Traction Orthosis for Oblique Proximal Phalangeal Fractures

NCT04298385 | Unknown

• 1 other identifier: V4 20012020
• Study Type: observational
• Target: 10
• Locations: 0 countries
• Sites: N/A

Brief Summary

The term Ligamentotaxis is used to define the method of distal traction to realign joint surfaces and reduce articular fragments after complex fractures. Traction and mobilization can be combined to help deliver the best outcome. This study will present a dynamic traction orthosis design with the aim that it is easy-to-make, non-invasive, low-profile and allow for ease in performing active and passive exercises. The clinical effectiveness of this method will be examined by analyzing treatment outcomes in a case series cohort.

Conditions

Trauma; Fractures, Bone; Finger Fracture

Outcome Measures

Primary Outcomes (3)

• Range of motion

  Goniometer: Measures in degrees range of movement of a joint

  up to three months post intervention

• Pain and function

  Patient Related Wrist Hand Evaluation: a Likert scale that measure pain and function on a total score of 0-100

  up to three months post intervention

• Grip

  Dynamometer: measure hand grip in Ibs and can be compared to normative data

  up to three months post intervention

Study Arms (1)

Individuals with oblique proximal phalanx fractures of finger

Traction orthosis and exercise

Other: Traction orthosis

Interventions

Traction orthosis OTHER

Traction applied to a finger using elastic thread and sports tape and attached to an orthosis

Also known as: exercise

Individuals with oblique proximal phalanx fractures of finger

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

People who have sustained a recent oblique proximal phalanx fractures that is displaced or potentially unstable

You may qualify if:

• Participants aged 18 years and over who are able to provide informed consent and independently comply with the orthosis and exercise regime
• A recent oblique proximal phalangeal fracture that is displaced or has the potential to become unstable. The decision for trial of a dynamic traction orthosis must be made by the orthopaedic surgeon
• No history of trauma or disease to the affected hand

You may not qualify if:

• A fracture which is more than 10 days from injury
• An open wound around the affected digit
• A history of allergic reactions to plasters
• Eczema or dermatitis to the affected hand
• The presence of sensory loss to the affected digit
• Ligament or tendon injury that will contra-indicate early mobilisation
• Transverse proximal phalanx fractures
• A tattoo to the affected hand that may prevent anonymity when producing photographs

Sponsors & Collaborators

• Southern Health and Social Care Trust: lead

Related Publications (17)

• Schenck RR. Dynamic traction and early passive movement for fractures of the proximal interphalangeal joint. J Hand Surg Am. 1986 Nov;11(6):850-8. doi: 10.1016/s0363-5023(86)80236-2.

  PMID: 3794242 RESULT

• Collins AL, Timlin M, Thornes B, O'Sullivan T. Old principles revisited--traction splinting for closed proximal phalangeal fractures. Injury. 2002 Apr;33(3):235-7. doi: 10.1016/s0020-1383(01)00138-3.

  PMID: 12084639 RESULT

• Fitzgerald JA, Khan MA. The conservative management of fractures of the shafts of the phalanges of the fingers by combined traction-splintage. J Hand Surg Br. 1984 Oct;9(3):303-6. doi: 10.1016/0266-7681(84)90048-2.

  PMID: 6512368 RESULT

• Goldman SB, Amaker RJ, Espinosa RA. James traction splinting for PIP fractures. J Hand Ther. 2008 Apr-Jun;21(2):209-15. doi: 10.1197/j.jht.2007.08.019.

  PMID: 18436143 RESULT

• Jehan S, Chandraprakasam T, Thambiraj S. Management of proximal phalangeal fractures of the hand using finger nail traction and a digital splint: a prospective study of 43 cases. Clin Orthop Surg. 2012 Jun;4(2):156-62. doi: 10.4055/cios.2012.4.2.156. Epub 2012 May 17.

