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Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT04921865
Other study ID # VA Clavicle
Secondary ID
Status Not yet recruiting
Phase
First received
Last updated
Start date April 30, 2024
Est. completion date September 30, 2029

Study information

Verified date March 2024
Source AO Innovation Translation Center
Contact Alix Frischknecht
Phone +41 79 606 41 48
Email alix.frischknecht@aofoundation.org
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

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.


Description:

Common problems with existing clavicular plates are poor plate 'fit,' unbalance fixation, plate prominence, associated soft tissue irritation, subacromial pain, plate and/or fixation failure (due to unbalanced fixation) and high reoperation rate (for plate removal) [1-3]. The newly developed DePuy Synthes (DPS) variable angle locking compression plate (VA-LCP®) Clavicle 2.7 System was designed to address these problems. The system consists of lateral, shaft and medial plates and hook plates of different sizes to cover a wide variation in clavicular morphology and diverse fracture, fracture-dislocation and dislocation indications. The objective is to describe the short and long-term clinical performance and safety of both systems, as well as the functional outcomes of this patient population. Outcomes will be collected at baseline, 2 weeks, 6 weeks, 3 months, 6 months 1, and 2 years after surgery. In addition, the surgeons' experience and utility of the devices will be surveyed. For the short term evaluation, an interim analysis will be done as soon as 30 patients in each group have completed 6 months of follow-up (FU). The final evaluation of long-term outcomes will be done after 2 years of FU. All treatments and follow-up visits are according to standard of care.


Recruitment information / eligibility

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

Study Design


Related Conditions & MeSH terms


Intervention

Device:
DPS VA-LCP® Clavicle Plate 2.7 System; DPS VA-LCP® Clavicle Hook Plate 2.7 System
The DPS VA-LCP® Clavicle Plate 2.7 System is indicated for the fixation of clavicle bone fragments. The system consists of three plate types: lateral, shaft, and medial, each available in different sizes and materials (titanium alloy and stainless steel). Each plate is available in left and right. The DPS VA-LCP® Clavicle Clavicle Hook Plate 2.7 System is indicated or the fixation of lateral clavicle fractures and AC joint dislocations. The Clavicle Hook Plate system consists of three plate types: long, short and button plates.

Locations

Country Name City State
Germany Universitätsklinikum Freiburg Freiburg
United Kingdom University College London Hospital London

Sponsors (1)

Lead Sponsor Collaborator
AO Innovation Translation Center

Countries where clinical trial is conducted

Germany,  United Kingdom, 

Outcome

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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