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.