Optimal Duration of Longitudinal Mechanical Traction in Displaced Radius Fractures: a Prospective Non-inferiority Study (DRF-LUKS)
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.
Przegląd badań
Status
Status
Warunki
Warunki
Interwencja / Leczenie
Interwencja / Leczenie
Typ studiów
Typ studiów
Zapisy (Szacowany)
Zapisy
Faza
Faza
- Nie dotyczy
Kontakty i lokalizacje
Kontakt w sprawie studiów
Kontakt w sprawie studiów
- Nazwa: Jill I de Bode
- Numer telefonu: +410412054770
- E-mail: jilliris.debode@luks.ch
Kopia zapasowa kontaktu do badania
- Nazwa: Bryan JM van de Wall
- E-mail: bryan.vandewall@luks.ch
Lokalizacje studiów
-
-
Canton of Lucerne
-
Lucerne, Canton of Lucerne, Szwajcaria, 6000
- Rekrutacyjny
- Luzerner Kantonsspital
-
Kontakt:
- Bryan JM van de Wall
- Numer telefonu: +410412054770
- E-mail: bryan.vandewall@luks.ch
-
-
Kryteria uczestnictwa
Kryteria kwalifikacji
Kryteria kwalifikacji
Wiek uprawniający do nauki
Akceptuje zdrowych ochotników
Płeć kwalifikująca się do nauki
Opis
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)
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie
- Przydział: Nie dotyczy
- Model interwencyjny: Zadanie dla jednej grupy
- Maskowanie: Brak (otwarta etykieta)
Liczba ramion
Broń i interwencje
Grupa uczestników / ArmGrupa uczestników / Arm |
Interwencja / LeczenieInterwencja / Leczenie |
|---|---|
|
Eksperymentalny: 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. |
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. |
Co mierzy badanie?
Podstawowe miary wyniku
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Change in volar/dorsal tilt
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
|
Miary wyników drugorzędnych
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Proportion of fractures with acceptable radiological alignment
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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
|
Współpracownicy i badacze
Sponsor
Sponsor
Publikacje i pomocne linki
Publikacje ogólne
- Court-Brown CM, Caesar B. Epidemiology of adult fractures: A review. Injury. 2006 Aug;37(8):691-7. doi: 10.1016/j.injury.2006.04.130. Epub 2006 Jun 30.
- McQueen M, Caspers J. Colles fracture: does the anatomical result affect the final function? J Bone Joint Surg Br. 1988 Aug;70(4):649-51. doi: 10.1302/0301-620X.70B4.3403617.
- Lippuner K, Johansson H, Kanis JA, Rizzoli R. Remaining lifetime and absolute 10-year probabilities of osteoporotic fracture in Swiss men and women. Osteoporos Int. 2009 Jul;20(7):1131-40. doi: 10.1007/s00198-008-0779-8. Epub 2008 Oct 31.
- Walenkamp MM, Goslings JC, Beumer A, Haverlag R, Leenhouts PA, Verleisdonk EJ, Liem RS, Sintenie JB, Bronkhorst MW, Winkelhagen J, Schep NW. Surgery versus conservative treatment in patients with type A distal radius fractures, a randomized controlled trial. BMC Musculoskelet Disord. 2014 Mar 19;15:90. doi: 10.1186/1471-2474-15-90.
- Candela V, Di Lucia P, Carnevali C, Milanese A, Spagnoli A, Villani C, Gumina S. Epidemiology of distal radius fractures: a detailed survey on a large sample of patients in a suburban area. J Orthop Traumatol. 2022 Aug 30;23(1):43. doi: 10.1186/s10195-022-00663-6.
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Szacowany)
Rozpoczęcie studiów
Zakończenie podstawowe (Szacowany)
Zakończenie podstawowe
Ukończenie studiów (Szacowany)
Ukończenie studiów
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Pierwszy wysłany
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia wysłana aktualizacja
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Dodatkowe istotne warunki MeSH
Inne numery identyfikacyjne badania
Inne numery identyfikacyjne badania
- BASEC-2026-01751
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .