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The Effects of a Stainless Steel Suture MGH Flexor Tendon Repair Coupled With Early Aggressive Range of Motion Rehabilitation: a Randomized Controlled Trial

28 de abril de 2011 actualizado por: University of Manitoba

A Pilot Study of a Randomized Controlled Trial Comparing Stainless Steel Suture Repair Coupled With Aggressive Post-Operative Rehabilitation to Polypropylene Suture Paired With Active Range of Motion Rehabilitation

The investigators are comparing the combination of a stainless steel repair and aggressive early active range of motion rehabilitation protocol for flexor tendon lacerations in the hand with a current, accepted treatment offered at our institution. Outcomes to be assessed will be time to return to work, joint range of motion in the injured fingers, and any potential complications that may arise (ex: surgical infections or repair rupture). All proposed treatments included in this study are currently being offered at our institution, but not in a randomized fashion.

Descripción general del estudio

Estado

Desconocido

Condiciones

Intervención / Tratamiento

Descripción detallada

This study will serve as a pilot-study for a future randomized controlled trial. Adult patients with zone 2 flexor tendon lacerations of the hand (anatomically from the A1 pulley of the hand to the insertion of the flexor digitorum superficialis) who have presented to the emergency room acutely (within 1 week of injury) at the Health Sciences Center in Winnipeg will be asked for their participation in this study. Consent will be obtained by a plastic surgery resident either in the emergency room or in the plastic surgency emergency decanting clinic. The investigators will include twenty-four patients in the study, randomized into one of two treatment groups (groups A and B) by block randomization. Randomization will be done once patients agree to participate in the study. All patients will be booked for surgery on the emergency slate. Each treatment group will be treated by a single surgeon who is an expert at treatment of these injuries. Group A patients will have their laceration(s) repaired using a modified Becker repair technique using stainless steel suture in the operating room, and then will proceed to undergo an aggressive early active range of motion rehabilitation administered by the hand therapists at HSC. Group B patients will undergo a double-locking loop suture repair using polypropylene. They will then undergo a less aggressive active range of motion rehabilitation protocol which is currently offered to patients at our center. Follow-up will occur in plastic surgery outpatient clinic at post-operative weeks 1, 2, 4, 6 and 12. Follow-up with hand therapy will be at the discretion of the therapists. At each visit with hand therapy, joint range of motion will be assessed at the PIP and DIP joints in the affected fingers. Final range of motion will be assessed using the Strickland system for evaluating flexor tendon surgery outcomes, and will be done by a blinded hand therapist.

Tipo de estudio

Intervencionista

Inscripción (Anticipado)

24

Fase

  • Fase 2

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Estudio Contacto

Copia de seguridad de contactos de estudio

  • Nombre: Ian R MacArthur, MD
  • Número de teléfono: 204-990-6397
  • Correo electrónico: i_macarthur@shaw.ca

Ubicaciones de estudio

  • Canadá
    • Manitoba
      • Winnipeg, Manitoba, Canadá, R3A 1R9
        • Health Sciences Center
        • Contacto:
        • Investigador principal:
          • Ian R MacArthur, MD
        • Sub-Investigador:
          • Sarvesh Logsetty, MD
        • Sub-Investigador:
          • Leif J Sigurdson, MD

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años a 70 años (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

Sí

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  • adults
  • living in Winnipeg, Manitoba
  • zone II flexor tendon lacerations in a single finger
  • able to consent to and comply with surgery

Exclusion Criteria:

  • crush injuries
  • vascular injuries requiring re-vascularization
  • fractures
  • infection
  • prior hand injury requiring surgery

