Treatment of Proximal Humeral Fractures

NCT ID: NCT01246167

Last Updated: 2020-03-10

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

NA

Total Enrollment

250 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-01-31

Study Completion Date

2019-11-30

Brief Summary

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This trial is designed to compare head-to-head conservative with operative treatment in 2 stratum. Stratum 1: In 2 part fractures the comparison is between conservative treatment and operative treatment with plate fixation with Philos. Stratum 2: In multi-fragmented fractures (MFF) meaning 3 and 4 part fractures, the comparison is between conservative treatment, operative treatment with Philos plate and operative treatment with Epoca prosthesis. Subgroup analysis will be performed in an effort to obtain limit values for specific treatment of different age and fracture groups. A cost-effectiveness analysis and comparison between different treatment modalities will be carried out. The primary outcome measure will be the DASH score and the secondary outcome measure the EQ-5D value. Recruitment period is 3 years and follow-up 2 years.

Detailed Description

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Conditions

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Humeral Fractures, Proximal

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Conservative

Active physiotherapy and self-training

Group Type ACTIVE_COMPARATOR

Control group

Intervention Type OTHER

Conservative control group

Philos locking plate

After operative treatment active physiotherapy and self-training

Group Type ACTIVE_COMPARATOR

Philos

Intervention Type DEVICE

Conservative treatment versus Philos locking plate in 2 part fracture group.

Conservative treatment versus Philos locking plating versus Epoca prosthesis in MFF group.

Epoca prosthesis

After operative treatment active physiotherapy and self-training

Group Type ACTIVE_COMPARATOR

Epoca

Intervention Type DEVICE

Conservative treatment versus Philos locking plate versus Epoca fracture prosthesis in MFF group

Interventions

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Philos

Conservative treatment versus Philos locking plate in 2 part fracture group.

Conservative treatment versus Philos locking plating versus Epoca prosthesis in MFF group.

Intervention Type DEVICE

Epoca

Conservative treatment versus Philos locking plate versus Epoca fracture prosthesis in MFF group

Intervention Type DEVICE

Control group

Conservative control group

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Low energy proximal humeral displaced (more than 1 cm or 45 degrees) 2 part fracture where fracture line emerges through the surgical (or anatomical) neck
* Low energy proximal humeral displaced (more than 1 cm or 45 degrees) 3 or 4 part fracture

Exclusion Criteria

* Refuse to participate the study
* Less than 60 years old
* Non-independent
* Dementia and/or institutionalized
* Does no understand written and spoken guidance in either Finnish or Swedish
* Pathological fracture or previous fracture in the same proximal humerus
* Serious intoxicant dependent, eg. In first aid breathalyzer shows more than 2‰
* Other operational injury in the same upper limb
* Major nerve injury (eg. Complete radialis- or delta palsy)
* Open fracture
* Multi-trauma or -fractured patient
* Fracture dislocation or head splitting fracture
* Undisplaced fracture
* Isolated tuberculum fracture
* Fracture has no precondition to ossify by conservative treatment (no bony contact between fracture parts or the humeral shaft is in contact with the articular surface)
* Treating surgeon considers patient unsuitable to attend the study on medical basis
* Cuff-arthropathy
Minimum Eligible Age

60 Years

Maximum Eligible Age

100 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Kuopio University Hospital

OTHER

Sponsor Role collaborator

Jyväskylä Central Hospital

OTHER

Sponsor Role collaborator

Karolinska University Hospital

OTHER

Sponsor Role collaborator

Tampere University

OTHER

Sponsor Role collaborator

Academy of Finland

OTHER

Sponsor Role collaborator

Uppsala University Hospital

OTHER

Sponsor Role collaborator

Aarhus University Hospital

OTHER

Sponsor Role collaborator

Regionaalhaigla, Tallinn

UNKNOWN

Sponsor Role collaborator

Tartu University Hospital

OTHER

Sponsor Role collaborator

Tampere University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Antti Launonen

