Surgery Clinical Trial
Official title:
A Prospective Randomized Trial Comparing Open Reduction and Internal Fixation With Non-operative Treatment for Ulnar Shaft Fractures
Verified date | August 2022 |
Source | University of Calgary |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
The purpose of this study is to determine if surgery using a plate and screws to fix a forearm fracture (ulnar shaft) will improve functional outcome compared to non-operative treatment out to 1 year of follow-up. It is hypothesized that in skeletally mature patients with isolated ulnar shaft fractures, the patients treated with surgery will have improved functional outcomes compared to non-surgical treatment with below-elbow cast at 1-year follow-up. This will be measured by the Disabilities of the Arm, Shoulder and Hand (DASH) scores. Secondary outcomes will include SF-36, range of motion, pain, grip strength, return to work, and time to union.
Status | Active, not recruiting |
Enrollment | 100 |
Est. completion date | July 2023 |
Est. primary completion date | March 8, 2023 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 16 Years and older |
Eligibility | Inclusion Criteria: - Over 16 years of age and skeletally mature - Subject has an isolated extra-articular ulnar diaphyseal fracture - Subject presents within 14 days or less between injury and study recruitment - Patient must be medically fit for anesthesia - Subject is willing and able to provide written informed consent for trial participation - Subject is willing and able to comply with the study protocol including return for all follow-up evaluations - Subject has an isolated ulnar diaphyseal fracture (AO type 22A1.1, 22A1.2, 23A1.2, 23A1.3, 22B1.1, 22B1.2) without extension to the articular surface - Fracture is displaced, but displacement is <50% after closed reduction, if closed reduction is required - Fracture less than 30-degrees of angulation following closed reduction, if closed reduction is required Exclusion Criteria: - Subject has a pre-existing ipsilateral wrist injury, degenerative condition, or congenital anomaly - Subject has a delay in treatment greater than 14 days from time of injury - Subject has an active infection in the area of surgical approach - Subject has concomitant injury which, in the opinion of the attending surgeon, is likely to impair rehabilitation or prolong ulnar fracture healing time (another long bone fracture, ipsilateral limb injury) - Subject has a history of rheumatoid arthritis, fibrous dysplasia, chronic renal failure, Paget's disease, or osteopetrosis - Subject has a high risk of death from surgery (ASA physical status Class V) - Subject is likely unable to maintain follow-up (no fixed address, plans to move out of town in the next year, states unable to comply with protocol, etc) - Subject has cognitive impairment or language difficulties that would impeded the valid completion of questionnaires - Subject is pregnant - Subject is a prisoner, currently detained - Subject has an articular fracture (AO Type 23A1.1, 23B or 23C) - Open ulnar fracture (any Gustilo grade) - Segmental fracture - Fractures within 2 cm of the distal radioulnar joint (AO 23A1.1) - Fracture of the proximal 1/3 of the ulnar shaft (i.e. Monteggia fracture pattern, AO Type 21A, 22A1.3, 22B1.3) - Pathologic fracture |
Country | Name | City | State |
---|---|---|---|
Canada | Dr. Paul J Duffy | Calgary | Alberta |
Canada | Queen Elizabeth II Hospital | Halifax | Nova Scotia |
Canada | McGill University Health Centre | Montreal | Quebec |
Canada | Royal Columbian Hospital | New Westminster | British Columbia |
Canada | Ottawa Hospital | Ottawa | Ontario |
Canada | Memorial University | St. John's | Newfoundland and Labrador |
Canada | St. Michael's Hospital | Toronto | Ontario |
Canada | Vancouver General Hospital | Vancouver | British Columbia |
United Kingdom | North Bristol NHS Trust | Bristol |
Lead Sponsor | Collaborator |
---|---|
University of Calgary | AO Research Fund, Calgary Surgical Research Development Fund, Canadian Orthopaedic Research Legacy, Canadian Orthopaedic Trauma Society |
Canada, United Kingdom,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Disabilities of the Arm, Shoulder and Hand (The DASH) | 30-item, self-reported questionnaire that evaluates function of the affected upper extremity and will reveal the impact of the forearm injury on the function of the entire limb | 1 year | |
Secondary | Range of Motion | An evaluation of the range of motion about the wrist and the elbow for both the affected limb and the unaffected limb post-treatment. It will be evaluated starting at 2 weeks for the surgical group and at 6 weeks for the below-elbow cast group. | 2 weeks, 6 weeks, 12 weeks, 6 months, 12 months | |
Secondary | Grip Strength | An evaluation of the grip strength for both the affected limb and the unaffected limb post-treatment. | 6 weeks, 12 weeks, 6 months, 12 months | |
Secondary | Radiologic outcome - time to union (fracture healing) | Radiologic outcome will be evaluated based on bridging callus evident on 2 x-ray views (AP and lateral). Time to union will be defined as bridging callus evide on 2 x-ray views. | baseline, 2 weeks, 6 weeks, 12 weeks, 6 months, 12 months | |
Secondary | SF-36 | 36-item, self-reported questionnaire is an outcome tool that examines patient-reported overall health and ease of activities of daily living | baseline, 2 weeks, 6 weeks, 12 weeks, 6 months, 12 months | |
Secondary | Pain Visual Analogue Score | • A standardized pain visual analogue scale will be used to rate pain with various activities of daily living on a scale from 0-10 | baseline, 2 weeks, 6 weeks, 12 weeks, 6 months, 12 months | |
Secondary | DASH score | 30-item, self-reported questionnaire that evaluates function of the affected upper extremity and will reveal the impact of the forearm injury on the function of the entire limb | baseline, 2 weeks, 6 weeks, 12 weeks, 6 months, 12 months |
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