- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04163172
Elbow Hemiarthroplasty Versus ORIF for Distal Humeral Fractures
Elbow Hemiarthroplasty Versus Open Reduction and Internal Fixation for AO/OTA Type C2 and C3 Fractures of Distal Humerus in Patients Aged 50 Years or Above; a Randomized Controlled Trial
Study Overview
Status
Detailed Description
Intraarticular distal humeral fractures AO/OTA type C2 and C3 pose a surgical challenge despite the evolution of surgical implants and techniques. Open reduction and internal fixation (ORIF) is often preferred as the first choice of treatment, but the results are varying, and sometimes disappointing. Total elbow arthroplasty (TEA) has been widely used for fractures that are not amenable to ORIF in elderly patients, but the mechanical complications remain a challenge, especially in active patients. Elbow hemiarthroplasty (EHA) provides a modern alternative that might avoid the mechanical complications and weight bearing restrictions related to the linked articulation in semiconstrained TEA. There are no studies comparing the results of EHA to that of TEA or ORIF, but case series have reported promising results.
In this study, forty-four patients with AO/OTA type C2 or C3 fractures of distal humerus will be randomized to either ORIF or EHA. The patients will be examined after the operation and at 3 months and 1, 2, 5 and 10 years after the surgery. The main objective of this study is to investigate the best treatment option for distal humeral fractures in patients aged 50 years or above. This can be of value to future patients sustaining these complicated fractures.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Ali Al-Hamdani, MD
- Phone Number: 004538673276
- Email: ali.kuthayer.khalil.al-hamdani@regionh.dk
Study Locations
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Copenhagen, Denmark
- Recruiting
- Herlev and Gentofte University Hospital
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Contact:
- Ali Al-Hamdani, MD
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Distal humeral fracture AO/OTA type C2 or C3 confirmed by plain radiographs with 2 perpendicular views and CT scan.
- ASA score 1-3 and physically fit for surgery.
- Age of 50 years or above.
Exclusion Criteria:
- Patients unable to follow the rehabilitation protocol or answer the Danish questionnaires because of physical or cognitive inabilities as evaluated by the recruiting surgeon.
- Significant elbow osteoarthritis as evaluated by the recruiting surgeon based on plain radiographs and CT scan.
- Fractures that are older than 6 weeks.
- Other associated elbow fractures.
- Pathological fractures or relevant elbow pathology.
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 |
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Active Comparator: Elbow hemiarthroplasty
The Latitude anatomical hemiarthroplasty (WRIGHT -Memphis, Tennessee) for distal humeral fractures.
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Latitude anatomical elbow hemiarthroplasty (WRIGHT -Memphis, Tennessee)
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Active Comparator: Open reduction and internal fixation
Double plating (Synthes - Switzerland and West Chester, Pennsylvania, United States) for distal humeral fractures.
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Double plating (Synthes - Switzerland and West Chester, Pennsylvania, United States)
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Oxford Elbow Score (OES)
Time Frame: 2 years after surgery.
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The OES is a 12-item patient-administrated questionnaire that measures the quality of life in patients with elbow disorder.
There are three unidimensional domains: Elbow function, pain, and social-psychological status.
Each question is answered on a 5-point scale with each question contributing equally to the total score.Thus, the total score ranges from 12-60, with 60 being the worst.
For ease of presentation the score is converted to a scale from 0-48 with 48 being the best.
The outcome can be interpreted based on a 48-point scale: 0 - 19 - poor; 20-29 - fair; 30-39 - good; and 40-48 - excellent.
The Danish version which will be used in this study, has been translated and cultural adapted according to the guidelines by Guillemin, Bombardier and Beaton.
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2 years after surgery.
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Mayo Elbow Performance Score (MEPS)
Time Frame: 3 months after surgery and 1, 2, 5, and 10 years after surgery.
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The MEPS is a surgeon-administrated instrument that evaluates the outcome after elbow surgery.
There are four domains including: Pain (0-45 points), range of motion (0-20 points), stability (0-10 points) and difficulties in daily activities (0-25 points).The outcome can be interpreted based on a 100 points scale: 0 - 60 - poor; 60-74 - fair; 75-89 - good; and 90-100 - excellent.
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3 months after surgery and 1, 2, 5, and 10 years after surgery.
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Pain severity score (VAS)
Time Frame: 3 months after surgery and 1, 2, 5, and 10 years after surgery.
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Pain is answered on a visual analogue scale (VAS) ranging from 0 to 10, with 10 being the worst and 0 represents a pain free elbow.
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3 months after surgery and 1, 2, 5, and 10 years after surgery.
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Range of motion
Time Frame: 3 months after surgery and 1, 2, 5, and 10 years after surgery.
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Measuring the flexion/extension and supination/pronation arcs in degrees.
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3 months after surgery and 1, 2, 5, and 10 years after surgery.
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Patients satisfaction
Time Frame: 3 months after surgery and 1, 2, 5, and 10 years after surgery.
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Patients satisfaction of the treatment will be recorded using 5-items score with 1 being the worst and 5 represents a very satisfied patient.
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3 months after surgery and 1, 2, 5, and 10 years after surgery.
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Ali Al-Hamdani, MD, Herlev and Gentofte University Hospital
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- EVORI
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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