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Minna Laitinen, Docent

Role: PRINCIPAL_INVESTIGATOR

Tampere University Hospital

Antti Launonen, MD

Role: STUDY_DIRECTOR

Tampere University Hospital

Pekka Rissanen, Professor

Role: STUDY_CHAIR

Tampere University

Johanna Ojanperä, MD

Role: STUDY_CHAIR

Kuopio University Hospital

Vesa Lepola, MD, PhD

Role: STUDY_CHAIR

Tampere University Hospital

Timo Viljakka, MD

Role: STUDY_CHAIR

Tampere University Hospital

Ville M Mattila, Professor

Role: STUDY_CHAIR

Tampere University Hospital

Juha Paloneva, MD PhD

Role: STUDY_CHAIR

Jyväskylä Central Hospital

Hans Berg, Docent

Role: STUDY_CHAIR

Karolinska University Hospital

Karl-Åke Jansson, Docent

Role: STUDY_CHAIR

Karolinska University Hospital

Kjeld Soballe, Professor

Role: STUDY_CHAIR

Aarhus University Hospital

Kaj Dossing, MD

Role: STUDY_CHAIR

Central Jutland Regional Hospital

Helle Ostergaard, Msc

Role: STUDY_CHAIR

Central Jutland Regional Hospital

Inger Mechlenburg, PhD

Role: STUDY_CHAIR

University of Aarhus

Locations

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Aarhus University Hospital

Aarhus, , Denmark

Site Status

Regionaalhaigla, PERH

Tallinn, , Estonia

Site Status

Jyväskylä Central Hospital

Jyväskylä, Central Finland, Finland

Site Status

Tampere University Hospital

Tampere, Pirkanmaa, Finland

Site Status

Karolinska University Hospital

Stockholm, , Sweden

Site Status

Uppsala University Hospital

Uppsala, , Sweden

Site Status

Countries

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Denmark Estonia Finland Sweden

References

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Launonen AP, Lepola V, Flinkkila T, Strandberg N, Ojanpera J, Rissanen P, Malmivaara A, Mattila VM, Elo P, Viljakka T, Laitinen M. Conservative treatment, plate fixation, or prosthesis for proximal humeral fracture. A prospective randomized study. BMC Musculoskelet Disord. 2012 Sep 7;13:167. doi: 10.1186/1471-2474-13-167.

Reference Type BACKGROUND
PMID: 22954329 (View on PubMed)

Launonen AP, Sumrein BO, Reito A, Lepola V, Paloneva J, Berg HE, Fellander-Tsai L, Kask K, Rahnel T, Tootsi K, Martson A, Jonsson KB, Wolf O, Strom P, Dossing K, Ostergaard HK, Mechlenburg I, Mattila VM, Laitinen MK. Surgery with locking plate or hemiarthroplasty versus nonoperative treatment of 3-4-part proximal humerus fractures in older patients (NITEP): An open-label randomized trial. PLoS Med. 2023 Nov 28;20(11):e1004308. doi: 10.1371/journal.pmed.1004308. eCollection 2023 Nov.

Reference Type DERIVED
PMID: 38015877 (View on PubMed)

Handoll HH, Elliott J, Thillemann TM, Aluko P, Brorson S. Interventions for treating proximal humeral fractures in adults. Cochrane Database Syst Rev. 2022 Jun 21;6(6):CD000434. doi: 10.1002/14651858.CD000434.pub5.

Reference Type DERIVED
PMID: 35727196 (View on PubMed)

Launonen AP, Sumrein BO, Reito A, Lepola V, Paloneva J, Jonsson KB, Wolf O, Strom P, Berg HE, Fellander-Tsai L, Jansson KA, Fell D, Mechlenburg I, Dossing K, Ostergaard H, Martson A, Laitinen MK, Mattila VM; as the NITEP group. Operative versus non-operative treatment for 2-part proximal humerus fracture: A multicenter randomized controlled trial. PLoS Med. 2019 Jul 18;16(7):e1002855. doi: 10.1371/journal.pmed.1002855. eCollection 2019 Jul.

Reference Type DERIVED
PMID: 31318863 (View on PubMed)

Other Identifiers

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R10127

Identifier Type: -

Identifier Source: org_study_id

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