Rib Fracture MultipleRF-AdvantageNCT04163224
Minimal Invasive Approach for Surgical Repair of Rib Fractures With a Novel Intrathoracic Device
An observational study of Rib Fracture Multiple, run by Zimmer Biomet.
Trial summary
A retrospective review of demographics and adverse events from cases completed with the RibFix Advantage System. Evaluation of device integrity, and performance by a prospective CT scan with a minimum of 3 months post-implantation. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Rib Fracture Multiple
- What is being tested?
- RibFix Advantage
- Type of treatment
- Medical device
- How many people
- 0 participants
- Where
- No sites listed yet
- Study dates
- 1 Apr 2020to 30 Dec 2020
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Patients treated for rib fracture repair using RibFix Advantage System alone or in combination with other methods for rib fracture repair
Who may be able to join
- Male or Female
- ≥ 18 years old (no upper limit)
- Underwent surgical repair of rib fracture(s) with the RibFix Advantage System alone or in combination with other systems for fracture repair
- Signed Informed Consent Form for participation in a clinical trial
- Willing and able to return for a follow-up visit (includes a computed tomography (CT) scan of the chest)
Who cannot join
- Off label use of RibFix Advantage (e.g., active or latent infection at the time of implantation, sepsis, metal sensitivity)
About this study
Official title: Minimal Invasive Approach for Surgical Repair of Rib Fractures With a Novel Intrathoracic Device. Case Series
A retrospective review of demographics and adverse events from cases completed with the RibFix Advantage System. Evaluation of device integrity, and performance by a prospective CT scan with a minimum of 3 months post-implantation.
Read the detailed description
The RibFix Advantage System is a novel intrathoracic titanium plating system that is FDA-cleared for the treatment of rib fractures. The RibFix Advantage System is designed to be implanted in a less invasive procedure where plates are introduced and placed on the pleural cortex of the rib during video-assisted thoracoscopic surgery. Intrathoracic plate placement allows for smaller cutaneous incisions and less muscle disruption, which may aid in patient recovery compared to traditional open reduction internal fixation systems that are currently available.
The purpose of this study is to gather the first clinical data on this novel device in the context of a case series of patients with radiologic and quality-of-life follow-up.
- Conditions
- Rib Fracture Multiple
- Being tested
- RibFix Advantage
- Keywords
- multiple rib fractures, chest stabilization, rib plates
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
RibFix AdvantageDevice
Class II device in the United States; consists of bridges (with locking posts) and locking caps for the thoracoscopic fixation and stabilization of ribs. These implants are manufactured from commercially pure titanium and titanium alloys. When fully assembled, the bridge plate is placed on the underside of the rib (pleural cortex); the threaded locking posts extend through pre-drilled holes in the rib, and the locking caps are fixed to the locking post on the anterior (cutaneous) side of the rib. The combined threaded locking post and cap provides for fixation of the bridge and stabilization of the fracture.
What is being measured
The primary outcome is the main question the study is designed to answer.
Fracture stability
Evaluated by a computed tomography (CT) scan. Rib fractures repaired with RibFix Advantage should demonstrate continuity without overlap
Measured: 3 months post-implantation
Device integrity
Evaluated by a computed tomography (CT) scan. Images should demonstrate no plate migration, no post/cap migration and no plate fracture
Measured: 3 months post-implantation
Secondary outcomes (1)
Adverse Events of Interest
Includes: Chest infections, Empyema, Mediastinitis. Wound infection, Wound dehiscence, Chest wall deformity related to the device, Pleural effusion related to the device, Hemothorax related to the device, Pneumothorax related to the device and Hemo-pneumothorax related to the device
Measured: From the the date of implantation until the day of hospital discharge, or up to 10 days post-implantation, whichever occurs first; 30 days post surgery; 3 month post-implantation
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Nov 2019
- Study start1 Apr 2020 (estimated)
- Primary completion30 Aug 2020 (estimated)
- Study completion30 Dec 2020 (estimated)
Why it stopped: Sponsor strategy change
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (15)Papers the sponsor has linked to this study.
