Fracture Clinical Trial
Official title:
Observational Case Series on the Clinical Performance of the DePuy Synthes Variable Angle Clavicle Plate and Clavicle Hook Plate 2.7 Systems
The purpose of this study is to gather early and mid- to long-term evidence to confirm the clinical performance, safety and use of the Clavicle Plate and Clavicle Hook Plate System. A minimum of 76 patients with clavicle fractures or dislocations of the AC joint surgically treated with any plate from the DPS VA-LCP Clavicle System will be enrolled in this observational post-market clinical investigation. Outcomes will be collected until up to 2 years after surgery.
Status | Not yet recruiting |
Enrollment | 76 |
Est. completion date | September 30, 2029 |
Est. primary completion date | January 31, 2027 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Age >= 18 years - Unilateral clavicel injury and primary surgical treatment within 21 days from injury with a DPS VA-LCP® Clavicle Plate according to manufacturer's instruction use: - VA-LCP® Clavicle Plates 2.7: Fixation of clavicle bone fragments - VA-LCP® Clavicle Hook Plates 2.7: Fixation of lateral clavicle fractures and dislocations of the acromioclavicular joint - VA-LCP Clavicle Button Hook Plates 2.7: Fixation of acromioclavicular joint dislocations - Expected ability to attend postoperative FU visits - Patient informed and consent obtained according to the IRB/EC defined and approved procedures Exclusion Criteria: - Stable clavicle fractures - Systemic infection or infection localized to the site of the proposed implantation - Concomitant nerve or vessel injury - Polytrauma (Injury Severity Score = 16) - BMI =40 - Uncontrolled severe systemic disease or terminal illness - Intraoperative decision to use other implant |
Country | Name | City | State |
---|---|---|---|
Germany | Universitätsklinikum Freiburg | Freiburg | |
United Kingdom | University College London Hospital | London |
Lead Sponsor | Collaborator |
---|---|
AO Innovation Translation Center |
Germany, United Kingdom,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Patient characteristics | Demographics | Baseline | |
Other | Patient characteristics | Height in centimeters | Baseline | |
Other | Patient characteristics | Weight in kilograms | Baseline | |
Other | Patient characteristics | Body Mass Index (BMI) in kg/m^2 | Baseline | |
Other | Comorbidities | Concomitant diseases will be assessed using the Charlson Comorbidity Index (CCI). This score assesses the comorbidity level by considering both the number and severity of pre-defined comorbid conditions. It provides a weighted score of a patient's comorbidities which can be used to predict mortality risk. The minimum possible score is 0 (no comorbidities) and maximum 29. The higher the score, the more likely the predicted outcome will result in mortality. | Baseline | |
Other | Injury details | Date of injury. Only the year of birth will be assessed. | Baseline | |
Other | Injury details | Side injured (i.e. left/right) | Baseline | |
Other | Fracture classification | - Clavicle fracture will be recorded using two classifications: AO/OTA Classification and Robinson Classification
- AC joint dislocation: Rockwood classification |
Baseline | |
Other | Surgical details | Date of surgery | Intraoperative | |
Other | Surgical time | Surgical time (i.e. defined as skin-to-skin time) in minutes | Intraoperative | |
Other | Plate details | Clavicle Plate System
Type of plate and size Lateral CS1 CS2 CS3 Shaft CS1 CS2 CS3 XL Medial Material Stainless steel Titanium alloy Clavicle Hook System Type of plate and hook depth Long 9 mm 12 mm 15 mm Short 9 mm 12 mm 15 mm Button 9 mm 12 mm 15 mm Material Stainless steel Titanium alloy |
Intraoperative | |
Other | Screw details | Screw details will be documented per fragment side (medial and lateral) as:
Number of screws Diameter Type variable angle locking metaphyseal cortex |
Intraoperative | |
Other | Adjunctive fixations | Osseo cerclage suture
Direct ligament suture Internal brace Ligament augmentation for primary repair Suture anchors Muscular reattachment Other |
Intraoperative | |
Other | Patient reported outcomes | Pain Numeric Rating Scale (NRS). Local pain will be assessed with the Numerical Rating Scale (NRS). The scale range goes from 0 (no pain) to 10 (worst imaginable pain). A higher value correlates with greater pain. | Patients treated with clavicle plate: From baseline up to 24 months after surgery; Patients treated with clavicle hook plate: From baseline until device removal (approximately 3months) and up to 12 months after device removal | |
Other | Radiographical outcomes - Screw density and distribution | Will be assessed in intraoperative or the first postoperative image by analyzing the screw placement with regards to the fracture line, their distribution and type of screws used | Patients treated with clavicle plate: Intraoperative, 2 weeks; Patients treated with clavicle hook plate: Intraoperative, 2 weeks | |
Other | Radiographical outcomes - Osteolysis | Defined as the presence of a lucent line in the acromion around the tip and body hook of the clavicle hook plate. It will be documented as:
Not assessable Partial: any lucency zone around the hook Tip: lucency limited to the tip of the hook Complete: lucency around all zones of the hook |
Patients treated with clavicle hook plate: Intraoperative until device removal (approximately 3months) | |
Other | Radiographical outcomes - Bone union | Bone union is defined as the presence of bridging callus in three of four cortices on orthogonal views | Patients treated with clavicle plate: From baseline up to 24 months after surgery; Patients treated with clavicle hook plate: From baseline until device removal (approximately 3months) and up to 12 months after device removal | |
Other | Radiographical outcomes - Quality of reduction | In cases of fixation failure, quality of reduction will be assessed in the immediate postoperative radiographs and documented as:
Accurate reduction of simple fracture Accurate alignment of complex fracture Inaccurate reduction of simple fracture Inaccurate alignment of complex fracture |
Patients treated with clavicle plate: Immediately after surgery; Patients treated with clavicle hook plate: Immediately after surgery | |
Other | Radiographical outcomes - Acromioclavicular and coracoclavicular | Acromioclavicular and coracoclavicular distances (in mm) will be assessed using AC joint anteroposterior and Alexander views (if available). The AC distance is the distance between the most medial point on the acromion visible on an anteroposterior view of the AC joint and a point on a line drawn perpendicular to the plane of the dorsal aspect of the lateral or fifth of the clavicle. | Patients treated with clavicle plate: From baseline up to 24 months after surgery; Patients treated with clavicle hook plate: From baseline until device removal (approximately 3months) and up to 12 months after device removal | |
Primary | Safety aspects | Adverse events (AE) related or possibly related to the investigational device (ADE) or the procedure | Patients treated with clavicle plate: From baseline up to 24 months after surgery; Patients treated with clavicle hook plate: From baseline until device removal (approximately 3months) and up to 12 months after device removal | |
Primary | Clinical performance | The outcome measures for clinical performance are a subcategory of safety-related parameters (e.g. incidence of complaints related to plate prominence or discomfort, fracture union rate, rate of stable AC joint healing) | Through study completion, an average of 1 year | |
Primary | Utility in terms of surgeons' experience | Surgeons satisfaction with the use and handling of the devices is evaluated in a questionnaire using 5-point Likert scale questions. These include:
Surgical time (skin to skin) required for fracture reduction and fixation Much less time than with other implants Slightly less time than with other implants No difference with other implants More time than with other implants Much more time than with other implants Surgeon's impression of the fitting of the device Implant fitted well, no contouring required Implant fitted well, minimal contouring required Implant fitted well laterally but required contouring medially Implant fitted well medially but required contouring laterally Implant required contouring medially and laterally |
Assessed immediately after the surgery | |
Primary | Surgical time | Surgical time in minutes | Assessed immediately after surgeries | |
Primary | Fluoroscopy time | Fluoroscopy time in minutes | Assessed immediately after surgeries | |
Primary | The Disabilities of the Arm Shoulder and Hand short form (QuickDASH) | The Disabilities of the Arm Shoulder and Hand short form (QuickDASH) questionnaire was designed as an occupational health and disability questionnaire. It includes 30 questions that have to be rated from 1 ("no difficulty") to 5 ("unable") where lower values indicate less disability and higher values indicate more disability. | Patients treated with clavicle plate: From baseline up to 24 months after surgery; Patients treated with clavicle hook plate: From baseline until device removal (approximately 3months) and up to 12 months after device removal | |
Primary | Patient-Reported Outcomes Measurement Information System (PROMIS) | The PROMIS Physical Function Upper Extremity Short Form 7a v2.0 (2018) consists of 7 questions aimed to evaluate activities that require use of the upper extremity including shoulder, arm, and hand activities. Questions can be rated from 1 "without any difficulties" to 5 "unable to do" where lower values indicate less disability and higher values indicate more disability. | Patients treated with clavicle plate: From baseline up to 24 months after device implantation surgery; Patients treated with clavicle hook plate: From baseline until device removal surgery (approximately 3months) and up to 12 months after device removal |
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