Suture Fixation Versus Tension Band Wiring of Simple Displaced Olecranon Fractures

NCT ID: NCT04189185

Last Updated: 2019-12-06

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

88 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-12-05

Study Completion Date

2023-11-20

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Simple displaced olecranon fractures are most often treated with tension band wiring. This is an effective treatment, but the risk of subsequent re-operation is high. The investigators propose open reduction and internal fixation with a strong suture, thus reducing the risk of re-operation significantly.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Background Olecranon fractures are frequent with an incidence of 11.5 per 100.000 people per year. Olecranon fractures are classified according to the Mayo classification in three groups. Type 1A and B are treated conservatively, while comminute fractures of type Mayo 2B and 3B are treated with plate osteosynthesis.

The most common type is a simple two part fracture, Mayo type 2A, which represents 74% of all olecranon fractures. The typical treatment of Mayo type 2A fractures is osteosynthesis using k-wires and tension band wiring. This provides adequate fracture healing and good functional results. The use of plate osteosynthesis for Mayo type 2A fractures does not provide functional or health economic benefits compared with operation with tension band wiring.

Common for both techniques is a high risk of re-operation due to delayed healing of the surgical wound, and complications arising from the implanted material.

Recently, new techniques for Mayo type 2A fractures have been described, in which no metal is implanted. Osteosynthesis is achieved with strong sutures. These techniques have been shown to reduce the high risk of complications leading to re-operation without effecting the functional outcome or fracture healing rate.

Hypothesis The investigators hypothesize that suture fixation of Mayo type 2A fractures will decrease the risk of re-operation and provide equal functional outcome compared with tension band wiring.

Design Prospective, randomized multicenter study

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Olecranon Fracture

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Two study arms. One arm is treated with k-wire tension band wiring and one leg is treated with suture fixation
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors
An envelope deciding the treatment modality is drawn while the patient is anesthetized. Post operative follow-up is performed by blinded assessors. The treatment will be revealed after one year, or if the patient is excluded from the study.

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

K-wire tension band wiring

The patient is treated with 1.6 mm k-wires and 1 mm cerclage

Group Type ACTIVE_COMPARATOR

Suture fixation

Intervention Type PROCEDURE

The fracture is reduced. A 2.5 mm hole is drilled in the dorsal olecranon 15mm from the fracture. A suture is passed through the hole and is fixed to the triceps muscle. A second suture is fixed to the triceps muscle in a figure 8 configuration.

Suture fixation

The fracture is reduced and fixed with 2.0 Orthocord suture.

Group Type ACTIVE_COMPARATOR

Suture fixation

Intervention Type PROCEDURE

The fracture is reduced. A 2.5 mm hole is drilled in the dorsal olecranon 15mm from the fracture. A suture is passed through the hole and is fixed to the triceps muscle. A second suture is fixed to the triceps muscle in a figure 8 configuration.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Suture fixation

The fracture is reduced. A 2.5 mm hole is drilled in the dorsal olecranon 15mm from the fracture. A suture is passed through the hole and is fixed to the triceps muscle. A second suture is fixed to the triceps muscle in a figure 8 configuration.

Intervention Type PROCEDURE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Olecranon fracture, Mayo Type 2A

Exclusion Criteria

* Bilateral upper extremity fracture
* Open fracture
* Neurovascular affection
* Injury to ligament, dislocation or subluxation
* Additional upper extremity fracture
* Pathological fracture
* Previous elbow issue
* Fracture more than 14 days old
* Substance abuse
* medical contraindication for surgery
* Previous fracture to the same elbow
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Regionshospitalet Horsens

OTHER

Sponsor Role collaborator

Aarhus University Hospital

OTHER

Sponsor Role collaborator

Regionshospitalet Viborg, Skive

OTHER

Sponsor Role collaborator

Kolding Sygehus

OTHER

Sponsor Role collaborator

Randers Regional Hospital

OTHER

Sponsor Role collaborator

Aalborg University Hospital

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Andreas Haubjerg Qvist

MD, Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Andreas Qvist, MD

Role: PRINCIPAL_INVESTIGATOR

Aalborg University Hostipital

Andreas Haubjerg Qvist, MD

Role: PRINCIPAL_INVESTIGATOR

Aalborg University Hospital

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Aalborg Sygehus - Farsø

Aalborg, , Denmark

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

Denmark

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Andreas Qvist, MD

Role: CONTACT

Phone: +45 9764 3000

Email: [email protected]

Bjørn Christensen, MD, PhD

Role: CONTACT

Phone: +4522449180

Email: [email protected]

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Andreas Qvist, MD

Role: primary

Bjørn Christensen, MD, PhD

Role: backup

References

Explore related publications, articles, or registry entries linked to this study.

Duckworth AD, Clement ND, Aitken SA, Court-Brown CM, McQueen MM. The epidemiology of fractures of the proximal ulna. Injury. 2012 Mar;43(3):343-6. doi: 10.1016/j.injury.2011.10.017. Epub 2011 Nov 9.

