A Prospective Trial Comparing the Cost of Post Operative X-rays for Fractures Treated With Stable Internal Fixation

NCT ID: NCT01644344

Last Updated: 2012-10-04

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

39 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-01-31

Study Completion Date

2012-08-31

Brief Summary

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The standard post-operative radiographic protocol for the monitoring of fractures at HSC includes post-operative in hospital radiographs as well as radiographs at the two week follow up appointment. This is in addition to good quality intra-operative radiographs. With current operative techniques and implants, orthopaedic surgeons can achieve reliably stable internal fixation. In fact, patients are often allowed to take weight through the fractured limb immediately post-operatively. In these cases, redundant post-operative radiographs likely represent an avoidable cost to the system financially, and an avoidable cost to the patient in additional time spent in hospital and unnecessary radiation exposure.

Detailed Description

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Conditions

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Simplified Postoperative Radiographs

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Caregivers

Study Groups

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X-ray

Control group: patients will receive standard radiographs post-operative day one or two in hospital, as well as radiographs in clinic at two and six weeks. Each time radiographs are completed, the surgeon or resident will document if a change in fixation position is noted and if a change in patient management will be entertained (addition, modification or maintenance of cast or splint use, modification of or decision not to advance activity level, need for further surgery to adjust fixation or fracture reduction). The patients' time spent in clinic will be recorded upon arrival and upon completion of the patient-physician interaction.

Group Type ACTIVE_COMPARATOR

Xray

Intervention Type OTHER

No X-ray

Group Type ACTIVE_COMPARATOR

No-Xray

Intervention Type OTHER

Treatment group: these patients will not have routine post-operative in hospital radiographs, or radiographs in clinic at two weeks. After examining the patient, the surgeon or resident can order radiographs if required at any time. The decision will be made based on patient complaints of increased pain, appearance of abuse of the splint or cast suggesting lack of compliance or visible clinical deformity of the limb. The reason leading to radiographs will be documented by the ordering physician. If radiographs are ordered based on a wound complication, this will be specifically documented. Radiographic findings will be documented on a form identical to that used for the control group.

Interventions

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No-Xray

Treatment group: these patients will not have routine post-operative in hospital radiographs, or radiographs in clinic at two weeks. After examining the patient, the surgeon or resident can order radiographs if required at any time. The decision will be made based on patient complaints of increased pain, appearance of abuse of the splint or cast suggesting lack of compliance or visible clinical deformity of the limb. The reason leading to radiographs will be documented by the ordering physician. If radiographs are ordered based on a wound complication, this will be specifically documented. Radiographic findings will be documented on a form identical to that used for the control group.

Intervention Type OTHER

Xray

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Femur fracture treated with intramedullary nailing
* Tibia fracture treated with intramedullary nailing
* Ankle fractures treated with standard compression technique
* Humeral shaft fractures treated with standard compression technique
* Forearm fractures treated with standard compression technique
* One or both bones fractured
* Simple fracture or presence of single butterfly fragment treated with lag screw
* Clavicle fracture treated with standard compression technique
* Olecranon fracture treated with standard compression technique

Exclusion Criteria

* Age \< 17 years, or open growth plates
* Multiple orthopaedic fractures
* History of radiographic appearance of osteoporosis or osteopenia or poor operative bone quality
* Likely difficult with follow-up in first 6 weeks
* Same day surgery case
* Surgeon feels patient should be excluded
Minimum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Health Sciences Centre Foundation, Manitoba

OTHER

Sponsor Role collaborator

University of Manitoba

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Health Sciences Centre

Winnipeg, Manitoba, Canada

Site Status

Countries

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Canada

Other Identifiers

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RI1211:135

Identifier Type: -

Identifier Source: org_study_id