Rock-Paper-Scissors-OK in Nerve Examination

March 25, 2026 updated by: Ankara City Hospital Bilkent

Rock-Paper-Scissors-OK Game for Neurological Examination in Pediatric Supracondylar Humerus Fractures: A Prospective Randomized Controlled Trial

Patients presenting to the Orthopedics and Traumatology Clinic of Ankara Bilkent City Hospital with supracondylar humerus (elbow) fractures will initially undergo closed reduction. Following the reduction procedure, radiographic imaging will be obtained and patients will be re-evaluated. If surgical intervention is deemed necessary based on this assessment, operative treatment will be recommended.

The surgical technique will consist of closed reduction followed by percutaneous Kirschner wire (K-wire) fixation. In cases where adequate fracture reduction cannot be achieved by closed means, open reduction will be performed through an anterior incision. In these patients, K-wires will again be inserted percutaneously.

Fixation will be achieved using one medial (ulnar side) and two lateral K-wires. Postoperatively, a neurological examination will be performed. In patients who are shown a video and taught the game beforehand, neurological assessment will be conducted using the "rock-paper-scissors" game. In other patients, the examination will be performed by demonstrating and requesting specific hand movements.

If ulnar nerve deficit is detected during postoperative neurological evaluation, the medial K-wire will be removed. The time interval between the patient's emergence from anesthesia and the neurological examination will be recorded.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

102

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Ankara
      • Ankara, Ankara, Turkey (Türkiye)
        • Ankara Bilkent City Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Children aged 4 to 10 years
  • Underwent surgical treatment for supracondylar humerus fracture
  • Willing to participate (assent/parental consent as applicable)

Exclusion Criteria:

  • Cognitive inability to understand or perform the rock-paper-scissors-OK movements
  • Declined participation (patient and/or parent/guardian refusal, as applicable)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Diagnostic
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: Smartphone-Assisted Neurological Examination
Participants undergo neurological examination using a smartphone-assisted application (preoperatively and postoperatively). Examination duration and patient satisfaction are recorded.
Other: Preoperative video-based training module
Participants in the smartphone-assisted group viewed a single standardized preoperative video-based training module delivered via YouTube (duration: 2 minutes 34 seconds).
Other: Conventional Neurological Examination
Participants undergo neurological examination using conventional bedside clinical assessment methods (preoperatively and postoperatively). Examination duration and patient satisfaction are recorded.
Other: Conventional Neurological Examination
Standard neurological examination performed by the clinician using conventional bedside assessment.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postoperative neurological examination duration (minutes)
Time Frame: Immediately postoperatively after awakening in the recovery room
Time required to complete the neurological examination postoperatively, recorded in minutes.
Immediately postoperatively after awakening in the recovery room

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Preoperative neurological deficit (yes/no)
Time Frame: Preoperatively in the emergency department (before surgery)
Presence of neurological deficit on examination (radial, ulnar, median, and anterior interosseous nerve function). Recorded as yes/no (frequency, %).
Preoperatively in the emergency department (before surgery)
Preoperative neurological examination duration (minutes)
Time Frame: Preoperatively in the emergency department (before surgery)
Time required to complete the neurological examination preoperatively, recorded in minutes.
Preoperatively in the emergency department (before surgery)
Patient/parent satisfaction: Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child HCAHPS)
Time Frame: On the day the patients is discharged after surgery (typically the 2nd or 3rd day after the operation)
Satisfaction was measured with the Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child HCAHPS). Domain scores were calculated as mean values on a 1-4 Likert scale (min=1, max=4); higher scores indicate better satisfaction/better care experience.
On the day the patients is discharged after surgery (typically the 2nd or 3rd day after the operation)
Postoperative neurological deficit (yes/no)
Time Frame: Immediately postoperatively after awakening in the recovery room
Presence of neurological deficit on examination (radial, ulnar, median, and anterior interosseous nerve function). Recorded as yes/no (frequency, %).
Immediately postoperatively after awakening in the recovery room

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Ankara City Hospital Bilkent

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 13, 2024

Primary Completion (Actual)

April 18, 2025

Study Completion (Actual)

May 22, 2025

Study Registration Dates

First Submitted

March 4, 2026

First Submitted That Met QC Criteria

March 16, 2026

First Posted (Actual)

March 18, 2026

Study Record Updates

Last Update Posted (Actual)

March 30, 2026

Last Update Submitted That Met QC Criteria

March 25, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • TABED 1-24-83; 13 March 2024

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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