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Triple

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Stainless steel MGH
Patients in this study arm will have their flexor tendon laceration repaired using stainless steel suture (size 3-0) in an MGH repair technique. They will then undergo aggressive early active range of motion rehabilitation post-operatively.
Procedimiento: Stainless steel suture
Stainless steel suture material will be used (size 3-0) in an MGH repair technique
Conductual: Aggressive early active range of motion rehabilitation
Patients undergoing this form of rehabilitation will have their splints discontinued at 4 weeks and ideally will be back at work at normal duties by 6 weeks. This rehabilitation uses more movement at a faster progression than other early active range of motion protocols.
Comparador activo: Polypropylene DOLL
Patients in this study arm will have their flexor tendon laceration repaired using polypropylene suture (size 3-0) in a double-locking loop repair technique. They will then undergo aggressive early active range of motion rehabilitation post-operatively.
Procedimiento: Polypropylene suture
Polypropylene suture (size 3-0) will be used in a double-locking loop repair technique
Conductual: Early active range of motion rehabilitation
Patients undergoing this form of rehabilitation will have their splints discontinued at 6 weeks and ideally will be back at work at normal duties by 10-12 weeks. This rehabilitation uses less movement at a slower progression than the early AROM rehabilitation protocol specified in the experimental group

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Return to work
Periodo de tiempo: Post-operative weeks 1, 2, 4, 6 and 12
At each clinic visit at the above mentioned time periods, the clinician will ask the patient if they have returned to work (if applicable)
Post-operative weeks 1, 2, 4, 6 and 12
Finger joint range of motion (PIP, DIP, MCP)
Periodo de tiempo: Post-operative weeks 1, 2, 4, 6 and 12
At each clinic / occupational therapy visit, a blinded assessor will determine the total range of motion of the finger DIP, PIP and MCP joints
Post-operative weeks 1, 2, 4, 6 and 12

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Compliance with therapy
Periodo de tiempo: Post-operative weeks 1, 2, 4, 6 and 12
At each clinic and occupational therapy visit, an assessor will ask the patient if they have been compliant with therapy
Post-operative weeks 1, 2, 4, 6 and 12
Rupture
Periodo de tiempo: Post-operative weeks 1, 2, 4, 6 and 12
At each follow-up visit with the clinician or occupational therapist, the presence of a rupture will be assessed for clinically. Alternatively this will be recorded if the patient presents to the emergency room with a flexor tendon rupture
Post-operative weeks 1, 2, 4, 6 and 12
Infection
Periodo de tiempo: Post-operative weeks 1, 2, 4, 6 and 12
At each clinic visit, the patient will be assessed clinically for the presence or absence of an infection. This will also be noted if the patient presents to the emergency room.
Post-operative weeks 1, 2, 4, 6 and 12
Attendance with follow-up clinic and occupational therapy
Periodo de tiempo: Post-operative weeks 1, 2, 4, 6 and 12
The patient's attendance will be determined at each clinic or occupational therapy visit.
Post-operative weeks 1, 2, 4, 6 and 12
Use of oral analgesics
Periodo de tiempo: Post-operative weeks 1, 2, 4, 6 and 12
At each clinic visit, the patient will be asked if they are still using oral analgesics
Post-operative weeks 1, 2, 4, 6 and 12
Oral antibiotic usage
Periodo de tiempo: Post-operative weeks 1, 2, 4, 6 and 12
At each clinic visit, the patient will be asked if they are using oral antibiotics.
Post-operative weeks 1, 2, 4, 6 and 12
Wound dehiscence (breakdown)
Periodo de tiempo: Post-operative weeks 1, 2, 4, 6 and 12
At each clinic and occupational therapy visit, the patient will be assessed to determine if a wound dehiscence (breakdown) has occurred.
Post-operative weeks 1, 2, 4, 6 and 12
Use of occupational therapy adjunctive treatments
Periodo de tiempo: Post-operative weeks 1, 2, 4, 6 and 12
At each occupational therapy visit, it will be recorded that they are either using or not using occupational therapy adjunctive treatments (ex: coban tape, ultrasound or electrical stimulation)
Post-operative weeks 1, 2, 4, 6 and 12

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

University of Manitoba

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de junio de 2011

Finalización primaria (Anticipado)

1 de junio de 2012

Finalización del estudio (Anticipado)

1 de junio de 2013

Fechas de registro del estudio

Enviado por primera vez

28 de abril de 2011

Primero enviado que cumplió con los criterios de control de calidad

28 de abril de 2011

Publicado por primera vez (Estimar)

29 de abril de 2011

Actualizaciones de registros de estudio

Última actualización publicada (Estimar)

29 de abril de 2011

Última actualización enviada que cumplió con los criterios de control de calidad

28 de abril de 2011

Última verificación

1 de febrero de 2011

Más información

Términos relacionados con este estudio

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • B2010:119

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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