- Other trials for Rib Fracture MultipleStudies of the same condition, open and under way.
- More trials run by Zimmer BiometThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Retrospective
- Enrolment
- 0 participants (actual)
Sponsor and investigators
- Lead sponsor
- Zimmer Biomet
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Mark Sun, Study director, Zimmer Biomet
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04163224
- Sponsor's protocol ID
- 0719-2
- Acronym
- RF-Advantage
- Status last verified
- Aug 2020
- First submitted
- 8 Nov 2019
- Last updated
- 1 Sep 2020
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- Yes
- Individual data sharing
- No
Publications
Granetzny A, Abd El-Aal M, Emam E, Shalaby A, Boseila A. Surgical versus conservative treatment of flail chest. Evaluation of the pulmonary status. Interact Cardiovasc Thorac Surg. 2005 Dec;4(6):583-7. doi: 10.1510/icvts.2005.111807. Epub 2005 Sep 15.
PubMed 17670487Majercik S, Wilson E, Gardner S, Granger S, VanBoerum DH, White TW. In-hospital outcomes and costs of surgical stabilization versus nonoperative management of severe rib fractures. J Trauma Acute Care Surg. 2015 Oct;79(4):533-8; discussion 538-9. doi: 10.1097/TA.0000000000000820.
PubMed 26402525Pieracci FM, Agarwal S, Doben A, Shiroff A, Lottenberg L, Whitbeck SA, White TW. Indications for surgical stabilization of rib fractures in patients without flail chest: surveyed opinions of members of the Chest Wall Injury Society. Int Orthop. 2018 Feb;42(2):401-408. doi: 10.1007/s00264-017-3612-1. Epub 2017 Aug 29.
PubMed 28852836Sarani B, Allen R, Pieracci FM, Doben AR, Eriksson E, Bauman ZM, Gupta P, Semon G, Greiffenstein P, Chapman AJ, Kim BD, Lottenberg L, Gardner S, Marasco S, White T. Characteristics of hardware failure in patients undergoing surgical stabilization of rib fractures: A Chest Wall Injury Society multicenter study. J Trauma Acute Care Surg. 2019 Dec;87(6):1277-1281. doi: 10.1097/TA.0000000000002373.
PubMed 31107433Edwards JG, Clarke P, Pieracci FM, Bemelman M, Black EA, Doben A, Gasparri M, Gross R, Jun W, Long WB, Lottenberg L, Majercik S, Marasco S, Mayberry J, Sarani B, Schulz-Drost S, Van Boerum D, Whitbeck S, White T; Chest Wall Injury Society collaborators. Taxonomy of multiple rib fractures: Results of the chest wall injury society international consensus survey. J Trauma Acute Care Surg. 2020 Feb;88(2):e40-e45. doi: 10.1097/TA.0000000000002282. No abstract available.
PubMed 31590175Leinicke JA, Elmore L, Freeman BD, Colditz GA. Operative management of rib fractures in the setting of flail chest: a systematic review and meta-analysis. Ann Surg. 2013 Dec;258(6):914-21. doi: 10.1097/SLA.0b013e3182895bb0.
PubMed 23511840Majercik S, Cannon Q, Granger SR, Van Boerum DH, White TW. Regarding: Long-term patient outcomes after surgical stabilization of rib fractures. Am J Surg. 2015 Jul;210(1):199-200. doi: 10.1016/j.amjsurg.2015.03.020. Epub 2015 May 21. No abstract available.
PubMed 26072282Majercik S, Cannon Q, Granger SR, VanBoerum DH, White TW. Long-term patient outcomes after surgical stabilization of rib fractures. Am J Surg. 2014 Jul;208(1):88-92. doi: 10.1016/j.amjsurg.2013.08.051. Epub 2014 Jan 4.
