Study Comparing Plate Stabilization to Conservative Treatment in Midshaft Clavicle Fractures

NCT ID: NCT01199653

Last Updated: 2010-09-13

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

PHASE2/PHASE3

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-08-31

Study Completion Date

2009-11-30

Brief Summary

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The purpose of this study is to find whether to operate or treat conservatively dislocated midshaft clavicle fractures.

Detailed Description

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Midshaft clavicle fractures are common comprising 2% of all fractures and 35% to 45% of all shoulder girdle injuries in adults. Old-established treatment practices, based on no randomised controlled trials, are used for clavicle fractures. By tradition, midshaft clavicle fractures have been treated conservatively with arm immobilized to a sling for few weeks. The goal of treatment is to restore painless function of the upper extremity.

There have been some recommendations for operative treatment, such as skin compromising in fracture area, open fracture, floating shoulder, neurovascular symptoms in upper extremity, or multiple injuries. Recently, increasing interest has emerged in the surgical treatment.

Conditions

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Clavicle Fracture

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Non-operative treatment

Non-operative (conservative) treatment of the clavicle fracture

Group Type ACTIVE_COMPARATOR

Non-operative treatment with arm immobilised to a sling

Intervention Type PROCEDURE

Arm is immobilised to a sling for three weeks. Pendulum movements are allowed immediately.

Operative treatment

Operative stabilization (i.e. ORIF) of the fracture with a plate and screws.

Group Type ACTIVE_COMPARATOR

Operative treatment

Intervention Type PROCEDURE

Fracture stabilization with stainless steel reconstruction plate and screws. After the operation arm is immobilized to a sling for three weeks. Pendulum movements are allowed immediately.

Interventions

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Operative treatment

Fracture stabilization with stainless steel reconstruction plate and screws. After the operation arm is immobilized to a sling for three weeks. Pendulum movements are allowed immediately.

Intervention Type PROCEDURE

Non-operative treatment with arm immobilised to a sling

Arm is immobilised to a sling for three weeks. Pendulum movements are allowed immediately.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* a completely displaced middle third clavicle fracture, no cortical contact between main fragments
* fresh fracture, treatment within seven days after injury
* age between 18 and 70 years
* provided informed consent

Exclusion Criteria

* fracture was not dislocated
* multiple injured patient
* associated neurovascular injury, or suspicion of it
* reduced cooperation
* cancer or any severe illness impairing health
* pathological fracture
* treatment seven days after injury
* open fracture
* corticosteroid or immunosuppressive medication
* upper extremity fracture at same time
* an earlier clavicle or shoulder region fracture
* pregnancy
* lack of consent
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Helsinki University Central Hospital

OTHER

Sponsor Role lead

Responsible Party

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Helsinki University Central Hospital

Principal Investigators

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Kaisa J Virtanen, MD

Role: PRINCIPAL_INVESTIGATOR

Helsinki Uiversity Central Hospital

Ville Remes, MD PhD

Role: STUDY_CHAIR

Helsinki University Central Hospital

Jarkko Pajarinen, MD PhD

Role: STUDY_CHAIR

Helsinki University Central Hospital

Vesa Savolainen, MD PhD

Role: STUDY_CHAIR

Helsinki University Central Hospital

Jan-Magnus Björkenheim, MD PhD

Role: STUDY_CHAIR

Helsinki University Central Hospital

Mika P Paavola, MD PhD

Role: STUDY_DIRECTOR

Helsinki University Central Hospital

Locations

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Helsinki University Central Hospital, Töölö Hospital

Helsinki, Uusimaa, Finland

Site Status

Countries

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Finland

References

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Canadian Orthopaedic Trauma Society. Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am. 2007 Jan;89(1):1-10. doi: 10.2106/JBJS.F.00020.

Reference Type BACKGROUND
PMID: 17200303 (View on PubMed)

Hill JM, McGuire MH, Crosby LA. Closed treatment of displaced middle-third fractures of the clavicle gives poor results. J Bone Joint Surg Br. 1997 Jul;79(4):537-9. doi: 10.1302/0301-620x.79b4.7529.

Reference Type BACKGROUND
PMID: 9250733 (View on PubMed)

McKee MD, Seiler JG, Jupiter JB. The application of the limited contact dynamic compression plate in the upper extremity: an analysis of 114 consecutive cases. Injury. 1995 Dec;26(10):661-6. doi: 10.1016/0020-1383(95)00148-4.

Reference Type BACKGROUND
PMID: 8745801 (View on PubMed)

NEER CS 2nd. Nonunion of the clavicle. J Am Med Assoc. 1960 Mar 5;172:1006-11. doi: 10.1001/jama.1960.03020100014003. No abstract available.

Reference Type BACKGROUND
PMID: 14426324 (View on PubMed)

Nordqvist A, Petersson C. The incidence of fractures of the clavicle. Clin Orthop Relat Res. 1994 Mar;(300):127-32.

Reference Type BACKGROUND
PMID: 8131324 (View on PubMed)

Nowak J, Holgersson M, Larsson S. Can we predict long-term sequelae after fractures of the clavicle based on initial findings? A prospective study with nine to ten years of follow-up. J Shoulder Elbow Surg. 2004 Sep-Oct;13(5):479-86. doi: 10.1016/j.jse.2004.01.026.

Reference Type BACKGROUND
PMID: 15383801 (View on PubMed)

Nowak J, Mallmin H, Larsson S. The aetiology and epidemiology of clavicular fractures. A prospective study during a two-year period in Uppsala, Sweden. Injury. 2000 Jun;31(5):353-8. doi: 10.1016/s0020-1383(99)00312-5.

Reference Type BACKGROUND
PMID: 10775691 (View on PubMed)

Poigenfurst J, Rappold G, Fischer W. Plating of fresh clavicular fractures: results of 122 operations. Injury. 1992;23(4):237-41. doi: 10.1016/s0020-1383(05)80006-3.

Reference Type BACKGROUND
PMID: 1618563 (View on PubMed)

Zlowodzki M, Zelle BA, Cole PA, Jeray K, McKee MD; Evidence-Based Orthopaedic Trauma Working Group. Treatment of acute midshaft clavicle fractures: systematic review of 2144 fractures: on behalf of the Evidence-Based Orthopaedic Trauma Working Group. J Orthop Trauma. 2005 Aug;19(7):504-7. doi: 10.1097/01.bot.0000172287.44278.ef.

Reference Type BACKGROUND
PMID: 16056089 (View on PubMed)

Other Identifiers

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T102020Z12

Identifier Type: OTHER

Identifier Source: secondary_id

TYH6267

Identifier Type: -

Identifier Source: org_study_id