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Optimal Duration of Longitudinal Mechanical Traction in Displaced Radius Fractures: a Prospective Non-inferiority Study (DRF-LUKS)

1. oktober 2026 oppdatert av: Luzerner Kantonsspital

The goal of this clinical trial is to learn if 1 minute of mechanical traction lines up a broken wrist bone as well as 5 or 10 minutes of traction in adults (18 years and older) who come to the emergency department with a displaced distal radius fracture (a broken wrist with the bone pieces out of place) that needs to be set and put in a cast. The main questions it aims to answer are:

Is the bone position on X-ray after 1 minute of traction no worse than after 5 or 10 minutes? Bone position is measured as wrist tilt, radial inclination, radial height and ulnar variance.

At what point during traction does the bone reach its best position?

There is no separate comparison group. Each participant serves as their own comparison. Researchers will compare X-rays taken before traction and after 1, 5 and 10 minutes of traction in the same participant to see if longer traction improves bone alignment.

Participants will:

Receive standard pain relief and have their arm placed in traction with finger loops and a 5 kg weight, as in usual care Have two extra wrist X-rays (front and side view) after 1 minute and again after 5 minutes of traction, in addition to the standard X-rays before traction and after 10 minutes Have their fracture set and a cast applied as usual. Participation ends when they leave the emergency department, and there are no extra follow-up visits.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Antatt)

36

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studer Kontakt Backup

Studiesteder

  • Sveits
    • Canton of Lucerne
      • Lucerne, Canton of Lucerne, Sveits, 6000
        • Rekruttering
        • Luzerner Kantonsspital
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

Age 18 years or older Acute, displaced distal radius fracture (AO/OTA 23-A, 23-B or 23-C) presenting to the Emergency Department and requiring closed reduction with mechanical traction and cast immobilisation Written informed consent

Exclusion Criteria:

Pathological fracture Open distal radius fracture Irreducible fracture requiring immediate operative fixation Previous surgery, previous fracture, or concomitant fracture of the same (ipsilateral) upper extremity Acute neurovascular compromise requiring immediate surgical intervention Inability to provide informed consent (e.g. severe cognitive impairment, dementia, acute substance intoxication, or a language barrier with no interpreter available) Pregnancy (screened per standard ED protocol)

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Sequential traction (1, 5 and 10 minutes)

Adults with an acute displaced distal radius fracture receive standard longitudinal mechanical traction, using finger traps on the thumb, index and middle fingers and a 5 kg counterweight. Standard wrist radiographs (PA and lateral) are taken before traction (T0) and after 10 minutes (T3). Two additional study radiographs (PA and lateral) are taken after 1 minute (T1) and 5 minutes (T2) of traction. Each participant serves as their own control. Closed reduction and casting then follow standard care.
Fremgangsmåte: Longitudinal mechanical traction

Continuous longitudinal traction with standardized finger traps and a 5 kg weight over a pulley on the emergency department reduction frame, lasting 10 minutes. Wrist radiographs are taken at 1, 5 and 10 minutes of traction.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in volar/dorsal tilt
Tidsramme: Before traction (0 minutes) and after 1, 5 and 10 minutes of tracti

Volar or dorsal tilt of the distal radius (degrees), measured on the lateral wrist radiograph. The difference between time points is compared against a non-inferiority margin of 5 degrees.
Before traction (0 minutes) and after 1, 5 and 10 minutes of tracti
Change in radial inclination
Tidsramme: Before traction (0 minutes) and after 1, 5 and 10 minutes of traction

Radial inclination (degrees), measured on the posteroanterior wrist radiograph. The difference between time points is compared against a non-inferiority margin of 5 degrees.
Before traction (0 minutes) and after 1, 5 and 10 minutes of traction
Change in radial height
Tidsramme: Before traction (0 minutes) and after 1, 5 and 10 minutes of traction

Radial height (mm), measured on the posteroanterior wrist radiograph. The difference between time points is compared against a non-inferiority margin of 2 mm.
Before traction (0 minutes) and after 1, 5 and 10 minutes of traction
Change in ulnar variance
Tidsramme: Before traction (0 minutes) and after 1, 5 and 10 minutes of traction

Ulnar variance (mm), measured on the posteroanterior wrist radiograph. The difference between time points is compared against a non-inferiority margin of 2 mm.
Before traction (0 minutes) and after 1, 5 and 10 minutes of traction

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Proportion of fractures with acceptable radiological alignment
Tidsramme: After 1, 5 and 10 minutes of traction

Percentage of participants whose fracture meets acceptable alignment criteria for volar/dorsal tilt, radial inclination, radial height and ulnar variance at each traction time point.
After 1, 5 and 10 minutes of traction
Time point of maximal radiological realignment
Tidsramme: Before traction (0 minutes) and after 1, 5 and 10 minutes of traction

The traction time point (1, 5 or 10 minutes) at which each of the four radiological parameters (volar/dorsal tilt, radial inclination, radial height, ulnar variance) reaches its maximal correction relative to baseline.
Before traction (0 minutes) and after 1, 5 and 10 minutes of traction
Effect of fracture morphology on change in radiological alignment
Tidsramme: Before traction (0 minutes) and after 1, 5 and 10 minutes of traction

Association between fracture type (AO/OTA 23-A, 23-B, 23-C) and baseline displacement, and the change in the four radiological parameters over time. This is analysed with linear mixed-effects models.
Before traction (0 minutes) and after 1, 5 and 10 minutes of traction
Effect of age and sex on change in radiological alignment
Tidsramme: Before traction (0 minutes) and after 1, 5 and 10 minutes of traction

Association between patient age and sex and the change in the four radiological parameters over time. This includes a sex × time interaction, analysed with linear mixed-effects models.
Before traction (0 minutes) and after 1, 5 and 10 minutes of traction
Effect of BMI, forearm circumference, time to presentation and pain on change in radiological alignment
Tidsramme: Before traction (0 minutes) and after 1, 5 and 10 minutes of traction

Association between BMI, forearm circumference (a proxy for muscle volume), time from injury to emergency department presentation and maximum pain during traction, and the change in volar/dorsal tilt, radial inclination, radial height and ulnar variance over time. Pain is scored on a Numeric Rating Scale (NRS) from 0 (no pain) to 10 (worst pain imaginable). This is analysed with linear mixed-effects models.
Before traction (0 minutes) and after 1, 5 and 10 minutes of traction

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Luzerner Kantonsspital

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Studer hoveddatoer

Studiestart (Antatt)

1. september 2026

Primær fullføring (Antatt)

1. november 2026

Studiet fullført (Antatt)

1. desember 2026

Datoer for studieregistrering

Først innsendt

1. oktober 2026

Først innsendt som oppfylte QC-kriteriene

1. oktober 2026

Først lagt ut (Faktiske)

6. oktober 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

6. oktober 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

1. oktober 2026

Sist bekreftet

1. september 2026

Mer informasjon

Begreper knyttet til denne studien

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • BASEC-2026-01751

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