Reference Type BACKGROUND
PMID: 22077988 (View on PubMed)

Ates Y, Atlihan D, Yildirim H. Current concepts in the treatment of fractures of the radial head, the olecranon and the coronoid. J Bone Joint Surg Am. 1996 Jun;78(6):969. No abstract available.

Reference Type BACKGROUND
PMID: 8666617 (View on PubMed)

Matar HE, Ali AA, Buckley S, Garlick NI, Atkinson HD. Surgical interventions for treating fractures of the olecranon in adults. Cochrane Database Syst Rev. 2014 Nov 26;2014(11):CD010144. doi: 10.1002/14651858.CD010144.pub2.

Reference Type BACKGROUND
PMID: 25426876 (View on PubMed)

Duckworth AD, Clement ND, White TO, Court-Brown CM, McQueen MM. Plate Versus Tension-Band Wire Fixation for Olecranon Fractures: A Prospective Randomized Trial. J Bone Joint Surg Am. 2017 Aug 2;99(15):1261-1273. doi: 10.2106/JBJS.16.00773.

Reference Type BACKGROUND
PMID: 28763412 (View on PubMed)

Helm RH, Hornby R, Miller SW. The complications of surgical treatment of displaced fractures of the olecranon. Injury. 1987 Jan;18(1):48-50. doi: 10.1016/0020-1383(87)90386-x.

Reference Type BACKGROUND
PMID: 3440616 (View on PubMed)

Romero JM, Miran A, Jensen CH. Complications and re-operation rate after tension-band wiring of olecranon fractures. J Orthop Sci. 2000;5(4):318-20. doi: 10.1007/s007760070036.

Reference Type BACKGROUND
PMID: 10982677 (View on PubMed)

Snoddy MC, Lang MF, An TJ, Mitchell PM, Grantham WJ, Hooe BS, Kay HF, Bhatia R, Thakore RV, Evans JM, Obremskey WT, Sethi MK. Olecranon fractures: factors influencing re-operation. Int Orthop. 2014 Aug;38(8):1711-6. doi: 10.1007/s00264-014-2378-y. Epub 2014 Jun 4.

Reference Type BACKGROUND
PMID: 24893946 (View on PubMed)

Macko D, Szabo RM. Complications of tension-band wiring of olecranon fractures. J Bone Joint Surg Am. 1985 Dec;67(9):1396-401.

Reference Type BACKGROUND
PMID: 3908460 (View on PubMed)

Phadnis J, Watts AC. Tension band suture fixation for olecranon fractures. Shoulder Elbow. 2017 Oct;9(4):299-303. doi: 10.1177/1758573216687305. Epub 2017 Jan 18.

Reference Type BACKGROUND
PMID: 28932288 (View on PubMed)

Das AK, Jariwala A, Watts AC. Suture Repair of Simple Transverse Olecranon Fractures and Chevron Olecranon Osteotomy. Tech Hand Up Extrem Surg. 2016 Mar;20(1):1-5. doi: 10.1097/BTH.0000000000000106.

Reference Type BACKGROUND
PMID: 26630656 (View on PubMed)

Nimura A, Nakagawa T, Wakabayashi Y, Sekiya I, Okawa A, Muneta T. Repair of olecranon fractures using fiberWire without metallic implants: report of two cases. J Orthop Surg Res. 2010 Oct 12;5:73. doi: 10.1186/1749-799X-5-73.

Reference Type BACKGROUND
PMID: 20937160 (View on PubMed)

Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med. 1996 Jun;29(6):602-8. doi: 10.1002/(SICI)1097-0274(199606)29:63.0.CO;2-L.

Reference Type BACKGROUND
PMID: 8773720 (View on PubMed)

EuroQol Group. EuroQol--a new facility for the measurement of health-related quality of life. Health Policy. 1990 Dec;16(3):199-208. doi: 10.1016/0168-8510(90)90421-9.

Reference Type BACKGROUND
PMID: 10109801 (View on PubMed)

Gummesson C, Atroshi I, Ekdahl C. The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: longitudinal construct validity and measuring self-rated health change after surgery. BMC Musculoskelet Disord. 2003 Jun 16;4:11. doi: 10.1186/1471-2474-4-11. Epub 2003 Jun 16.

Reference Type BACKGROUND
PMID: 12809562 (View on PubMed)

Hunsaker FG, Cioffi DA, Amadio PC, Wright JG, Caughlin B. The American academy of orthopaedic surgeons outcomes instruments: normative values from the general population. J Bone Joint Surg Am. 2002 Feb;84(2):208-15. doi: 10.2106/00004623-200202000-00007.

Reference Type BACKGROUND
PMID: 11861726 (View on PubMed)

Qvist AH, Christensen BB. Suture fixation versus tension band wiring in simple displaced olecranon fractures - a study protocol. Dan Med J. 2024 Oct 18;71(11):A01240038. doi: 10.61409/A01240038.

Reference Type DERIVED
PMID: 39575943 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

20190039

Identifier Type: -

Identifier Source: org_study_id