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FractureNCT05580848

Wrist Arthroscopy During Surgical Treatment of Distal Radius Fractures

A study testing Wrist arthroscopy in people with Fracture and Radius Fracture Distal, run by Clinic for Orthopedics Lovran.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Wrist arthroscopy (WA) is a potentially useful adjuvant procedure in the surgical treatment (osteosynthesis) of distal radius fractures (DRFs). Previous research on the contribution of WA to DRF treatment has shown different results. Read more about this study

Who is it for?
Ages 50 to 69 years, women only
Conditions the study is for
Fracture, Radius Fracture Distal
What is being tested?
Wrist arthroscopy
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
56 participants
Where
No sites listed yet
Study dates
20 Nov 2022to 20 Sep 2024
Phase
Interventional
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 50 to 69 years
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Distal radius fractures with an indication for surgical treatment according to the AO/OTA classification of patients aged 50-69 years who have signed an informed consent to participate in the research.

Who cannot join

  • Distal radius fractures( DRF) that have an indication for surgical treatment in all patients and in patients younger than 50 and older than 69,
  • DRF that do not have an indication for surgical treatment,
  • Refusal to participate in the research,
  • Inability to decide independently about participation in the research (persons under guardianship),
  • Open fractures,
  • Presence of severe soft tissue injuries,
  • Infections,
  • Poor general condition of patients and internal medicine contraindications.

Trial locations and contacts

No sites are listed yet.

Borjan Josifovski, MD contact

+385911542647

borjan.josifovski@gmail.com

About this study

Official title: Wrist Arthroscopy During Surgical Treatment of Distal Radius Fractures Improves Functional Outcome: a Randomized Controlled Trial

Wrist arthroscopy (WA) is a potentially useful adjuvant procedure in the surgical treatment (osteosynthesis) of distal radius fractures (DRFs). Previous research on the contribution of WA to DRF treatment has shown different results.

Objectives of the study: (1) Validate wrist functional outcome questionnaires; (2) To determine whether arthroscopically assisted repositioning of fracture fragments in articular DRFs leads to a better treatment outcome; (3) To determine whether arthroscopic observation and treatment of associated soft tissue and / or cartilage injuries in articular DRFs leads to a better treatment outcome; (4) To determine whether arthroscopic observation and treatment of associated soft tissue and / or cartilage injuries in extraarticular DRFs leads to a better treatment outcome.

Read more

Research hypotheses: (1) Validated questionnaires will have satisfactory measurement properties (validity, reliability) and will be able to be used in a WA randomized controlled trial; (2) WA as an adjunct to DRF osteosynthesis improves the clinical outcome of treatment.

Subjects: 56 female patients with indication for DRF osteosynthesis aged 50-69 years divided into 2 groups: 1. examined - 28 patients with indication for DRF osteosynthesis (14 patients with extraarticular DRF and 14 patients with intraarticular DRF) with associated WA, and 2. control - 28 patients with indication for DRF osteosynthesis (14 patients with extraarticular DRF and 14 patients with intraarticular DRF) without associated WA.

Methods: As a primary outcome measure, functional outcomes of treatment will be analyzed with the Disabilities of the Arm, Shoulder and Hand (DASH) Score at 3 and 6 months after surgery. As a secondary outcome measures it will be analyzed pain level according to a visual analog scale (VAS), preoperative and postoperative radiographic parameters of distal radius, and clinical outcomes of treatment with the Mayo Wrist Score (MWS) and Patient-Rated Wrist Evaluation (PRWE) score at 3 and 6 months after surgery. Expected scientific contribution: providing answers on the role of WA in the treatment of DRF and associated injuries as well as its impact on treatment outcome.

Being tested
Wrist arthroscopy
Keywords
Arthroscopy, Radius Fractures, Surveys and Questionnaires, Treatment Outcome, Wrist
Medical subject headings
Fractures, Bone, Wrist Fractures, Radius Fractures

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Wrist arthroscopyProcedure or surgery

    Wrist arthroscopy is a minimally invasive endoscopic method that enables the diagnosis and treatment of certain diseases and injuries of the radiocarpal, mediocarpal and distal radioulnar joints.

    Wrist arthroscopy enables a direct view of the articular surface of the wrist and the assessment and adequate treatment of articular fractures The wrist arthroscopy procedure also enables the detection and necessary treatment of associated soft tissue injuries (scapho-lunate and/or luno-triquetral ligament, i.e. triangular fibrocartilaginous complex) and/or cartilage lesions in extra-articular and articular fractures.

