A Trial Comparing Circumferential Casting Versus Splinting in Displaced Colles' Fractures

NCT ID: NCT00704743

Last Updated: 2008-06-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

1998-11-30

Study Completion Date

2004-01-31

Brief Summary

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Displaced fractures of the distal radius requiring closed reduction (otherwise known as Colles fractures) are common in the emergency department. The purpose of the study is to determine if there is any difference between 3 methods of immobilization for these fractures: circumferential cast, volar-dorsal splint, and modified sugar tong splint. Maintenance of position was assessed at 4 weeks after the injury and wrist strength and function were assessed at 2 months and 6 months. We hypothesize that there will not be a clinically important difference between these methods of immobilizing for displaced fractures of the distal radius requiring closed reduction.

Extended description of the protocol, including information not already contained in other fields.

Objectives:

Primary: To determine the effectiveness of three immobilization methods (circumferential cast \[CC\], volar dorsal splint \[VDS\], modified sugar-tong \[MST\] splint) in maintaining the position of displaced distal radius fractures after successful closed reduction.

Secondary to assess long term functional outcomes associated with fiberglass splint immobilization versus standard cylindrical casting in patients maintaining initial non-operative reductions.

Design: Randomized prospective single blind controlled trial Patients/Participants: Patients over 18 years of age who presented to the emergency department with a displaced fracture of the distal radius, requiring closed reduction.

Outcome Measurements: Loss of reduction (radiological slippage or the need for surgical fixation during the 3-4 week primary immobilization period after initial successful reduction). Secondary outcomes were DASH score, return to work, activities of daily living (ADL), wrist pain, range of motion (ROM) and grip strength.

Study Phase Phase 3 Study Type Interventional - Assigned to treatment Recruitment status Completed 2003 Record Verification Date March 2003 Anticipated trial start date November 1998 Last Follow-Up Date December 2002 Data Entry Closure Date January 2004 Study Completion Date July 2004 Purpose Treatment Allocation Randomized

Masking Single Blind Control Active Assignment Parallel Endpoints Efficacy Primary outcome Radiologic slippage of fracture at 4 weeks post reduction

Key secondary outcomes Functional outcomes: DASH score, return to work, activities of daily living (ADL), wrist pain, range of motion (ROM) and grip strength

Detailed Description

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Primary: To determine the effectiveness of three immobilization methods (circumferential cast \[CC\], volar dorsal splint \[VDS\], modified sugar-tong \[MST\] splint) in maintaining the position of displaced distal radius fractures after successful closed reduction.

Secondary to assess long term functional outcomes associated with fiberglass splint immobilization versus standard cylindrical casting in patients maintaining initial non-operative reductions.

Design: Randomized prospective single blind controlled trial Patients/Participants: Patients over 18 years of age who presented to the emergency department with a displaced fracture of the distal radius, requiring closed reduction.

Outcome Measurements: Loss of reduction (radiological slippage or the need for surgical fixation during the 3-4 week primary immobilization period after initial successful reduction). Secondary outcomes were DASH score, return to work, activities of daily living (ADL), wrist pain, range of motion (ROM) and grip strength.

Conditions

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Colles' Fracture

Keywords

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Colles fracture treatment Displaced fracture of distal radius distal radius fracture treatment RCT Emergency Department cast splint treatment

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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1

Cylindrical cast

Group Type ACTIVE_COMPARATOR

Cylindrical cast

Intervention Type DEVICE

Arm cast/immobilization technique for wrist fracture

2

Modified sugar tong cast

Group Type ACTIVE_COMPARATOR

Modified sugar tong cast

Intervention Type DEVICE

Arm cast/immobilization technique for wrist fracture

3

Volar dorsal splint

Group Type ACTIVE_COMPARATOR

Volar dorsal splint

Intervention Type DEVICE

Arm cast/immobilization technique for wrist fracture

Interventions

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Cylindrical cast

Arm cast/immobilization technique for wrist fracture

Intervention Type DEVICE

Modified sugar tong cast

Arm cast/immobilization technique for wrist fracture

Intervention Type DEVICE

Volar dorsal splint

Arm cast/immobilization technique for wrist fracture

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Age \> 18 years
* Displaced fracture of distal radius requiring closed reduction

Exclusion Criteria

* Open fracture
* Previous displaced fracture involving the same or contralateral distal radius
* neuromuscular deficits or CVA of either upper extremity that impaired functional outcome assessment
* concurrent carpal bone fractures or dislocations - - unstable fractures requiring primary open reduction and internal fixation
* skin allergy or sensitivity to either of the immobilization materials
* Smith's, Barton's or Chauffeur fractures
* Neurovascular compromise of the affected limb - - Bilateral distal radius fractures that prevented follow-up comparison with a normal contralateral limb
* Other significant and concurrent injuries in the ipsilateral extremity.
* Undisplaced distal radius fracture
* Reduction performed in the ED did not meet criteria for successful fracture reduction
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Smith & Nephew, Inc.

INDUSTRY

Sponsor Role collaborator

University of British Columbia

OTHER

Sponsor Role lead

Responsible Party

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University of British Columbia

Principal Investigators

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Robert Stenstrom, MD, Ph.D

Role: PRINCIPAL_INVESTIGATOR

University of British Columbia

Eric Grafstein, MD

Role: STUDY_DIRECTOR

University of British Columbia

Locations

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Department of Emergency Medicine, St Paul's Hospital

Vancouver, British Columbia, Canada

Site Status

Countries

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Canada

Other Identifiers

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P98-0172

Identifier Type: -

Identifier Source: org_study_id