Use of Compression Glove to Prevent Complications After Distal Radius Fractures: a Randomized Controlled Trial

This study is currently recruiting participants.
Verified January 2013 by J&M Shuler
Sponsor:
Information provided by (Responsible Party):
Michael Shuler, J&M Shuler
ClinicalTrials.gov Identifier:
NCT01118715
First received: April 30, 2010
Last updated: January 28, 2013
Last verified: January 2013
  Purpose

Distal radius fractures (DRF) are the most common type of fracture in the human body, and a large proportion of DRFs result in complications. Previously proposed preventive strategies have questionable efficacy and may impose additional risks on the patient. Because many complications secondary to distal radius fractures are associated with excessive swelling, a prophylactic means for edema reduction could dramatically reduce morbidity among this population. A compression glove is a non-invasive, non-pharmacological way to reduce edema. Previous studies have confirmed its utility in edema reduction after hand trauma and among patients with chronic inflammatory conditions, but none have sufficiently investigated the application to patients with distal radius fractures, a population in which this intervention could have a large impact. The investigators propose a randomized controlled trial to evaluate use of a compression glove during recovery among patients who have sustained an unstable distal radius fracture. The investigators hypothesize that patients who wear a compression glove after a distal radius fracture:

  • Will experience less edema
  • Will demonstrate greater functionality
  • Will recover more quickly
  • Will have lower incidence rates of carpal tunnel syndrome
  • Will have lower incidence rates of complex regional pain syndrome

Condition Intervention
Post-traumatic Carpal Tunnel Syndrome
Complex Regional Pain Syndrome
Edema
Device: Compression glove

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Prevention
Official Title: Use of Compression Glove to Prevent Complications After Distal Radius Fractures: a Randomized Controlled Trial

Resource links provided by NLM:


Further study details as provided by J&M Shuler:

Primary Outcome Measures:
  • Incidence of Post-traumatic Carpal Tunnel Syndrome (CTS) [ Time Frame: 2 wks ] [ Designated as safety issue: No ]
    Suspected CTS will be evaluated using Durkans' test, with confirmation via nerve conduction tests

  • Incidence of Post-traumatic Carpal Tunnel Syndrome (CTS) [ Time Frame: 5 wks ] [ Designated as safety issue: No ]
    Suspected CTS will be evaluated using Durkans' test, with confirmation via nerve conduction tests

  • Incidence of Post-traumatic Carpal Tunnel Syndrome (CTS) [ Time Frame: 3 mos ] [ Designated as safety issue: No ]
    Suspected CTS will be evaluated using Durkans' test, with confirmation via nerve conduction tests

  • Incidence of Post-traumatic Carpal Tunnel Syndrome (CTS) [ Time Frame: 6 mos ] [ Designated as safety issue: No ]
    Suspected CTS will be evaluated using Durkans' test, with confirmation via nerve conduction tests


Secondary Outcome Measures:
  • Incidence of Complex Regional Pain Syndrome [ Time Frame: 2 wks, 5 wks, 3 mos, 6 mos ] [ Designated as safety issue: No ]
    Using reserach diagnostic criteria proposed by IASP (Budapest, 2003).

  • Edema [ Time Frame: 2 wks, 5 wks, 3 mos, 6 mos ] [ Designated as safety issue: No ]
    1. Circumferential measurements taken at the wrist and mid-aspect of proximal phalanx from four fingers.
    2. Figure-of-eight measurement of hand size

  • Grip strength [ Time Frame: 5 wks, 3 mos, 6 mos ] [ Designated as safety issue: No ]
    measured in kgs, using a Jamar dynamometer

  • Disabilities of the Arm, Shoulder, & Hand questionnaire [ Time Frame: 2 wks, 5 wks, 3 mos, 6 mos ] [ Designated as safety issue: No ]
    30-item questionnaire designed to quanitfy functional outcomes of the upper extremity and measure symptoms of pain, physical, emotional, and social domains associated with musculoskeletal disorders of the upper limb.

  • Pain [ Time Frame: Baseline, 2wks, 5wks, 3mos, 6mos ] [ Designated as safety issue: No ]
    Using a 1-10 pain scale

  • Time-to-recovery [ Time Frame: Time point when patient is discharged from occupational therapy ] [ Designated as safety issue: No ]
    Time at which occupational therapist decrees that the patient has reached a recovery point beyond which a home exercise program is sufficient to complete their rehabilitation.


Estimated Enrollment: 460
Study Start Date: April 2010
Estimated Study Completion Date: April 2014
Estimated Primary Completion Date: April 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Compression glove
Patients in this group have a compression glove incorporated into their splint for 2 weeks post-op, and wear a glove underneath their cast for 3 weeks. The patient then wears the glove at night after cast removal.
Device: Compression glove
A compression glove worn during recovery from distal radius fracture
No Intervention: Control
Patients in this group undergo standard recovery procedures. This includes a splint worn for 2 weeks post-op, followed by a short arm cast worn for the next 3 weeks.

  Eligibility

Ages Eligible for Study:   18 Years to 85 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Male or female
  • Between the ages of 18-85
  • Patients with unstable unilateral distal radius fractures (requiring surgical stabilization)

Exclusion Criteria:

  • Pre-existing cases of carpal tunnel syndrome and/or complex regional pain syndrome
  • Nerve or tendon laceration
  • Decompression of carpal tunnel concomitant with surgical stabilization
  • Additional fractures, including carpal fractures, more proximal fractures of the radius, and finger injuries will be excluded from the study (Ulnar styloid and ulnar head and neck fractures will be included)
  • Uncontrolled rheumatoid arthritis patients
  • Bilateral fractures
  • Unable or unwilling to provide written informed consent.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01118715

Contacts
Contact: Michael S Shuler, MD 706-433-4031 msimmss@hotmail.com

Locations
United States, Georgia
Athens Orthopedic Clinic Recruiting
Athens, Georgia, United States, 30606
Principal Investigator: Michael S Shuler, MD         
Sponsors and Collaborators
J&M Shuler
Investigators
Principal Investigator: Michael S Shuler, MD J&M Shuler
  More Information

No publications provided

Responsible Party: Michael Shuler, Hand and Upper Extremity Specialist, J&M Shuler
ClinicalTrials.gov Identifier: NCT01118715     History of Changes
Other Study ID Numbers: DRF-001
Study First Received: April 30, 2010
Last Updated: January 28, 2013
Health Authority: United States: Institutional Review Board

Keywords provided by J&M Shuler:
distal radius fracture
post-traumatic carpal tunnel syndrome
complex regional pain syndrome
compression glove
edema glove

Additional relevant MeSH terms:
Arm Injuries
Carpal Tunnel Syndrome
Edema
Radius Fractures
Somatoform Disorders
Complex Regional Pain Syndromes
Median Neuropathy
Mononeuropathies
Peripheral Nervous System Diseases
Neuromuscular Diseases
Nervous System Diseases
Nerve Compression Syndromes
Cumulative Trauma Disorders
Sprains and Strains
Wounds and Injuries
Signs and Symptoms
Forearm Injuries
Fractures, Bone
Mental Disorders
Autonomic Nervous System Diseases

ClinicalTrials.gov processed this record on April 17, 2014