Study groups in NCT05580848
Study groupRoleWhat they receive
Examined groupExperimental28 patients with indication for distal radius fracture (DRF) osteosynthesis : 14 patients with extraarticular DRF and 14 patients with intraarticular DRF with associated wrist arthroscopy
Receives: Procedure: Wrist arthroscopy
Control groupNo intervention28 patients with indication for distal radius fracture (DRF) osteosynthesis : 14 patients with extraarticular DRF and 14 patients with intraarticular DRF without associated wrist arthroscopy.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. DASH Score

    Disabilities of the Arm, Shoulder and Hand It consists of 30 questions and is used to assess functional disorders of the upper extremity. 21 questions examine the extent to which the patient had problems performing certain activities during the last week. 6 questions assess specific symptoms (eg, pain, paresthesias, sleep disturbances) during the last week, and 3 questions assess social or occupational limitations during the last week. The possible score ranges from 0 to 100 points. 0 points represents complete, unrestricted function of the upper extremities, while 100 points represents the greatest possible functional impairment.

    Measured: 3 months after surgery

  2. DASH Score

    Disabilities of the Arm, Shoulder and Hand It consists of 30 questions and is used to assess functional disorders of the upper extremity. 21 questions examine the extent to which the patient had problems performing certain activities during the last week. 6 questions assess specific symptoms (eg, pain, paresthesias, sleep disturbances) during the last week, and 3 questions assess social or occupational limitations during the last week. The possible score ranges from 0 to 100 points. 0 points represents complete, unrestricted function of the upper extremities, while 100 points represents the greatest possible functional impairment.

    Measured: 6 months after surgery

Secondary outcomes (6)
  1. VAS

    The visual analogue scale (VAS) of pain will be used in this study as a tool to assess the clinical outcome of treatment. It consists of the length of a solid line with values at the beginning and end of the line from 0 to 10 cm (0 - 100 mm). The leftmost side means the absence of pain, and the rightmost side means unbearable pain.

    Measured: 3 months after surgery.

  2. VAS

    The visual analogue scale (VAS) of pain will be used in this study as a tool to assess the clinical outcome of treatment. It consists of the length of a solid line with values at the beginning and end of the line from 0 to 10 cm (0 - 100 mm). The leftmost side means the absence of pain, and the rightmost side means unbearable pain.

    Measured: 6 months after surgery.

  3. MWS

    The Mayo Wrist Score (MWS) will be evaluated through 4 questions: (1) pain intensity, (2) functional status - ability to return to regular work, (3) active range of motion of bending /extension of the affected wrist compared to the contralateral side (5 answers offered to be scored from 0 to 25 points) and (4) grip strength of the affected hand compared to the contralateral side (5 answers offered to be scored from 0 to 25 points). The possible score ranges from 0 to 100 points. Interpretation of the results: from 90-100 points is an excellent result, 80-90 points is a good result, 60-80 points is a satisfactory result, and below 60 points is a bad result.

    Measured: 3 months after surgery.

  4. MWS

    The Mayo Wrist Score (MWS) will be evaluated through 4 questions: (1) pain intensity, (2) functional status - ability to return to regular work, (3) active range of motion of bending /extension of the affected wrist compared to the contralateral side (5 answers offered to be scored from 0 to 25 points) and (4) grip strength of the affected hand compared to the contralateral side (5 answers offered to be scored from 0 to 25 points). The possible score ranges from 0 to 100 points. Interpretation of the results: from 90-100 points is an excellent result, 80-90 points is a good result, 60-80 points is a satisfactory result, and below 60 points is a bad result.

    Measured: 6 months after surgery.

  5. PRWE

    The Patient-Rated Wrist Evaluation (PRWE) score is a highly reliable and valid 15-question questionnaire designed to measure wrist pain and disability in activities of daily living. The PRWE allows patients to assess their own level of pain and disability in the wrist from 0 to 10, and consists of 2 parts: pain and function. The part about pain contains 5 questions, the maximum score in this part is 50, and the minimum is 0. The part about function contains 10 questions divided into 2 parts, i.e. specific activities (6 questions) and usual activities (4 questions). The maximum score in this part is 50, and the minimum is 0.

    Measured: 3 months after surgery.

  6. PRWE

    The Patient-Rated Wrist Evaluation (PRWE) score is a highly reliable and valid 15-question questionnaire designed to measure wrist pain and disability in activities of daily living. The PRWE allows patients to assess their own level of pain and disability in the wrist from 0 to 10, and consists of 2 parts: pain and function. The part about pain contains 5 questions, the maximum score in this part is 50, and the minimum is 0. The part about function contains 10 questions divided into 2 parts, i.e. specific activities (6 questions) and usual activities (4 questions). The maximum score in this part is 50, and the minimum is 0.

    Measured: 6 months after surgery.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Oct 2022
  2. Study start20 Nov 2022 (estimated)
  3. Primary completion20 Dec 2023 (estimated)
  4. Study completion20 Sep 2024 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
56 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05580848
Sponsor's protocol ID
ClinicOL
Status last verified
Oct 2022
First submitted
1 Oct 2022
Last updated
18 Oct 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • 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.