PubMed 24507379Majercik S, Vijayakumar S, Olsen G, Wilson E, Gardner S, Granger SR, Van Boerum DH, White TW. Surgical stabilization of severe rib fractures decreases incidence of retained hemothorax and empyema. Am J Surg. 2015 Dec;210(6):1112-6; discussion 1116-7. doi: 10.1016/j.amjsurg.2015.08.008. Epub 2015 Sep 18.
PubMed 26454653Marasco SF, Davies AR, Cooper J, Varma D, Bennett V, Nevill R, Lee G, Bailey M, Fitzgerald M. Prospective randomized controlled trial of operative rib fixation in traumatic flail chest. J Am Coll Surg. 2013 May;216(5):924-32. doi: 10.1016/j.jamcollsurg.2012.12.024. Epub 2013 Feb 13.
PubMed 23415550Pieracci FM. Completely thoracoscopic surgical stabilization of rib fractures: can it be done and is it worth it? J Thorac Dis. 2019 May;11(Suppl 8):S1061-S1069. doi: 10.21037/jtd.2019.01.70.
PubMed 31205763Pieracci FM, Lin Y, Rodil M, Synder M, Herbert B, Tran DK, Stoval RT, Johnson JL, Biffl WL, Barnett CC, Cothren-Burlew C, Fox C, Jurkovich GJ, Moore EE. A prospective, controlled clinical evaluation of surgical stabilization of severe rib fractures. J Trauma Acute Care Surg. 2016 Feb;80(2):187-94. doi: 10.1097/TA.0000000000000925.
PubMed 26595710Pieracci FM, Majercik S, Ali-Osman F, Ang D, Doben A, Edwards JG, French B, Gasparri M, Marasco S, Minshall C, Sarani B, Tisol W, VanBoerum DH, White TW. Consensus statement: Surgical stabilization of rib fractures rib fracture colloquium clinical practice guidelines. Injury. 2017 Feb;48(2):307-321. doi: 10.1016/j.injury.2016.11.026. Epub 2016 Nov 27. No abstract available.
PubMed 27912931Slobogean GP, MacPherson CA, Sun T, Pelletier ME, Hameed SM. Surgical fixation vs nonoperative management of flail chest: a meta-analysis. J Am Coll Surg. 2013 Feb;216(2):302-11.e1. doi: 10.1016/j.jamcollsurg.2012.10.010. Epub 2012 Dec 5.
PubMed 23219148Tanaka H, Yukioka T, Yamaguti Y, Shimizu S, Goto H, Matsuda H, Shimazaki S. Surgical stabilization of internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients. J Trauma. 2002 Apr;52(4):727-32; discussion 732. doi: 10.1097/00005373-200204000-00020.
PubMed 11956391
Study at a glance
From the registry record, last updated by the sponsor on 1 Sep 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Minimal Invasive Approach for Surgical Repair of Rib Fractures With a Novel Intrathoracic Device. Case Series
- ClinicalTrials.gov ID
- NCT04163224
- Acronym / sponsor ID
- RF-Advantage / 0719-2
- Conditions
- Rib Fracture Multiple
- Keywords
- multiple rib fractures, chest stabilization, rib plates
- Study type
- Observational
- Recruitment status
- WithdrawnReason stopped: Sponsor strategy change
- Enrolment
- 0 participants (actual)
- Lead sponsor
- Zimmer BiometIndustry (pharma, biotech, devices)
- Study start
- 1 Apr 2020 (estimated)
- Primary completion
- 30 Aug 2020 (estimated)
- Study completion
- 30 Dec 2020 (estimated)
- First posted
- 14 Nov 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
A retrospective review of demographics and adverse events from cases completed with the RibFix Advantage System. Evaluation of device integrity, and performance by a prospective CT scan with a minimum of 3 months post-implantation.
