Pelvic Ring Injury

Does Residual Displacement On Standard Radiographic Views Correlate With Pelvic Ring Injury Clinical Outcome?

The purpose of this study is to determine whether displacement on one or all of the standard radiography views done within 6 months and 1 year after a pelvic injury is related to health related quality of life outcomes of patients with an isolated pelvic ring injury.

Study Overview

• Status: Completed
• Conditions: Pelvic Ring Injury

Detailed Description

This is a multicenter prospective investigation to assess the clinical outcomes of patients with an isolated pelvic ring injury. The study team plans on enrolling 60 subjects. This group will include both patients treated with and without surgical repair of the pelvic ring injury.

Concomitant injuries will be accounted in two ways first by tracking the patient's ISS (Injury Severity Score), second by tracking lower extremity fractures and lumbar spine injuries that require fixation. All patients will be enrolled within 2 weeks of injury to allow collection of outcome information asking the patients to score in a manner reflecting their perceived pre-injury level of function. The outcome instruments administered will include the short-musculoskeletal functional assessment (SMFA), the Oswestry Disability Score, Majeed Pelvis Score, and a visual analog pain score.

Patient demographics including age, income level, educational level, family support, and work status will be recorded. Additional demographic information associated with motivation of recovery from injury will be collected at the time of enrollment. Associated aspects of the injury including neurologic, urologic, or bowel injuries associated with the injury will be documented. All operative complications or wound infections involving the care of the pelvic ring injury will also be recorded. Injury classification and operative data of surgical repair will also be collected. At time of follow-up neurologic deficits, evidence of painful hardware, limb length discrepancy will be documented.

Initial radiographs and CT imaging will be taken in accordance with standard clinical care at participating centers. The decision for operative or non-operative management will be made at the discretion of the treating surgeon. At 6 months and 1 year follow-up time points, plain film radiographs including an AP Pelvis, 40 degree inlet and 40 degree outlet views will be made with a calibrated marker as described by Suzuki et al. Calibrated markers are available in standard clinical practice in Orthopaedic Surgery outpatient clinic radiology units. Use of the calibrated marker requires only that the marker, a metal ball 25mm in diameter, is included in the x-ray beam adjacent to the patient at the time of taking the radiograph. Radiographs are routine clinical practice at the follow-up time points in these patients. Outcome instruments will be administered to the patient at these time points as well.

• Study Type: Observational
• Enrollment (Actual): 40

Contacts and Locations

Study Locations

• United States
  • North Carolina
    • Durham, North Carolina, United States, 27707
      • Duke University Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Urgent care patients. Patients coming to the ER with a Pelvic ring Fx

Description

Inclusion Criteria:

1. Subject is male or female age 18 year or older
2. Subject has an acute pelvic ring injury defined as sustaining fracture(s) and or dislocation(s) involving the continuity of the bony pelvic ring
3. Standard of Care CT scan and AP, Inlet, Outlet radiographs are performed done at baseline (admission)
4. Subject is willing and able to provide written informed consent for study participation with 14 days after pelvic injury
5. Subject is willing and able to comply with study protocol including return for all follow-up evaluations.

Exclusion Criteria:

1. pre-existing or injury related spinal cord injuries
2. Pre-existing arthrosis of the Sacroiliac joints or Hip joints
3. Previous pelvic ring injury
4. Type IIIB or Type IIIC open fracture other than the pelvis injury
5. no CT scan done at baseline
6. Patient does not speak or read English
7. Patient is a prisoner or is at high risk of incarceration during the follow/up period
8. Subject is likely to have problems, in the judgment of the Investigator or Research Coordinator, with maintaining follow-up (such as no fixed address, plan to move out of town in the next year, etc.)

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Only
• Time Perspectives: Prospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in displacement on one or all of the standard radiographic views	Participants will be scheduled for Standard of Care follow ups at 6 months and 1 year where x-rays will be taken to assess the fracture	6 months and 1 year after injury

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in health related quality of life outcomes	Questionnaires (short-musculoskeletal functional assessment (SMFA), SF-12, the Oswestry Disability Score, Majeed Pelvis Score, and a visual analog pain score) will help the study team understand participant progress.	Enrollment, 6 months and 1 year follow up

Collaborators and Investigators

• Sponsor: Duke University
• Collaborators: Wake Forest University Health Sciences; Orthopaedic Trauma Association; Prisma Health-Upstate
• Investigators: Study Director: Steven Olson, MD, Duke University

Study record dates

Study Major Dates

• Study Start: March 1, 2013
• Primary Completion (Actual): February 1, 2016
• Study Completion (Actual): April 1, 2016

Study Registration Dates

• First Submitted: March 27, 2013
• First Submitted That Met QC Criteria: March 27, 2013
• First Posted (Estimate): April 1, 2013

Study Record Updates

• Last Update Posted (Estimate): July 27, 2016
• Last Update Submitted That Met QC Criteria: July 26, 2016
• Last Verified: July 1, 2016

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Wounds and Injuries
• Other Study ID Numbers: Pro00043568

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No