  PMID: 22662302 RESULT

• Baier S, Szekeres M. The hand arc--a hand-based splint design for intraarticular fractures. J Hand Ther. 2010 Jan-Mar;23(1):73-76. doi: 10.1016/j.jht.2009.07.006. Epub 2009 Nov 1.

  PMID: 19883994 RESULT

• Byrne A, Yau T. A modified dynamic traction splint for unstable intra-articular fractures of the proximal interphalangeal joint. J Hand Ther. 1995 Jul-Sep;8(3):216-8. doi: 10.1016/s0894-1130(12)80022-6. No abstract available.

  PMID: 8535487 RESULT

• Kadelbach D. Swing design dynamic traction splinting for the treatment of intra-articular fractures of the digits. J Hand Ther. 2006 Jan-Mar;19(1):39-42. doi: 10.1197/j.jht.2005.11.001.

  PMID: 16473733 RESULT

• Murray KA, McIntyre FH. Active traction splinting for proximal interphalangeal joint injuries. Ann Plast Surg. 1995 Jul;35(1):15-8. doi: 10.1097/00000637-199507000-00003.

  PMID: 7574279 RESULT

• Hardy MA. Principles of metacarpal and phalangeal fracture management: a review of rehabilitation concepts. J Orthop Sports Phys Ther. 2004 Dec;34(12):781-99. doi: 10.2519/jospt.2004.34.12.781.

  PMID: 15643733 RESULT

• Feehan LM, Bassett K. Is there evidence for early mobilization following an extraarticular hand fracture? J Hand Ther. 2004 Apr-Jun;17(2):300-8. doi: 10.1197/j.jht.2004.02.014.

  PMID: 15162112 RESULT

• Chinchalkar SJ, Gan BS. Management of proximal interphalangeal joint fractures and dislocations. J Hand Ther. 2003 Apr-Jun;16(2):117-28. doi: 10.1016/s0894-1130(03)80007-8.

  PMID: 12755163 RESULT

• Miller L, Ada L, Crosbie J, Wajon A. Pattern of recovery after open reduction and internal fixation of proximal phalangeal fractures in the finger: a prospective longitudinal study. J Hand Surg Eur Vol. 2017 Feb;42(2):137-143. doi: 10.1177/1753193416670591. Epub 2016 Oct 4.

  PMID: 27702779 RESULT

• O'Brien L, Presnell S. Patient experience of distraction splinting for complex finger fracture dislocations. J Hand Ther. 2010 Jul-Sep;23(3):249-9; quiz 260. doi: 10.1016/j.jht.2010.01.002.

  PMID: 20399606 RESULT

• Packham TL, Ball PD, MacDermid JC, Bain JR, DalCin A. A scoping review of applications and outcomes of traction orthoses and constructs for the management of intra-articular fractures and fracture dislocations in the hand. J Hand Ther. 2016 Jul-Sep;29(3):246-68. doi: 10.1016/j.jht.2016.04.001.

  PMID: 27496982 RESULT

• Spurrier E, Pathak G, Khanna A. Pressure exerted by finger traps. J Perioper Pract. 2011 Apr;21(4):140-1. doi: 10.1177/175045891102100405.

  PMID: 21560555 RESULT

• Mathiowetz V, Kashman N, Volland G, Weber K, Dowe M, Rogers S. Grip and pinch strength: normative data for adults. Arch Phys Med Rehabil. 1985 Feb;66(2):69-74.

  PMID: 3970660 RESULT

MeSH Terms

Conditions

Wounds and Injuries; Fractures, Bone

Interventions

Exercise

Intervention Hierarchy (Ancestors)

Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Advanced Occupational Therapist

Study Record Dates

• First Submitted: January 30, 2020
• First Posted: March 6, 2020
• Study Start: March 1, 2020
• Primary Completion: August 1, 2020
• Study Completion: August 1, 2020
• Last Updated: March 6, 2020

Record last verified: 2020-03

Data Sharing

• IPD Sharing: Will not share