Detailed description
The RibFix Advantage System is a novel intrathoracic titanium plating system that is FDA-cleared for the treatment of rib fractures. The RibFix Advantage System is designed to be implanted in a less invasive procedure where plates are introduced and placed on the pleural cortex of the rib during video-assisted thoracoscopic surgery. Intrathoracic plate placement allows for smaller cutaneous incisions and less muscle disruption, which may aid in patient recovery compared to traditional open reduction internal fixation systems that are currently available.
The purpose of this study is to gather the first clinical data on this novel device in the context of a case series of patients with radiologic and quality-of-life follow-up.
Study design
- Observational model
- Cohort
- Time perspective
- Retrospective
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Patients treated for rib fracture repair using RibFix Advantage System alone or in combination with other methods for rib fracture repair
Key inclusion criteria (5 listed)
- Male or Female
- ≥ 18 years old (no upper limit)
- Underwent surgical repair of rib fracture(s) with the RibFix Advantage System alone or in combination with other systems for fracture repair
- Signed Informed Consent Form for participation in a clinical trial
- Willing and able to return for a follow-up visit (includes a computed tomography (CT) scan of the chest)
Key exclusion criteria (1 listed)
- Off label use of RibFix Advantage (e.g., active or latent infection at the time of implantation, sepsis, metal sensitivity)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| RibFix AdvantageClass II device in the United States; consists of bridges (with locking posts) and locking caps for the thoracoscopic fixation and stabilization of ribs. These implants are manufactured from commercially pure titanium and titanium alloys. When fully assembled, the bridge plate is placed on the underside of the rib (pleural cortex); the threaded locking posts extend through pre-drilled holes in the rib, and the locking caps are fixed to the locking post on the anterior (cutaneous) side of the rib. The combined threaded locking post and cap provides for fixation of the bridge and stabilization of the fracture. | Device | – |
Primary outcome
Fracture stability
Time frame: 3 months post-implantation
Evaluated by a computed tomography (CT) scan. Rib fractures repaired with RibFix Advantage should demonstrate continuity without overlap
Device integrity
Time frame: 3 months post-implantation
Evaluated by a computed tomography (CT) scan. Images should demonstrate no plate migration, no post/cap migration and no plate fracture
1 secondary outcome
Adverse Events of Interest
Time frame: From the the date of implantation until the day of hospital discharge, or up to 10 days post-implantation, whichever occurs first; 30 days post surgery; 3 month post-implantation
Results and safety
The study was withdrawn before enrolling participants, so there are no results.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 Sep 2020.
- Background: PubMed 17670487Granetzny A, Abd El-Aal M, Emam E, Shalaby A, Boseila A. Surgical versus conservative treatment of flail chest. Evaluation of the pulmonary status. Interact Cardiovasc Thorac Surg. 2005 Dec;4(6):583-7. doi: 10.1510/icvts.2005.111807. Epub 2005 Sep 15.
- Background: PubMed 26402525Majercik S, Wilson E, Gardner S, Granger S, VanBoerum DH, White TW. In-hospital outcomes and costs of surgical stabilization versus nonoperative management of severe rib fractures. J Trauma Acute Care Surg. 2015 Oct;79(4):533-8; discussion 538-9. doi: 10.1097/TA.0000000000000820.
- Background: PubMed 28852836Pieracci FM, Agarwal S, Doben A, Shiroff A, Lottenberg L, Whitbeck SA, White TW. Indications for surgical stabilization of rib fractures in patients without flail chest: surveyed opinions of members of the Chest Wall Injury Society. Int Orthop. 2018 Feb;42(2):401-408. doi: 10.1007/s00264-017-3612-1. Epub 2017 Aug 29.
- Background: PubMed 31107433Sarani B, Allen R, Pieracci FM, Doben AR, Eriksson E, Bauman ZM, Gupta P, Semon G, Greiffenstein P, Chapman AJ, Kim BD, Lottenberg L, Gardner S, Marasco S, White T. Characteristics of hardware failure in patients undergoing surgical stabilization of rib fractures: A Chest Wall Injury Society multicenter study. J Trauma Acute Care Surg. 2019 Dec;87(6):1277-1281. doi: 10.1097/TA.0000000000002373.
