- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00298259
Trial of Operative Fixation of Fractured Ribs in Patients With Flail Chest
Prospective Randomised Trial of Operative Fixation of Fractured Ribs in Patients With Flail Chest
Background: Fracture of several ribs in more than one place as the result of trauma, leads to paradoxical movement of the chest wall and ventilatory failure. The mainstay of management in these patients has traditionally been analgesia and positive pressure ventilation to splint the chest wall and allow healing of the ribs to begin. However, this management option leads to prolonged intensive care unit (ICU) stay with increasing complication rates as patients remain on a ventilator for prolonged periods. Patients often remain on a ventilator for two to three weeks while waiting for enough rib healing to provide sufficient chest wall stability to allow the patient to take over all their breathing themselves. Until that time, patients are at risk of pneumonia and sepsis and other complications. Long term disabilities which have been reported in these patients include ongoing pain syndromes, inability to return to work, particularly manual type labour and cosmetic chest wall deformities.
An alternative treatment strategy is to operatively fix the ribs. By fixing the ribs operatively, the patient no longer requires internal pneumatic stabilization (provided by mechanical ventilation) and can be weaned from the ventilator within days rather than weeks. This can potentially lead to earlier discharge from the intensive care unit, and an avoidance of the multiple complications which arise in the ventilated patient. Rib fixation may also lead to less pain and deformity, improved mobility in the post injury phase and earlier return to work.
Hypothesis: that early operative fixation of ribs in patients presenting with flail chest secondary to trauma will result in less mechanical ventilatory requirements, earlier discharge from the intensive care unit and lower rate of complications associated with prolonged mechanical ventilation. This will lead to cost savings in the treatment of these patients.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Victoria
-
Melbourne, Victoria, Australia, 3181
- The Alfred Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- patients with multiple (>3) fractured ribs between the level of ribs 3 to 10 resulting in a paradoxical movement of the chest wall -
Exclusion Criteria:
- age > 75 years
- Spinal injuries which would preclude placement of the patient in a lateral decubitus position
- Open rib fractures with soiling or infection
- Severe head injury
- Uncorrected coagulopathy
- Adult respiratory distress syndrome
- Sepsis
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: ORIF
open reduction internal fixation of fractured ribs in flail chest patients
|
ORIFof fractured ribs in flail chest patients
|
No Intervention: conservative management
current standard conservative management
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Mechanical ventilation hours
Time Frame: open
|
open
|
intensive care stay hours
Time Frame: open
|
open
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Silvana Marasco, FRACS, The Alfred
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 50/06
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.
Clinical Trials on Ventilation
-
Rabin Medical CenterUnknownMechanical Ventilation | Weaning | Prolonged Ventilation
-
Drägerwerk AG & Co. KGaAUniversity of Göttingen; Prof. Dr. med. ImhoffSuspendedMechanical Ventilation | Ventilation Perfusion MismatchGermany
-
Thammasat UniversityCompletedProlonged Mechanical Ventilation | Home Mechanical VentilationThailand
-
Capital Medical UniversityUnknownMechanical Ventilation | Neurosurgery | Electrical Impedance Tomography | Inhomogeneous VentilationChina
-
Prince of Songkla UniversityCompletedNewborn Morbidity | Noninvasive Ventilation | High-Frequency Ventilation | Intermittent Positive-Pressure VentilationThailand
-
JOSE IVAN RODRIGUEZ DE MOLINA SERRANOCompletedMechanical Ventilation Complication | Mechanical Power | Driving Pressure | Lung Protective VentilationMexico
-
Mbarara University of Science and TechnologyUniversity of Calgary; Alberta Children's Hospital Research Institute; The ELMA... and other collaboratorsNot yet recruitingVentilation Skills Acquisition and Retention | Ventilation Knowledge Acquisition and Retention
-
Rambam Health Care CampusCompletedOne Lung Ventilation | Continuous Positive Airway Pressure | Differential Lung VentilationIsrael
-
Ligue Pulmonaire GenevoiseCompleted
-
Assiut UniversityCompleted
Clinical Trials on operative fixation of fractured ribs
-
Virginia Commonwealth UniversitySynthes Inc.Terminated
-
University of British ColumbiaCompleted
-
University of Missouri-ColumbiaWithdrawnClavicle FracturesUnited States
-
University of Missouri-ColumbiaTerminatedMetacarpal FractureUnited States
-
Peking University People's HospitalUnknown
-
The University of New South WalesUnknown
-
The University of New South WalesCROSSBAT InvestigatorsCompletedAnkle FracturesAustralia
-
Cedars-Sinai Medical CenterUnknown
-
University of Maryland, BaltimoreIndiana University HealthCompletedLC Pelvic FractureUnited States
-
Unity Health TorontoOrthopaedic Trauma Association; Osteosynthesis & Trauma CareCompletedShoulder DislocationCanada