The Effect of Point-of-care Ultrasound Guidance for Distal Radius Fracture Reduction

NCT ID: NCT02962206

Last Updated: 2024-07-29

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 22 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2017-01-10
• Study Completion Date: 2018-06-30

Brief Summary

Distal radius (Colle's) fractures in adult patients are commonly reduced in the emergency department before casting. Standard of care currently requires that x-rays be performed before and after fracture reduction, and inadequate reductions may be subject to repeat attempts and are at a higher risk to require surgery. This study will assess the use of point-of-care ultrasound (POCUS) in addition to standard care as a tool to decrease the angulation at the fracture site after a reduction is performed. If this angulation is decreased, it would suggest that POCUS for distal radius fracture reduction could decrease the number of failed reduction attempts and therefore the number of repeated reduction attempts.

Conditions

Point-of-care Ultrasound, Distal Radius Fracture

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Standard of care

Patients will undergo standard closed fracture reduction. The sedation type, reduction method, and immobilization method will be at the discretion of the treating physician. Point-of-care ultrasound will not be used.

Group Type: ACTIVE_COMPARATOR

Closed fracture reduction

Intervention Type: PROCEDURE

The distal radius fracture will be reduced with using a combination of local anesthetic, sedation, reduction maneouvers and immobiliazation at the discretion of the treating physician

Experimental Group

Patients will undergo standard closed fracture reduction with the addition of point-of-care ultrasound use to assess post-reduction dorsal angulation. The sedation type, reduction method, and immobilization method will be at the discretion of the treating physician.

Group Type: EXPERIMENTAL

Point-of-care ultrasound

Intervention Type: DEVICE

After the fracture reduction maneouver, the physician will assess residual dorsal angulation using point-of-care ultrasound. If deemed adequate, the physician will progress to immobilization. If the reduction is not adequate, the physician will attempt further reduction at their discretion.

Closed fracture reduction

Intervention Type: PROCEDURE

The distal radius fracture will be reduced with using a combination of local anesthetic, sedation, reduction maneouvers and immobiliazation at the discretion of the treating physician

Interventions

Point-of-care ultrasound

After the fracture reduction maneouver, the physician will assess residual dorsal angulation using point-of-care ultrasound. If deemed adequate, the physician will progress to immobilization. If the reduction is not adequate, the physician will attempt further reduction at their discretion.

Intervention Type: DEVICE

Closed fracture reduction

The distal radius fracture will be reduced with using a combination of local anesthetic, sedation, reduction maneouvers and immobiliazation at the discretion of the treating physician

Intervention Type: PROCEDURE

Other Intervention Names

POCUS

Eligibility Criteria

Inclusion Criteria

• radiographically confirmed distal radius fracture

Exclusion Criteria

• patients who do not consent
• patients with multiple acute injuries, open fractures, or other local fractures evident (a simple ulnar styloid fracture will not be considered an exclusion criterion)
• patients with neurovascular compromise
• patients with bilateral distal radius fractures
• patients with minimally displaced distal radius fractures that do not require closed reduction before casting

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's

OTHER

Sponsor Role: collaborator

Marcus Van Aarsen

OTHER

Sponsor Role: lead

Responsible Party

Marcus Van Aarsen

Resident Physician

Responsibility Role: SPONSOR_INVESTIGATOR

Locations

St. Joseph's Health Care London

London, Ontario, Canada

London Health Sciences Centre

London, Ontario, Canada

Countries

Canada

Other Identifiers

107331

Identifier Type: -

Identifier Source: org_study_id