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Study of Tibial Shaft Fractures in Children

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ClinicalTrials.gov Identifier: NCT01238523
Recruitment Status : Completed
First Posted : November 10, 2010
Last Update Posted : August 17, 2017
Sponsor:
Collaborator:
Information provided by (Responsible Party):

Study Description
Brief Summary:

Tibial shaft fracture is one of the most common fractures in children and adolescents. It encompasses approximately 15 % of all long-bone fractures and is third behind only fractures of the femur and both bones of the forearm. (2). Although most authorities agree that closed tibial shaft fractures are best treated by immobilization in a long-leg cast, there is no clear consensus as to when to allow weight bearing on the injured extremity. While most recent articles have recommended long-leg casts with the knee bent in flexion of 30-60 degrees to preclude weight-bearing(1,2,3,4), other authors have recommended much less flexion, 0-5 degrees, to encourage early weight bearing.(5).

The purpose of this randomized controlled prospective study is to determine if the position of immobilization of the knee influences the rate of healing, delayed union, and nonunion As well, we will assess if the type of immobilization affects the function of the patient during the period of treatment using the Activities Scale for Kids - Performance (ASK-P) child self-report musculoskeletal outcome measure . A minimum of 36 patients in each group for a total of 72 patients between 4 and 14 years of age (open physis) with closed fractures of the tibia, with or without fracture of the fibula, will be included in the study


Condition or disease Intervention/treatment
Tibial Shaft Fractures in Children Procedure: Long leg cast in full extension Procedure: Long leg cast with 45 degrees of flexion

Study Design

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 81 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Early Weight-Bearing in the Closed Treatment of Tibial Shaft Fractures in Children
Study Start Date : May 2007
Primary Completion Date : May 2010
Study Completion Date : May 2010

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Fractures
U.S. FDA Resources

Arms and Interventions

Arm Intervention/treatment
Experimental: Long leg cast in full extension
Long leg cast in full extension with instructions to begin immediate weight bearing as tolerated on the injured extremity
Procedure: Long leg cast in full extension
Long leg cast in full extension with instructions to begin immediate weight bearing as tolerated on the injured extremity
Experimental: Long leg cast with 45 degrees of flexion
Long leg cast with 45 degrees of flexion at the knee with instructions not to bear weight on the injured extremity
Procedure: Long leg cast with 45 degrees of flexion
Long leg cast with 45 degrees of flexion at the knee with instructions not to bear weight on the injured extremity


Outcome Measures

Primary Outcome Measures :
  1. The Activities Scale for Kids - Performance (ASK-P) [ Time Frame: May 2007 - May 2010 ]
    The Activities Scale for Kids (ASK) is a 30 item child self-report musculoskeletal outcome measure that focuses on the child's physical disability, and is scored with a summary score with no sub-scales. The performance format ASK-P will be used in this study. The scoring system is from 0-100 with 100 being the best possible score.


Secondary Outcome Measures :
  1. Time to Healing [ Time Frame: May 2007 - May 2010 ]
    Radiographic union will be defined as the presence of callus bridging of 3 out of 4 cortices as seen on anterior posterior and lateral radiographs.


Eligibility Criteria

Information from the National Library of Medicine

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Ages Eligible for Study:   4 Years to 14 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients between 4 and 14 years of age (open physis)
  • Patients seen at the Los Angeles Orthopaedic Medical center within 7 days of the original injury
  • All closed tibia and tibia and fibula shaft fractures regardless of fracture pattern

Exclusion Criteria:

  • Fractures with greater than 2 cm of initial shortening
  • Open fractures
  • Patients that have other orthopaedic medical issues such as hemophilia
Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01238523


Locations
United States, California
Los Angeles Orthopaedic Hospital
Los Angeles, California, United States, 90007
Sponsors and Collaborators
University of California, Los Angeles
Los Angeles Orthopaedic Hospital
More Information

Publications:
Responsible Party: Mauricio Silva, Principal Investigator, University of California, Los Angeles
ClinicalTrials.gov Identifier: NCT01238523     History of Changes
Other Study ID Numbers: OH-001
First Posted: November 10, 2010    Key Record Dates
Last Update Posted: August 17, 2017
Last Verified: May 2010

Keywords provided by Mauricio Silva, University of California, Los Angeles:
tibia
shaft
fracture
children

Additional relevant MeSH terms:
Fractures, Bone
Wounds and Injuries
Calpastatin
Cysteine Proteinase Inhibitors
Protease Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action