Buried Intramedullary K-wire Fixation Compared With Plate and Screw Fixation for Metacarpal Fractures in Unstable Extra-Articular Metacarpal Fractures
Primary Purpose
Metacarpal Fracture
Status
Enrolling by invitation
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Buried Intramedullary K-wire Fixation
Plate and Screw Fixation
Sponsored by
About this trial
This is an interventional treatment trial for Metacarpal Fracture
Eligibility Criteria
Inclusion Criteria:
- The patient has an unstable extra-articular metacarpal fracture that meets operative indications
- Informed consent is obtained from the patient or proxy
- Male or female who are 16 years of age or older
Exclusion Criteria:
- If the patients range of motion was decreased prior to injury (previous upper extremity injury, osteoarthritis, etc.)
- Pathological Fracture
- Greater than 21 days from fracture to definitive open reduction and internal fixation
- If contamination or wounds from open fractures do not permit standardized buried intramedullary fixation or plate and screw fixation
- Highly comminuted diaphyseal fractures
- Articular fractures
- Multiple fractures involving bones other than another metacarpal in the same upper extremity
- The patient had a previous upper extremity injury that has limited hand function or finger range of motion
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Buried Intramedullary K-wire Fixation
Plate and Screw Fixation
Arm Description
Patients randomized to buried intramedullary k-wire fixation will undergo a standardized antegrade open reduction and fixation procedure with an intramedullary k-wire.
Patients randomized to Plate and Screw Fixation will undergo a standardized open reduction and internal fixation with plate and screws. Brand of plate will be left to the operating surgeon's discretion.
Outcomes
Primary Outcome Measures
Disability as measured by Disability of Arm, Shoulder and Hand Score
Secondary Outcome Measures
Total Active Motion in degrees
Measured by goniometer
Grip Strength
Disability as measured by Disability of Arm, Shoulder and Hand Score
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02718170
Brief Title
Buried Intramedullary K-wire Fixation Compared With Plate and Screw Fixation for Metacarpal Fractures in Unstable Extra-Articular Metacarpal Fractures
Official Title
Buried Intramedullary K-wire Fixation Compared With Plate and Screw Fixation in Unstable Extra-Articular Metacarpal Fractures: A Randomized, Controlled Study
Study Type
Interventional
2. Study Status
Record Verification Date
April 2023
Overall Recruitment Status
Enrolling by invitation
Study Start Date
March 2015 (undefined)
Primary Completion Date
March 2025 (Anticipated)
Study Completion Date
March 2026 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Prisma Health-Upstate
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Randomized controlled trial comparing a technique for buried intramedullary k-wire fixation to plate and screw fixation for unstable extra-articular metacarpal fractures.
Detailed Description
Metacarpal fractures are a common injury to the hand. Most fractures occur due to direct force from either a axial load to the dorsum of the metacarpophalangeal joint or low energy fall onto an outstretched hand. Many of these fractures can be treated closed with a closed reduction and splinting however, some displaced or angulated fractures require open reduction and internal fixation. Many fixation techniques have been used, however to the investigators knowledge, no one has prospectively randomized patients to compare plate and screw fixation with buried intramedullary k-wire fixation.
The purpose of this study is to compare Plate and screw and buried intramedullary fixation, using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire as the primary outcome measured. Secondary outcomes will include total active motion, complications, cost, reoperation rate.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metacarpal Fracture
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
110 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Buried Intramedullary K-wire Fixation
Arm Type
Experimental
Arm Description
Patients randomized to buried intramedullary k-wire fixation will undergo a standardized antegrade open reduction and fixation procedure with an intramedullary k-wire.
Arm Title
Plate and Screw Fixation
Arm Type
Active Comparator
Arm Description
Patients randomized to Plate and Screw Fixation will undergo a standardized open reduction and internal fixation with plate and screws. Brand of plate will be left to the operating surgeon's discretion.
Intervention Type
Procedure
Intervention Name(s)
Buried Intramedullary K-wire Fixation
Intervention Type
Procedure
Intervention Name(s)
Plate and Screw Fixation
Primary Outcome Measure Information:
Title
Disability as measured by Disability of Arm, Shoulder and Hand Score
Time Frame
3 months
Secondary Outcome Measure Information:
Title
Total Active Motion in degrees
Description
Measured by goniometer
Time Frame
3 months
Title
Grip Strength
Time Frame
3 months
Title
Disability as measured by Disability of Arm, Shoulder and Hand Score
Time Frame
1 year
10. Eligibility
Sex
All
Minimum Age & Unit of Time
14 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
The patient has an unstable extra-articular metacarpal fracture that meets operative indications
Informed consent is obtained from the patient or proxy
Male or female who are 16 years of age or older
Exclusion Criteria:
If the patients range of motion was decreased prior to injury (previous upper extremity injury, osteoarthritis, etc.)
Pathological Fracture
Greater than 21 days from fracture to definitive open reduction and internal fixation
If contamination or wounds from open fractures do not permit standardized buried intramedullary fixation or plate and screw fixation
Highly comminuted diaphyseal fractures
Articular fractures
Multiple fractures involving bones other than another metacarpal in the same upper extremity
The patient had a previous upper extremity injury that has limited hand function or finger range of motion
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
John Millon, MD
Organizational Affiliation
Prisma Health-Upstate
Official's Role
Principal Investigator
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Buried Intramedullary K-wire Fixation Compared With Plate and Screw Fixation for Metacarpal Fractures in Unstable Extra-Articular Metacarpal Fractures
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