Osteosynthesis of Intraarticular Calcaneal Fractures: Arthroscopically Assisted Percutaneous Technique Versus Sinus Tarsi Approach

NCT ID: NCT04372251

Last Updated: 2024-12-09

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

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

70 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-05-05

Study Completion Date

2031-12-31

Brief Summary

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In this randomized controlled trial, the outcomes of two surgical techniques for intraarticular calcaneal fractures will be evaluated and compared.

Detailed Description

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Operative treatment of calcaneal features through an extensile lateral approach (ELA) has been the gold standard over many years despite high rates of infection and soft tissue complications.

Lately, there has been a trend towards less invasive fixation methods. Minimally invasive plate osteosynthesis using the sinus tarsi approach (STA) has gained popularity during the last decade.

Furthermore, percutaneous reduction and fixation techniques have been described and used for a few decades. In the early 2000s, Rammelt et al. were the first who introduced a percutaneous technique assisted by hindfoot arthroscopy. The percutaneous and arthroscopically assisted calcaneal osteosynthesis (PACO) is applicable in Sanders II and III fractures and has been shown to provide good clinical outcomes as well as a low rate of complications.

The study is designed as a superiority study. Our hypothesis is that the percutaneous and arthroscopically assisted technique provides superior outcomes compared to the sinus tarsi approach in Sanders II and III calcaneal fractures.

Conditions

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Calcaneus Fracture

Keywords

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Calcaneal fracture Subtalar arthroscopy Trauma Calcaneus

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Two-arm parallel assignment. Patients er randomized to operative treatment with either the sinus tarsi approach or percutaneous and arthroscopically assisted osteosynthesis.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators
The investigators that will conduct the follow-up examinations 2 and 5 years after surgery will be blinded for the operative treatment.

Study Groups

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Sinus tarsi approach (STA)

Patients randomized to this arm are operated with plate osteosynthesis via the sinus tarsi approach

Group Type ACTIVE_COMPARATOR

Sinus tarsi approach (STA)

Intervention Type PROCEDURE

Osteosynthesis

Percutaneous Arthroscopically Assisted Osteosynthesis (PACO)

Patients randomized to this arm are operated with percutaneous reduction of the fracture and osteosynthesis with screws, assisted by subtalar arthroscopy

Group Type ACTIVE_COMPARATOR

Percutaneous Arthroscopically Assisted Osteosynthesis (PACO)

Intervention Type PROCEDURE

Osteosynthesis

Interventions

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Sinus tarsi approach (STA)

Osteosynthesis

Intervention Type PROCEDURE

Percutaneous Arthroscopically Assisted Osteosynthesis (PACO)

Osteosynthesis

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Dislocated intraarticular calcaneal fracture, type Sanders II or Sanders III with an intraarticular step \> 2mm
* Patients between 18 and 70 years of age
* Acute presentation at one of our departments, enabling surgery within 10 days after injury

Exclusion Criteria

* Intraarticular step of \< 2mm
* Sanders IV fractures
* Open fractures
* Bilateral injuries
* Concomitant major injuries of the foot, ankle or leg that affect the rehabilitation process
* Multitraumized patients
* Previous injury or surgery of the hindfoot
* Charcot foot
* Serious medical condition that contradicts surgery
* Noncompliant patients
* Insufficient Norwegian or English language skills
* Patients not available for follow-up
* Inability to conduct the rehabilitation protocol
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Oslo University Hospital

OTHER

Sponsor Role collaborator

Haukeland University Hospital

OTHER

Sponsor Role collaborator

Vestre Viken Hospital Trust

OTHER

Sponsor Role collaborator

Ostfold Hospital Trust

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Are Stødle, MD

Role: PRINCIPAL_INVESTIGATOR

Oslo University Hospital

Frede Frihagen, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Ostfold Hospital Trust

Locations

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Haukeland University Hospital

Bergen, , Norway

Site Status

Vestre Viken Hospital Trust - Drammen hospital

Drammen, , Norway

Site Status

Oslo university hospial

Oslo, , Norway

Site Status

Vestre Viken Hospital Trust - Bærum hospital

Sandvika, , Norway

Site Status

Østfold Hospital Trust

Sarpsborg, Østfold fylke, Norway

Site Status

Countries

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Norway

Other Identifiers

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20/00912

Identifier Type: -

Identifier Source: org_study_id