a 3U change in placebo(rounded to the nearest 30U interval change from 200U, with a maximum of 300U). 45-55 kg: 140U 55-65 kg: 170U 65-75 kg: 200U 75-85 kg: 230U 85-95 kg: 260U 95-105 kg: 290U 105-115 kg: 300U

Locations

Country Name City State
United States Carolinas Medical Center Charlotte North Carolina

Sponsors (1)

Lead Sponsor Collaborator
Wake Forest University Health Sciences

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Primary Ankle Dorsiflexion of Injured Extremity The difference in ankle dorsiflexion between the injured and un-injured ankles as measured with goniometer 6 month from surgery. 6 month follow-up visit
Secondary Short Form-36 (SF-36)Health Related Quality of Life The SF-36 is a patient reported survey of health. Physical functioning, role functioning/physical and general health sub-scores ranges from 0 (worst)- 100 (best) 6 month follow-up visit
Secondary Short Form-36 (SF-36) Health Related Quality of Life The SF-36 is a patient reported survey of health. Physical functioning, role functioning/physical and general health sub-scores ranges from 0 (worst)- 100 (best) 12 month follow-up visits
Secondary Ankle Pain at 6 Month Brief pain inventory (BPI) severity subscale measures pain severity with a higher score indicates worse pain (10) and lower score of no pain (0). The pain interference subscale of the BPI measures interference of pain on average of the 7 questions assessing the interference of pain for general activity, mood, walking ability, normal work, relations with other people, sleep, and enjoyment of life. 6 month follow-up visit
Secondary Ankle Pain at 12 Month Brief pain inventory (BPI) severity subscale measures pain severity with a higher score indicates worse pain (10) and lower score of no pain (0). The pain interference subscale of the BPI measures interference of pain on average of the 7 questions assessing the interference of pain for general activity, mood, walking ability, normal work, relations with other people, sleep, and enjoyment of life. 12 month follow-up visit
Secondary Functional Status of the Ankle at 6 Month The Foot and Ankle Ability Measure (FAAM) will be obtained to assess the functional status of the affected ankle.
Each item is scored on a 5-point Likert scale (4 to 0) from 'no difficulty at all' to 'unable to do'. Item score totals, which range from 0 to 84 for the ADL subscale and 0 to 32 for the Sports subscale, were transformed to percentage scores. Higher scores represent higher levels of function for each subscale, with 100% representing no dysfunction.
6 month follow-up visit
Secondary Functional Status of the Ankle at 12 Month The Foot and Ankle Ability Measure (FAAM) will be obtained to assess the functional status of the affected ankle. A higher score represents a higher level of physical function. 12 month follow-up visit