- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01939808
Flexor Tendon Injury Rehabilitation Regime Study
Comparison of the Effect of Splinting the Wrist in Extension Versus Neutral Positioning During Rehabilitation Following Zone I/II Flexor Tendon Repair
Hand flexor tendons bend the fingers down towards the palm, and can be cut during a sharp penetrating injury (e.g. from a knife or saw). Damaged flexor tendons are repaired surgically with sutures (stitches). After repair, a splint is applied to the fingers, hand and wrist for six to twelve weeks to protect the repair while the tendon heals and regains its normal strength.
Most rehabilitation protocols use a splint in which the wrist position is kept straight (neutral) or bent (flexed). Some groups have described splinting with the wrist cocked back (extended) and have made the argument that this may improve outcomes, as experimental data suggests that splinting the hand with the wrist extended increases the range of movement of the repaired flexor tendon (excursion), and therefore reduces the chance of the tendon sticking down to the surrounding tissues (adhesion). Previous studies have shown no adverse effects from splinting hands with the wrist extended, and no evidence tells us which wrist splint position is better (a state of clinical equipoise or apparently equivalent outcomes). This randomised trial aims to produce this evidence, and therefore improve functional outcomes for patients in future.
We propose to carry out a study to compare the outcomes (grip strength and range of movement) of flexor tendon repair in two groups of patients: one with wrists splinted in a neutral position and the other splinted in an extended position during their postoperative rehabilitation. No changes will be made to patient assessment and management,the surgery undertaken and the rehabilitation regime other than those to splint position. Previous work suggests that both positions are safe and effective. Informed consent will be obtained from all patients enrolled in the trial, and we aim to find out if the extended splint position produces better functional results.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
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Prescot, United Kingdom, L35 5DR
- Whiston Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Primary inclusion criteria for the study is patients who have had 100% division by sharp laceration to the Flexor Digitorum Profundus (FDP+)/Flexor Digitorum Superficialis (FDS) within zone I or II and who have undergone repair with cruciate and epitendinous suture. Patients with multiple digit involvement will be included in the study.
- All repairs performed with 3/0 prolene suture cruciate repair and 6/0 prolene for the epitendinous repair as per departmental protocol.
- Patients with digital nerve repair along with the above injury will be included in the study
Exclusion Criteria:
- Patients with associated phalangeal fractures, skin and soft tissue loss or who had vascular compromise will be excluded from the study.
- Patients with tendon repairs other than cruciate will be excluded from the study
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 |
---|---|
Other: Wrist splinted in extended position
We propose to carry out a study to compare the outcomes (grip strength and range of movement) of flexor tendon repair in two groups of patients: one with wrists splinted in a neutral position and the other splinted in an extended position during their postoperative rehabilitation
|
|
Other: Wrist Splinted in the Neutral postion
We propose to carry out a study to compare the outcomes (grip strength and range of movement) of flexor tendon repair in two groups of patients: one with wrists splinted in a neutral position and the other splinted in an extended position during their postoperative rehabilitation
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Assessing the Range of Movement up to 26 week post surgery
Time Frame: up to 26 weeks post surgery
|
The primary outcome measures will be "Range of Movement" (ROM).
Total active motion will be measured using a Roylan finger goniometer following a standardised procedure and recorded on an electronic audit form (Appendix 1.5).
This will be recorded up to 26 weeks post surgeries.
Outcome data will be taken and recorded by a senior hand therapist who will be blinded to the position of splintage that has been worn by the participant.
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up to 26 weeks post surgery
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Assessment of Grip Strength at 12 and 26 weeks post surgery
Time Frame: 12 & 26 weeks post surgery
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grip strength will be measured at both 12 and 26 weeks post surgery assessing change.
This will be measured my using a Jamar Dynamometer and taken following a standard Procedure
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12 & 26 weeks post surgery
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
assessing for flexor tendon rupture
Time Frame: 26 weeks post surgery
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flexor tendon rupture to be identified by 26 weeks post surgery.
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26 weeks post surgery
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Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Actual)
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 (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- RBN854-STHK
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 Flexor Tendon
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-
University Hospital, BrestCompletedTendon Injury - Hand | Tendon Rupture | Flexor Digitorum Longus on the Right | Flexor Digitorum Longus on the LeftFrance
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Pamukkale UniversityRecruitingFlexor Tendon RuptureTurkey
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Clinical Trials on Splint Extended
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Federal University of São PauloCompleted
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University of AlbertaCompleted
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Mardin Artuklu UniversityCompletedCarpal Tunnel Syndrome | Pregnancy Related | SplintsTurkey
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Cairo UniversityUnknown
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Rambam Health Care CampusCompletedHand Tendon InjuryIsrael
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Manchester University NHS Foundation TrustCompletedTendon InjuriesUnited Kingdom
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Massachusetts General HospitalCompletedPost-traumatic Stiff ElbowsUnited States
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Western University, CanadaNot yet recruitingSplints | Thumb Osteoarthritis | CMC
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Massachusetts General HospitalTerminatedTrapeziometacarpal (TMC) ArthrosisUnited States