NCT04674046

Brief Summary

Prospective cohort study to evaluate the use of a NanoScopic procedure to assess deltoid ligament injuries with outcomes measured at baseline, 6 weeks, 12 weeks, 1 year and 2 years. Further to examine whether the findings correlate with results on gravity stress test and weightbearing radiographs.

Trial Health

43
At Risk

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
40

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Sep 2020

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

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

Study Start

First participant enrolled

September 15, 2020

Completed
2 months until next milestone

First Submitted

Initial submission to the registry

November 17, 2020

Completed
1 month until next milestone

First Posted

Study publicly available on registry

December 17, 2020

Completed
3.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 15, 2024

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

September 15, 2024

Completed
Last Updated

December 17, 2020

Status Verified

December 1, 2020

Enrollment Period

4 years

First QC Date

November 17, 2020

Last Update Submit

December 15, 2020

Conditions

Keywords

Weber BRotational ankle fractureAnkle stabilityDeep deltoid ligamentDeltoid ligament injury

Outcome Measures

Primary Outcomes (1)

  • Change in Manchester-Oxford Foot Questionnaire (MOXFQ)

    The MOXFQ (Dawson et al., 2006) was developed to measure perceived foot- specific functioning and health-related quality of life. The MOXFQ is supported as the current most valid, reliable and responsive ankle-specific instrument (Jia, Huang, \& Gagnier, 2017) and has been validated for use in ankle pathology (Dawson et al., 2011). It is available in Norwegian, but it has not been validated in its translated form. The score comprises a total of 16 items. They are distributed within 3 dimensions; foot pain (5 items), walking/standing (7 items) and social interaction (4 items) where all items are scored on a 5-point Likert scale, scored 0 (best) to 4 (worst). The MOXFQ index (Morley et al., 2013) will be used, where scores are converted to a metric (0-100) scale. Lower scores indicate less pain and higher levels of ankle/foot functioning (Morley et al., 2013).

    6 weeks, 12 weeks, 52 weeks, 104 weeks

Secondary Outcomes (3)

  • Registration of adverse events

    104 weeks.

  • Registration of fracture union

    12 weeks.

  • Registration of the incidence of concomitant cartilage injuries.

    Baseline.

Study Arms (2)

Nonoperative treatment if deltoid ligament is intact

EXPERIMENTAL

AirCast Air-stirrup (DJO Global) functional orthosis for 6 weeks.

Device: Nonoperative treatmentBehavioral: Standardized education

Operative treatment if deltoid ligament is ruptured

EXPERIMENTAL

Open reduction, internal fixation of the fibular fracture using plate and screws.

Procedure: Operative treatmentBehavioral: Standardized education

Interventions

Patients where the ankle is evaluated as stable using arthroscopy will be treated with conservative treatment using a functional brace (AirCast) for 6 weeks. Participants will be instructed to bear weight as tolerated and to actively do standardized range-of-motion exercises.

Also known as: Conservative Treatment
Nonoperative treatment if deltoid ligament is intact

Patients where the ankle is evaluated as unstable using arthroscopy will be operated on. Standard operative treatment is open reduction and internal fixation (ORIF) of the fracture using plate and screws. The goal is an osteosynthesis that allow for early range-of-motion exercises, but weightbearing is usually not tolerated until 6 weeks postoperatively.

Also known as: Open reduction, internal fixation
Operative treatment if deltoid ligament is ruptured

All participants, regardless of group allocation, will receive education focusing on basic self- management. A physiotherapist will be responsible for the education. The intention will be to increase self-efficacy and encourage self-management. Participants will learn about crutch walking, cast or orthosis usage, loading principles, be advised to stay physically active within proper restrictions and how to rest and reduce pain and swelling of the ankle in the acute phase. Participants will also receive a standard information brochure about the condition, treatment and basic self-management.

Nonoperative treatment if deltoid ligament is intactOperative treatment if deltoid ligament is ruptured

Eligibility Criteria

Age18 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients:
  • With isolated Weber type B fractures without radiological signs of medial clear space widening on initial plain radiographs (MCS \< 7mm).
  • Demonstrating at least one positive stress radiograph (weightbearing or gravity) or a plain radiograph with a MCS measurement above the threshold (5 mm AND 1 mm or more increase compared to the contralateral ankle) (WP2).
  • years of age.
  • With pre-injury walking ability without aids.

You may not qualify if:

  • Patients:
  • With fracture of the medial malleolus, pre-hospital closed fracture reduction, open fracture, fracture resulting from high-energy trauma or multi-trauma and pathologic fracture.
  • With poorly regulated Diabetes Mellitus type 1 and 2, neuropathies and generalized joint disease such as Rheumatoid Arthritis.
  • That are assumed not compliant (drug use, cognitive- and/or psychiatric disorders).
  • With previous history of ipsilateral ankle fracture.
  • With previous history of ipsilateral major ankle-/foot surgery.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Østfold HT

Sarpsborg, Østfold fylke, 1719, Norway

RECRUITING

MeSH Terms

Conditions

Ankle FracturesSprains and Strains

Interventions

Conservative TreatmentOpen Fracture ReductionFracture Fixation, Internal

Condition Hierarchy (Ancestors)

Fractures, BoneWounds and InjuriesAnkle InjuriesLeg Injuries

Intervention Hierarchy (Ancestors)

TherapeuticsFracture FixationOrthopedic ProceduresSurgical Procedures, Operative

Study Officials

  • Marius Molund, Md, PhD

    Ostfold HT

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Marius Molund, MD, PhD

CONTACT

Martin G Gregersen, PT, Msc

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NON RANDOMIZED
Masking
NONE
Purpose
DIAGNOSTIC
Intervention Model
PARALLEL
Model Details: Prospective cohort study where participants will be assigned to nonoperative or operative treatment based on minimally invasive arthroscopic evaluation.
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Senior Consultant Foot and Ankle Surgery

Study Record Dates

First Submitted

November 17, 2020

First Posted

December 17, 2020

Study Start

September 15, 2020

Primary Completion

September 15, 2024

Study Completion

September 15, 2024

Last Updated

December 17, 2020

Record last verified: 2020-12

Data Sharing

IPD Sharing
Will not share

Locations