Effectiveness of Immobilization in the Postoperative Analgesia of Surgically Treated Distal Radius Fractures

March 14, 2018 updated by: Fernando B Andrade-Silva, MD, University of Sao Paulo

Effectiveness of Immobilization in the Postoperative Analgesia of Patients With Distal Radius Fracture Treated With Volar Locking Plating: a Prospective, Randomized Clinical Trial

The purpose of this study is to determine wether postoperative immobilization is effective in controlling the pain of patients with intra-articular distal radius fractures treated with volar locking plate fixation. The study hypotheses is that postoperative immobilization does not enhance the analgesia of these patients.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Volar locking plate fixation has been used as the gold standard treatment for intra-articular distal radius fractures. The need for postoperative immobilization after this type of fixation is controversial, with some authors advocating its use for analgesia. Conversely, the use of immobilization might retard the recovery of wrist range of motion and function. The objective of this study is to compare the level of pain and function of patients undergoing surgical fixation of distal radius fractures using or not postoperative immobilization. Patients will be randomly assigned to receive a plaster splint or conventional dressing immediately after the surgery. The main outcome is the level of pain in the first two weeks postoperatively.

Study Type

Interventional

Enrollment (Actual)

39

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • SP
      • Sao Paulo, SP, Brazil, 05403010
        • Institute of Orthopedics and Traumatology - University of Sao Paulo

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Intra-articular distal radius fracture treated with volar locking plate fixation;
  • Fracture occurred within the prior 30 days;
  • Consent to participate in the study

Exclusion Criteria:

  • Concomitant fracture of the ipsilateral upper limb
  • Previous lesion of the ipsilateral upper limb with functional deficit
  • Bilateral fracture
  • Concomitant neurologic injury
  • Patient not amenable to follow-up

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: No immobilization
Patients receive a conventional dressing made with gauze, cotton padding and inelastic bandage after the surgery. They are instructed to start light wrist movements on the first postoperative day and progress as tolerated, beginning rehabilitation with physiotherapy after 2 weeks postoperatively.
Conventional wrist dressing
Active Comparator: Volar splint
Patients receive a volar plaster splint with inelastic bandage after the surgery, and are instructed not to remove the immobilization for 2 weeks. After this period, the immobilization is removed and patients begin rehabilitation with physiotherapy.
Volar plaster splint

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Level of pain
Time Frame: 12 hours
Visual analogue scale for pain
12 hours
Level of pain
Time Frame: 18 hours
Visual analogue scale for pain
18 hours
Level of pain
Time Frame: 24 hours
Visual analogue scale for pain
24 hours
Level of pain
Time Frame: Once a day in the first week
Visual analogue scale for pain
Once a day in the first week
Level of pain
Time Frame: 2 weeks
Visual analogue scale for pain
2 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Level of pain
Time Frame: 6 weeks
Visual analogue scale for pain
6 weeks
Level of pain
Time Frame: 3 months
Visual analogue scale for pain
3 months
Level of pain
Time Frame: 6 months
Visual analogue scale for pain
6 months
DASH score
Time Frame: 6 weeks
Disabilities of the Arm, Shoulder and Hand (DASH)
6 weeks
DASH score
Time Frame: 3 months
Disabilities of the Arm, Shoulder and Hand (DASH)
3 months
DASH score
Time Frame: 6 months
Disabilities of the Arm, Shoulder and Hand (DASH)
6 months
Wrist flexion-extension arc
Time Frame: 2 weeks
Assessed by goniometry
2 weeks
Wrist flexion-extension arc
Time Frame: 6 weeks
Assessed by goniometry
6 weeks
Wrist flexion-extension arc
Time Frame: 3 months
Assessed by goniometry
3 months
Wrist flexion-extension arc
Time Frame: 6 months
Assessed by goniometry
6 months
Forearm rotation arc
Time Frame: 2 weeks
Assessed by goniometry
2 weeks
Forearm rotation arc
Time Frame: 6 weeks
Assessed by goniometry
6 weeks
Forearm rotation arc
Time Frame: 3 months
Assessed by goniometry
3 months
Forearm rotation arc
Time Frame: 6 months
Assessed by goniometry
6 months
Tramadol use
Time Frame: Once a day in the first week post-op
Percentage of patients requesting additional analgesia with tramadol in the first week
Once a day in the first week post-op
Complication
Time Frame: up to 24 weeks
Percentage of patients presenting with any type of local orthopedic complication
up to 24 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Study Chair: Kodi E Kojima, MD, Institute of Orthopedics - University of Sao Paulo

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

May 1, 2013

Primary Completion (Actual)

June 1, 2017

Study Completion (Actual)

November 1, 2017

Study Registration Dates

First Submitted

January 19, 2017

First Submitted That Met QC Criteria

June 12, 2017

First Posted (Actual)

June 14, 2017

Study Record Updates

Last Update Posted (Actual)

March 16, 2018

Last Update Submitted That Met QC Criteria

March 14, 2018

Last Verified

March 1, 2018

More Information

Terms related to this study

Other Study ID Numbers

  • Distalradius

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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