    PubMed 16814787
  • Rundgren J, Bojan A, Mellstrand Navarro C, Enocson A. Epidemiology, classification, treatment and mortality of distal radius fractures in adults: an observational study of 23,394 fractures from the national Swedish fracture register. BMC Musculoskelet Disord. 2020 Feb 8;21(1):88. doi: 10.1186/s12891-020-3097-8.

    PubMed 32035488
  • Ochen Y, Peek J, van der Velde D, Beeres FJP, van Heijl M, Groenwold RHH, Houwert RM, Heng M. Operative vs Nonoperative Treatment of Distal Radius Fractures in Adults: A Systematic Review and Meta-analysis. JAMA Netw Open. 2020 Apr 1;3(4):e203497. doi: 10.1001/jamanetworkopen.2020.3497.

    PubMed 32324239
  • Song J, Yu AX, Li ZH. Comparison of conservative and operative treatment for distal radius fracture: a meta-analysis of randomized controlled trials. Int J Clin Exp Med. 2015 Oct 15;8(10):17023-35. eCollection 2015.

    PubMed 26770293
  • Ju JH, Jin GZ, Li GX, Hu HY, Hou RX. Comparison of treatment outcomes between nonsurgical and surgical treatment of distal radius fracture in elderly: a systematic review and meta-analysis. Langenbecks Arch Surg. 2015 Oct;400(7):767-79. doi: 10.1007/s00423-015-1324-9. Epub 2015 Aug 30.

    PubMed 26318178
  • Chen Y, Chen X, Li Z, Yan H, Zhou F, Gao W. Safety and Efficacy of Operative Versus Nonsurgical Management of Distal Radius Fractures in Elderly Patients: A Systematic Review and Meta-analysis. J Hand Surg Am. 2016 Mar;41(3):404-13. doi: 10.1016/j.jhsa.2015.12.008. Epub 2016 Jan 20.

    PubMed 26810824
  • Armstrong KA, von Schroeder HP, Baxter NN, Zhong T, Huang A, McCabe SJ. Stable rates of operative treatment of distal radius fractures in Ontario, Canada: a population-based retrospective cohort study (2004-2013). Can J Surg. 2019 Dec 1;62(6):386-392. doi: 10.1503/cjs.016218.

    PubMed 31782295
  • Mauck BM, Swigler CW. Evidence-Based Review of Distal Radius Fractures. Orthop Clin North Am. 2018 Apr;49(2):211-222. doi: 10.1016/j.ocl.2017.12.001.

    PubMed 29499822
  • Cazzola M, Bergamaschi G, Melazzini M, Ponchio L, Rosti V, Molinari E. Chronic myelogenous leukemia following radiotherapy and chemotherapy for non-Hodgkin lymphoma. Haematologica. 1990 Sep-Oct;75(5):477-9.

    PubMed 2097266
  • Baron JA, Karagas M, Barrett J, Kniffin W, Malenka D, Mayor M, Keller RB. Basic epidemiology of fractures of the upper and lower limb among Americans over 65 years of age. Epidemiology. 1996 Nov;7(6):612-8. doi: 10.1097/00001648-199611000-00008.

    PubMed 8899387
  • Brogren E, Petranek M, Atroshi I. Incidence and characteristics of distal radius fractures in a southern Swedish region. BMC Musculoskelet Disord. 2007 May 31;8:48. doi: 10.1186/1471-2474-8-48.

    PubMed 17540030
  • Mellstrand-Navarro C, Pettersson HJ, Tornqvist H, Ponzer S. The operative treatment of fractures of the distal radius is increasing: results from a nationwide Swedish study. Bone Joint J. 2014 Jul;96-B(7):963-9. doi: 10.1302/0301-620X.96B7.33149.

    PubMed 24986952
  • Stirling ERB, Johnson NA, Dias JJ. Epidemiology of distal radius fractures in a geographically defined adult population. J Hand Surg Eur Vol. 2018 Nov;43(9):974-982. doi: 10.1177/1753193418786378. Epub 2018 Jul 17.

    PubMed 30016904
  • Solvang HW, Nordheggen RA, Clementsen S, Hammer OL, Randsborg PH. Epidemiology of distal radius fracture in Akershus, Norway, in 2010-2011. J Orthop Surg Res. 2018 Aug 13;13(1):199. doi: 10.1186/s13018-018-0904-0.

    PubMed 30103788
  • Whipple TL. The role of arthroscopy in the treatment of intra-articular wrist fractures. Hand Clin. 1995 Feb;11(1):13-8.

    PubMed 7751326

Questions about this trial

What is this clinical trial studying?

A study testing Wrist arthroscopy in people with Fracture and Radius Fracture Distal, run by Clinic for Orthopedics Lovran.

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 1 inclusion and 8 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: status not confirmed, as of the sponsor's last update on 18 Oct 2022. 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?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Borjan Josifovski, MD (+385911542647, borjan.josifovski@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

DASH Score (time frame: 3 months after surgery). 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 NCT05580848, which also lists 33 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 18 Oct 2022.

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