Randomised Study Between Intramedullary Locking Nails and Locking Plates for Treatment of Proximal Humerus Fractures (HUMERUS)
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
Purpose
Primary purpose of this study was to compare functional outcomes after displaced and proximal humerus fracture between nails and locked plates.
The hypothesis is that intramedullary nails provides satisfactory fixation and functional outcome compared to locked plate.
| Condition | Intervention |
|---|---|
|
Proximal Humerus Fractures |
Procedure: Intramedullary nail Procedure: Locked plate |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Randomised Study Between Intramedullary Locking Nails and Locking Plates for Treatment of Proximal Humerus Fractures in Patients After 40-year-old |
- Constant and MURLEY Score [ Time Frame: 12 months ] [ Designated as safety issue: No ]comparaison of shoulder function outcome between 2 groups using Constant- Murley score after 12 months( mobility, function, pain and strength)
- Quick Dash, complication (mal union, necrosis, infection) [ Time Frame: 3, 6 and 18 months ] [ Designated as safety issue: No ]
comparaision of Constant-Murley score after 3, 6 and 18 months, comparision of complications rates and patients satisfaction( DASH and STT scores).
Those criteriae will be analysed on global groups and for each Neer and Duparc classification type fracture.
| Estimated Enrollment: | 144 |
| Study Start Date: | February 2012 |
| Estimated Study Completion Date: | November 2015 |
| Estimated Primary Completion Date: | August 2015 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Intramedullary nail |
Procedure: Intramedullary nail
the fracture was reduced and fix by an intramedullary humeral nail (Multilock, SYNTHES, Switzerland) using an open surgery. An anterolateral approach will be performed, the patient sit in beach chair position under general anesthesia. If required additional sutures will be authorized to fix the tuberosities.
Other Name: SURFIX, Integra
|
| Experimental: Locked plate |
Procedure: Locked plate
the fracture was reduced and fix by a locking plate using an open surgery (SURFIX, Integra, France). A deltopectoral approach will be performed, the patient sit in beach position under general anesthesia. If required, additional sutures will be authorized to fix the tuberosities.
Other Name: Multilock, SYNTHES
|
Detailed Description:
: Proximal humerus fractures have a higher occurrence in elderly patients and therefore represent a public health problem.
Prognosis depends on greater and lesser tuberosity status, where rotator tendons of the shoulder have their insertion site.
Surgical treatment is recommended in case of tuberosities displacement. Goals are their anatomic reduction and stable primary fixation that will allow good bone healing and early mobilization. It has been demonstrated that an extended immobilization can result in stiffness by capsular retraction. On the contrary a too early mobilization can lead to secondary displacement of tuberosities and malunion.
These sequelae can be responsible for real disability when occuring in active patients, in particular when dominant limb is affected.
Internal fixation by locking intramedullary nails is currently the first choice technique because less invasive. However it doesn't always provide a good bone fixation, leading to tuberosities displacement or longer immobilization that decrease shoulder function prognosis. Locking plates represent a good alternative to avoid these complications by offering a better fixation of tuberosities in osteoporotic bone.
Though there is no existing randomised study comparing these techniques regarding functional outcomes, complications rates, and patient satisfaction.
Eligibility| Ages Eligible for Study: | 40 Years to 85 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- patients between 40 and 85-years-old, who didn't expressed opposition to inclusion, with type III or IV displaced CEPHALOTUBEROSITY fracture( classification of Neer and DUPARC).
Exclusion Criteria:
- CEPHALOTUBEROSITY fractures type IV - CT4 will not be included because it can correspond to posterior or anterior fracture-dislocation of humeral head and therefore be associated to very high risk level of avascular necrosis . In this case a surgical treatment by arthroplasty is recommended.
Dislocated fracture Patient who express opposition to inclusion polytrauma
Contacts and Locations| Contact: Patrick Boyer, MD, PhD | 01.40.25.75.00 ext + 33 | patrick.boyer@bch.aphp.fr |
| France | |
| Groupe Hospitalier Bichat - Claude Bernard 46, rue Henri-Huchard | Recruiting |
| Paris, Ile de France, France, 75018 | |
| Contact: Patrick Boyer, MD, PhD 01.40.25.75.00 ext + 33 patrick.boyer@bch.aphp.fr | |
| Principal Investigator: | Patrick Boyer, MD, PhD | Assistance Publique - Hôpitaux de Paris |
More Information
No publications provided
| Responsible Party: | Assistance Publique - Hôpitaux de Paris |
| ClinicalTrials.gov Identifier: | NCT01557413 History of Changes |
| Other Study ID Numbers: | AOO269-32 |
| Study First Received: | March 16, 2012 |
| Last Updated: | March 16, 2012 |
| Health Authority: | France: Ministry of Health |
Keywords provided by Assistance Publique - Hôpitaux de Paris:
|
Humerus fracture nail plate tuberosity |
Additional relevant MeSH terms:
|
Fractures, Bone Humeral Fractures Wounds and Injuries Arm Injuries |
ClinicalTrials.gov processed this record on June 18, 2013