Active clinical trials for "Humeral Fractures"

Will patients who suffer complex humerus fractures have better functional outcomes and less implant failure with shoulder replacement (reverse total shoulder arthroplasty, RTSA) compared to shoulder repair (open reduction and internal fixation, ORIF)?

Type I supracondylar fractures are elbow fractures that occur in children aged 3-10 years. Many different treatment options exist to treat this type of fracture. The purpose of this study is to compare three different treatment modalities with regards to pain experienced during treatment, the amount of pain medication needed during treatment, and any short-term complications. We hypothesize that above elbow casting and long-arm splinting will result in less pain and have fewer complications than taping the elbow in flexion.

The primary objective is to determine if a difference exists in functional outcomes, as measured by the Constant score, when comparing nonoperative management and locking plate surgical fixation of low-energy displaced proximal humerus fractures in the elderly population over a 2-year follow-up period. Secondary outcomes will include an assessment of the ASES score, the SF-36 quality of life score, complication rates, re-operation rates, radiographic time to union, radiographic malunion, hardware position and evidence of avascular necrosis or posttraumatic osteoarthritis .

Goal of this study is to evaluate the accuracy of 3D computer-planned fracture fixation with patient-specific instruments for clavicle, upper extremity, lower extremity and pelvis fractures compared with the standard procedure of fracture fixation.

There is currently no consensus amongst orthopedic specialists on the best way to treat 3- and 4-part proximal humerus fractures. No surgery and surgery with a type of shoulder replacement called a reverse total shoulder arthroplasty are two options that many orthopedists use. This study is being performed to evaluate the differences in short- and long-term pain and functional outcomes between patients who are treated with these two different options.

In the investigators' prospective randomized study, the investigator will investigate the effect of different bandage types on functional and radiological results of proximal humerus fractures over 18 years of age, for whom conservative treatment is decided. In recent studies, it has been shown that surgical treatment in proximal humerus fractures has a high complication rate and is also not superior to conservative treatments in terms of functional results. Therefore, the importance of conservative treatment is increasing day by day in this group of fractures, especially in elderly patients with high risk for surgery. In these studies in the literature, the method in conservative treatment is not clearly specified, and the investigator will apply 3 different bandages to adjust the rotation of the shoulder in 3 different ways during the investigators' conservative treatment. The investigator will compare functional and radiological results between these groups.

Bone grafting is widely used in hospitals to repair injured, aged or diseased skeletal tissue. In Europe, about one million patients encounter a surgical bone reconstruction annually and the numbers are increasing due to our ageing population. Bone grafting intends to facilitate bone healing through osteogenesis (i.e. bone generation) at the site of damage, but this is only attained presently by including cells capable of forming bone into the augmentation. Bone autograft is the safest and most effective grafting procedure, since it contains patient's own bone growing cells (to enhance osteogenesis) and proteins (to enhance osteoinduction), and it providing a scaffold for the new bone to grow into (osteoconduction). However, bone autograft is limited in quantity (about 20 cc) and its harvesting (e.g. from the iliac crest) represents an additional surgical intervention, with frequent consequent pain and complications. We hypothesize that using autologous bone marrow cells expanded in GMP facility surgically implanted with synthetic bone substitutes contribute to the resolution of the health and socioeconomic complications of delayed union or non-union after diaphyseal and metaphyseal-diaphyseal fractures with safety and efficacy.

The primary objective is to compare the mechanical failure risks in the first year after treatment.

In the present phase-I clinical trial we investigate safety and feasibility of an augmentation with preoperatively isolated autologous BMC cells seeded onto ß-TCP in combination with an angle stable fixation (Philos plate®) for the therapy of proximal humeral fractures.

The humerus forms the bone structure of the arm area between the shoulder and the elbow. Proximal humerus is the upper end of this bone that joins with the shoulder. While proximal humerus fractures occur with high-energy trauma such as traffic accident, fall from height, gunshot injury in young patients, these fractures happen with a simple trauma in elderly patients. Surgical intervention is generally not considered in the proximal humerus fractures treatment. Exercises have very important benefits in the post-fracture period. These exercises allow the shoulder and arm to regain their former mobility. In addition, electrotherapy which is one of the auxiliary methods in the treatment process, is the use of the physical effects of the electric current for therapeutic purposes. The aim of interferential current therapy, which is a frequently used electrotherapy method, is to accelerate recovery, fracture healing, and reduce pain. The aim of this study is to investigate the effect of interferential current therapy on shoulder functions, pain and disability in patients with conservatively treated proximal humerus fractures. Patients will be randomly divided into 2 groups according to the preformed form. The reason why patients are randomly divided into 2 groups (randomization) is to make the study more objective. You have a 50% chance to join one of the 2 treatment groups. An orthopedic rehabilitation program consisting of the same exercise program will be applied to regain shoulder and arm functions for all patients participating in the study. In addition to exercise therapy, active interferential current therapy will be applied to the first group for 3 days a week before the exercises, and sham electric current therapy will be applied to the second group. Being in the second group will not affect the treatment process negatively because of interferential current is not an absolute treatment method for patients with fractures. Shoulder functions, pain (visual analogue scale), disability and range of motion will be evaluated at the end of the exercise program (6th week), 10th and 22nd weeks of all patients who accepted to participate in the study. In addition, the amount of acetaminophen usage will be noted at each visit.