NCT02398006

Brief Summary

Background: Fracture of the clavicle is common accounting for 2.6% to 4 % of all fractures, with an overall incidence of 36.5 to 64 per 100,000 per year. Around 80% of clavicle fractures occur in the middle third of the clavicle. There is a lack of evidence of randomised controlled trials assessing the best treatment of these fractures. The objective of this study is to evaluate the effects (benefits and harms) of conservative interventions: figure-of-eight bandage versus sling for the treating middle third clavicle fractures. Methods/Design: this project has been designed as a single-centre, parallel-group randomised controlled trial that will compare figure-of-eight bandage versus sling. The investigators aim to recruit 110 adults, aged 18 years or older, with an acute (less than 10 days) middle third clavicle fracture. Primary outcomes will be function or disability measured by DASH questionnaire; the secondary outcomes will be: modified UCLA score pain, treatment failure, adverse events and numbers returning to previous activities. Data analysis: the chi-square test will be used to analyse the results of categorical variables, and Student t-test will be used to compare groups with respect to the numerical variables. The Student t-test is used to compare the clinical outcome of each group at 1, 2 and 4 weeks and at 6 and 12 months after the intervention. The significance level of 5% (alpha = 0.05) is used for all statistical tests such that tests have a value of less than 0.05 are considered statistically significant. Discussion: According to current evidence there is very limited evidence from two single trials only regarding the effectiveness of different methods of conservative interventions for treating clavicle fractures. This study is one of the first randomised controlled trials following the CONSORT statements designed to compare two conservative methods for treating clavicle fractures (figure-of-eight versus sling).

Trial Health

35
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
110

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Apr 2015

Typical duration for not_applicable

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 12, 2015

Completed
13 days until next milestone

First Posted

Study publicly available on registry

March 25, 2015

Completed
7 days until next milestone

Study Start

First participant enrolled

April 1, 2015

Completed
1.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 1, 2016

Completed
1.2 years until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2017

Completed
Last Updated

March 25, 2015

Status Verified

March 1, 2015

Enrollment Period

1.4 years

First QC Date

March 12, 2015

Last Update Submit

March 19, 2015

Conditions

Keywords

Clavicle [mh]Fracture Healing [mh]Fractures, Bone [mh]Treatment outcome [mh]Conservative treatment [tw]

Outcome Measures

Primary Outcomes (1)

  • Function or disability will be measured by DASH - Disability of the Arm, Shoulder, and Hand questionnaire

    Function or disability will be measured by DASH - Disability of the Arm, Shoulder, and Hand questionnaire validated and translated into Portuguese in Brazil, the final score of the DASH questionnaire will be converted to a percentage via the following formula: Scoring = \[Sum of answers n/n - 1\] X 25, where n is the number of complete answers. The two optional modules will not be measured. The value obtained will be directly proportional to the percentage of impairment of the limb function.

    12 months

Secondary Outcomes (5)

  • Modified University of California at Los Angeles (modified - UCLA)

    12 months

  • Pain measured on a 0 to 100 using visual analogue scale (VAS)

    12 months

  • Treatment failure measured by the number of participants who have undergone or are being considered a surgical intervention

    12 months

  • Adverse events

    12 months

  • Numbers returning to previous activities (work, sport, activities of daily living), including time to return.

    12 months

Study Arms (2)

Group 1: a standard arm sling

ACTIVE COMPARATOR

Group 1: the orthopaedic surgeon will apply a standard arm sling that will be used for four weeks; however, during these weeks, participants will be encouraged to discard the sling when their pain has subsided. After four weeks the same orientations of group 1 will be done to this group.

Other: a standard arm sling

Group 2: a figure-of-eight bandage

ACTIVE COMPARATOR

Group 2: a figure-of-eight bandage will be used for four weeks, and every week the participants will return to check and adjust the immobilisation. In this way, the dominant hand can remain free and simple activities will be allowed (writing, keyboarding and other). After four weeks, participants will be encouraged to discard the bandage, but load bearing will not be allowed before osseous consolidation (around 10 weeks).

Other: a figure-of-eight bandage

Interventions

Closed reduction (re-aligning the fragments of the fracture) will be not performed because the reduced position is practically impossible to maintain.

Group 1: a standard arm sling

Closed reduction (re-aligning the fragments of the fracture) will be not performed because the reduced position is practically impossible to maintain.

Group 2: a figure-of-eight bandage

Eligibility Criteria

Age18 Years - 65 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Adults aged 18 years or older and 65 years or less with middle third clavicle fracture,
  • Acute fracture (less than 10 days), we will include all types of middle third clavicle fractures (non-displaced and displaced fractures),
  • No medical contraindication to proposed methods of immobilisation,
  • Understanding of Portuguese language and written informed consent.

You may not qualify if:

  • Pathological fracture,
  • Open fracture,
  • Neurovascular injury on physical examination,
  • Associated head injury (Glasgow Coma Scale score of \<12),
  • Ipsilateral upper limb fractures and/or dislocation(except hand and fingers),
  • History of frozen shoulder,
  • Previous disease in the limb that could influence the results (e.g. rheumatoid arthritis),
  • Inability to comply with follow-up (inability to read or complete forms).

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (1)

  • Lenza M, Taniguchi LF, Ferretti M. Figure-of-eight bandage versus arm sling for treating middle-third clavicle fractures in adults: study protocol for a randomised controlled trial. Trials. 2016 May 4;17(1):229. doi: 10.1186/s13063-016-1355-8.

MeSH Terms

Conditions

Fractures, Bone

Condition Hierarchy (Ancestors)

Wounds and Injuries

Study Officials

  • Mario Lenza, PhD

    Hospital Israelita Albert Einstein

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Mario Ferretti, PhD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Dr

Study Record Dates

First Submitted

March 12, 2015

First Posted

March 25, 2015

Study Start

April 1, 2015

Primary Completion

September 1, 2016

Study Completion

December 1, 2017

Last Updated

March 25, 2015

Record last verified: 2015-03