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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT03539029
Other study ID # 2018-00513
Secondary ID
Status Completed
Phase
First received
Last updated
Start date May 1, 2018
Est. completion date April 30, 2020

Study information

Verified date March 2024
Source University Hospital, Basel, Switzerland
Contact n/a
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

The decision whether to operate an ankle fracture or not is often highly dependent on the surgeon's individual judgment. There is consensus that non-displaced Weber A-type fractures rarely require operative treatment, and that Weber C-type or grossly displaced fractures are unstable and therefore require surgery. The decision for appropriate treatment is less clear for minimally displaced Weber B-type ankle fractures, and especially Weber B1 fractures are treated either surgically or conservatively at our clinic. Conservative management of ankle fractures generally comprises immobilisation in a below-knee VacoPed or cast for six weeks to stabilise the fracture and allow osseous and soft tissue healing. Surgical treatment involves the reduction (if displaced) of the fractured fragments and fixation using various devices such as metal plates, screws, or intramedullary rods. While patients show changes in plantar pressure distribution during gait 18 months after surgical treatment of ankle fractures, to date the functional outcome regarding ankle joint mechanics during daily activities are unknown. Understanding gait function is important because compromised function may not only limit a persons daily activities but also may lead to secondary conditions such as osteoarthritis at the ankle or at adjacent joints. The primary objective is: • To compare differences in hindfoot and forefoot kinematics between level and uphill treadmill walking in relation to passive range of motion The secondary objectives are: - To compare ankle biomechanics during overground walking and level and uphill treadmill walking between patients with Weber B1 fracture treated either surgically or conservatively and healthy control persons. - To determine the relationship between passive ankle range of motion, lower leg muscle strength and dynamic ankle range of motion. - To determine the relationship between lower leg muscle strength and balance. - To determine the relationship between dynamic range of motion and the Foot and Ankle Outcome Score.


Description:

At the initial assessment, written informed consent will be obtained before participants will undergo a clinical exam (inspection and palpation of the foot, measurement of bilateral passive ankle range of motion). All participants will complete the Foot and Ankle Outcome score and the EQ-5D-5L health questionnaire to obtain pain and functional scores. Participants will be able to familiarize with treadmill walking at their preferred walking speed. Surface electrodes will be placed bilaterally over the tibialis anterior, gastrocnemius medialis and lateralis, soleus, and peroneus longus. Isokinetic muscle strength in ankle plantarflexion/ dorsiflexion will be tested using the Biodex system 4 Pro. Reflective surface markers will be placed bilaterally on anatomic landmarks according to the PlugIn Gait model9 and a specific foot model. These markers are seen by 8 Vicon cameras. Data for a standing reference trial will be collected, and participants will be asked to walk back and forth on a flat walkway until three valid left and right steps will be recorded (force plate hit centrally, approximately 10 minutes). Then, they will be asked to balance on one leg for 30 seconds per leg. Participants will be asked to stand on the treadmill (h/p cosmos, Zebris), and they will perform three single-limb heel rises with each leg while kinematic, electromyography (EMG), and pressure data will be measured. Participants will then walk barefoot for 2 minutes at 0% slope while kinematic, EMG, and pressure data will be recorded. Subsequently, the treadmill incline will be increased to 15%, and data for 2 minutes walking at this slope will be recorded.


Recruitment information / eligibility

Status Completed
Enrollment 29
Est. completion date April 30, 2020
Est. primary completion date April 30, 2020
Accepts healthy volunteers
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Age = 18 years - Surgical or conservative treatment after lateral malleolar fracture - =12 months follow-up Exclusion Criteria: - Neuromuscular disorders affecting gait - Additional pathologies that influence the mobility of the ankle joint - Bilateral trauma at presentation - Persistent use of walking aids - Inability to provide informed consent

Study Design


Related Conditions & MeSH terms


Intervention

Procedure:
Surgery
Surgical fracture fixation
Conservative treatment
immobilisation with plaster cast

Locations

Country Name City State
Switzerland University Hospital Basel Basel Basel Stadt

Sponsors (1)

Lead Sponsor Collaborator
University Hospital, Basel, Switzerland

Country where clinical trial is conducted

Switzerland, 

Outcome

Type Measure Description Time frame Safety issue
Primary 3D hindfoot and forefoot range of motion during level and uphill walking assessed in degrees as max plantarflexion to max dorsiflexion of the ankle using marker and camera based motion capture Baseline
Secondary single leg balance length of center of pressure during 30sec single leg stance measured in mm Baseline
Secondary ankle power dynamic ankle power during walking measured in Nm/s Baseline
Secondary Isokinetic strength in plantarflexion, dorsiflexion, inversion, and eversion Max moment assessed using a Biodex measured as Nm Baseline
Secondary Lower leg muscle activation Max electromyographic signal intensity measured in mV Baseline
Secondary clinical outcome assessed using the Foot and Ankle Outcome score (100 - no problems, 0 - extreme problems) Baseline
Secondary Health related quality of life assessed using the EQ-5D-5L health questionnaire (100 - best healthy you can imagine; 0 - worst health you can imagine) Baseline
Secondary Pain in the ankle joint assessed using a 15 cm visual analogue scale converted to 0 to 100 scale (0 - no pain; 100 - worst pain imaginable) Baseline
Secondary heel rise performance To assess the single-limb heel rise ability, participants will complete three single-limb heel rise to maximum possible height. Heel rises will be performed with straight knees Baseline
See also
  Status Clinical Trial Phase
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Completed NCT04168307 - Physiotherapy Versus Use of a New Ankle Trainer Device After Ankle Fracture Operation. N/A
Completed NCT04437355 - Operative Treatment of Ankle Fractures N/A
Recruiting NCT05445960 - Correlation Between Intraoperative Tourniquet Use and Limb pH, Functional Measures and Patient-reported Outcomes After Ankle Fracture Surgery N/A