- Results publication: PubMed 31590175Edwards JG, Clarke P, Pieracci FM, Bemelman M, Black EA, Doben A, Gasparri M, Gross R, Jun W, Long WB, Lottenberg L, Majercik S, Marasco S, Mayberry J, Sarani B, Schulz-Drost S, Van Boerum D, Whitbeck S, White T; Chest Wall Injury Society collaborators. Taxonomy of multiple rib fractures: Results of the chest wall injury society international consensus survey. J Trauma Acute Care Surg. 2020 Feb;88(2):e40-e45. doi: 10.1097/TA.0000000000002282. No abstract available.
- Results publication: PubMed 23511840Leinicke JA, Elmore L, Freeman BD, Colditz GA. Operative management of rib fractures in the setting of flail chest: a systematic review and meta-analysis. Ann Surg. 2013 Dec;258(6):914-21. doi: 10.1097/SLA.0b013e3182895bb0.
- Results publication: PubMed 26072282Majercik S, Cannon Q, Granger SR, Van Boerum DH, White TW. Regarding: Long-term patient outcomes after surgical stabilization of rib fractures. Am J Surg. 2015 Jul;210(1):199-200. doi: 10.1016/j.amjsurg.2015.03.020. Epub 2015 May 21. No abstract available.
- Results publication: PubMed 24507379Majercik S, Cannon Q, Granger SR, VanBoerum DH, White TW. Long-term patient outcomes after surgical stabilization of rib fractures. Am J Surg. 2014 Jul;208(1):88-92. doi: 10.1016/j.amjsurg.2013.08.051. Epub 2014 Jan 4.
- Results publication: PubMed 26454653Majercik S, Vijayakumar S, Olsen G, Wilson E, Gardner S, Granger SR, Van Boerum DH, White TW. Surgical stabilization of severe rib fractures decreases incidence of retained hemothorax and empyema. Am J Surg. 2015 Dec;210(6):1112-6; discussion 1116-7. doi: 10.1016/j.amjsurg.2015.08.008. Epub 2015 Sep 18.
- Results publication: PubMed 23415550Marasco SF, Davies AR, Cooper J, Varma D, Bennett V, Nevill R, Lee G, Bailey M, Fitzgerald M. Prospective randomized controlled trial of operative rib fixation in traumatic flail chest. J Am Coll Surg. 2013 May;216(5):924-32. doi: 10.1016/j.jamcollsurg.2012.12.024. Epub 2013 Feb 13.
- Results publication: PubMed 31205763Pieracci FM. Completely thoracoscopic surgical stabilization of rib fractures: can it be done and is it worth it? J Thorac Dis. 2019 May;11(Suppl 8):S1061-S1069. doi: 10.21037/jtd.2019.01.70.
- Results publication: PubMed 26595710Pieracci FM, Lin Y, Rodil M, Synder M, Herbert B, Tran DK, Stoval RT, Johnson JL, Biffl WL, Barnett CC, Cothren-Burlew C, Fox C, Jurkovich GJ, Moore EE. A prospective, controlled clinical evaluation of surgical stabilization of severe rib fractures. J Trauma Acute Care Surg. 2016 Feb;80(2):187-94. doi: 10.1097/TA.0000000000000925.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Mark Sun study director
Zimmer Biomet
Questions about this trial
What is this clinical trial studying?
An observational study of Rib Fracture Multiple, run by Zimmer Biomet.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: withdrawn, as of the sponsor's last update on 1 Sep 2020. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study was withdrawn before enrolling participants, so there are no results.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Fracture stability (time frame: 3 months post-implantation). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04163224, which also lists 15 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Sep 2020.