- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05159310
Cast Vs Splint in Distal Radius Fractures
A Randomized Controlled Trial Comparing Clinical Outcomes of Casting Versus Splinting in Distal Radius Fractures in Patients 60 Years and Above
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Casts and splints are both established methods of treating DRF. Casts have been traditionally the gold standard for non-operative care of fractures, but there are distinct disadvantages such as skin rash and pruritus, malodour, skin maceration and loosening as the initial swelling subsides. Casts require specialized tools for removal and they have to be reapplied by specialized staff if the casts become loose or wet. Splints have the advantage of being removable and therefore facilitate hygiene and provide a better fit because of the adjustable straps. Splints are theoretically less rigid and patient non-compliance because of the ease of removal may result in a greater likelihood of fracture displacement. However, it is known that fractures displace even in casts and the efficacy of casts at maintaining reduction over splints has not been established. Moreover, it has been clearly shown that the elderly patients have good functional outcomes that do not correlate with the position in which the fracture heals i.e. they tolerated a large degree of fracture malunion (Arora; Egol).
The primary goal of this study is to show that there is no difference in the final functional outcome between distal radius fractures treated non-operatively with splints and casts. The secondary goals are to demonstrate: (1) splinting results in greater patient comfort and acceptance; (2) there is no significant difference in final radiographic outcomes between DRF treated with casts and splints; and (3) there is no difference in clinical outcome at the 6-month and 12-month follow-up points.
This study is clinically important for several reasons. First, patients may be encouraged to use splints instead of casts if there is no difference in functional outcome and the former provide better comfort. Second, patients may not be required to present for long (>6-month) follow-ups if it can be shown that the clinical improvement plateaus at 6 months after injury. This is consistent with our aim to improve patients' overall quality of life after musculoskeletal injuries and forms a core component of functional ageing.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Vanessa Wan
- Phone Number: 67728237
- Email: vanessa_wan@nuhs.edu.sg
Study Locations
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-
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Singapore, Singapore, 119074
- Recruiting
- National University Hospital
-
Contact:
- Vanessa Wan
- Phone Number: 67728237
- Email: vanessa_wan@nuhs.edu.sg
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Principal Investigator:
- Soumen Das De
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Closed DRF in patients > 60 years
- Presenting to HRMC within 10 days of injury
- Isolated injury
- With or without M&R performed in EMD
- Declined surgical fixation after appropriate discussion
Exclusion Criteria:
- Wounds - skin tears, bad abrasions, open fracture
- Ulnar fracture > styloid
- Other MSK / non-MSK injuries
- Bilateral fractures
- Prior wrist fractures / wrist surgery
- Other upper limb conditions affecting function (e.g. CVA)
- Cognitive impairment
- Allergy to plaster or fiberglass
Study Plan
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 |
---|---|
Other: Cast
Patients presenting with DRF will be screened by the attending consultant.
The temporary backslab will be removed, X-rays will be obtained, and the attending consultant will discuss the treatment options.
Patients who are planned for non-operative treatment and meet the inclusion criteria will be eligible for the study.
The purpose and details of the study will be explained and informed consent will then be taken by the research coordinator (RC).
The participants will then be randomized (using a block-randomization method) to either treatment by splint or cast.
A research assistant will facilitate the randomisation process so that the RC and the treating physician remain blinded to treatment allocation.
|
Patients presenting with DRF will be screened by the attending consultant.
The temporary backslab will be removed, X-rays will be obtained, and the attending consultant will discuss the treatment options.
Patients who are planned for non-operative treatment and meet the inclusion criteria will be eligible for the study.
The purpose and details of the study will be explained and informed consent will then be taken by the research coordinator (RC).
The participants will then be randomized (using a block-randomization method) to either treatment by splint or cast.
|
Other: Splint
Patients presenting with DRF will be screened by the attending consultant.
The temporary backslab will be removed, X-rays will be obtained, and the attending consultant will discuss the treatment options.
Patients who are planned for non-operative treatment and meet the inclusion criteria will be eligible for the study.
The purpose and details of the study will be explained and informed consent will then be taken by the research coordinator (RC).
The participants will then be randomized (using a block-randomization method) to either treatment by splint or cast.
A research assistant will facilitate the randomisation process so that the RC and the treating physician remain blinded to treatment allocation.
|
Patients presenting with DRF will be screened by the attending consultant.
The temporary backslab will be removed, X-rays will be obtained, and the attending consultant will discuss the treatment options.
Patients who are planned for non-operative treatment and meet the inclusion criteria will be eligible for the study.
The purpose and details of the study will be explained and informed consent will then be taken by the research coordinator (RC).
The participants will then be randomized (using a block-randomization method) to either treatment by splint or cast.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Splinting results in Quick Disabilities of Arm, Shoulder, Hand (QuickDASH) scores that are not poorer as compared to casting
Time Frame: 12 months
|
The resultant score is reported on a scale of 0 to 100, where 0 represents no disability and 100 represents total disability. Splinting in patients ≥60 years with distal radius fracture (DRF) results in 12-month QuickDASH scores that are significantly inferior compared to scores in patients treated in cast. The alternate hypothesis is that splinting results in 12-month QuickDASH scores that are not significantly inferior compared to casting in this group of patients. |
12 months
|
Collaborators and Investigators
Investigators
- Principal Investigator: Soumen Das De, National University Hospital, Singapore
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
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
- 2019/00510
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Records for all participants, including all source documentation (containing evidence to study eligibility, history and physical findings, results of consultations etc) as well as IRB records and other regulatory documentation will be retained by the principal investigator via the following means:
- Electronic records will be kept on an encrypted hard drive
- Hardcopy data will be stored in a locked cabinets in the office of the principal investigator and accessed only by the principal investigator, co-investigators or study administrators.
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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