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Trial registered on ANZCTR
Registration number
ACTRN12610000026022
Ethics application status
Approved
Date submitted
1/11/2009
Date registered
11/01/2010
Date last updated
24/09/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Randomized Clinical Trial to compare straight arm skin traction and olecranon skeletal traction for displaced supracondylar fractures of the humerus in children
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Scientific title
Randomised clinical trial to compare the effect of straight arm skin traction versus olecranon skeletal traction on cubitus varus deformity and range of movement in children with displaced supracondylar fracture of the humerus.
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Secondary ID [1]
1258
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Nil
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Universal Trial Number (UTN)
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Trial acronym
SCFSTVSOT
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
supracondylar fracture treatment by overhead skeletal olecranon traction vs stright-arm skin traction
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Condition category
Condition code
Injuries and Accidents
252297
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0
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Fractures
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Surgery
252366
252366
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0
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Surgical techniques
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Skeletal traction protocol consists on (i) application of the olecranon skeletal traction with Steinmann pin and frame under generals anaesthesia, (ii) overhead traction with 1.5 to 2 kg weight, with the forearm in supination and supported on ventral long arm slab, with the elbow positioned at 90 degrees of flexion (iii) continuation of traction from 2 – 3 weeks depending on the child’s age. When the patient could actively lift the arm off the pillow, usually 14 to 18 days after the injury, traction was removed and the elbow was rested in a sling and the patient was discharged. Active mobilization of the elbow was encouraged. No supervised physiotherapy was advised.
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Intervention code [1]
255728
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Treatment: Surgery
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Comparator / control treatment
Skin traction protocol consists on (i) application of the skeletal traction to the forearm with the patient under sedation, (ii) the extremity positioned with the elbow in extension and elevated, the arm was rested on a pillow. (iii) usual weight 1-1.5 kg, (iv) the continuation of traction from 2-3 weeks depending on child’s age. When the patient could actively lift the arm off the pillow, usually 14 to 18 days after the injury, traction was removed and the elbow was rested in a sling and the patient was discharged. Active mobilization of the elbow was encouraged. No supervised physiotherapy was advised.
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Control group
Active
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Outcomes
Primary outcome [1]
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cubitus varus
The carrying angle (cubitus varus) is measured with a goniometer placed on the anterior aspect of the upper limb with the elbow in extension and the forearm in supination. The axis of the goniometer is placed over the center of the cubital fossa, its proximal arm aligned with the humeral shaft and its distal arm lying on a line from the center of the antecubital fossa to the center of the wrist.
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Assessment method [1]
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Timepoint [1]
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3 months follow-up
however if the patient does not present to the clinic we try to call the patient and assess up to 6 moths after the procedure
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Primary outcome [2]
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elbow range of movement
The flexion ROM and extension ROM were measured with a goniometer placed on the lateral aspect of the elbow with the axis of the goniometer centered over the lateral epicondyle of the humerus.
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Assessment method [2]
253171
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Timepoint [2]
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3 months follow-up
however if the patient does not present to the clinic we try to call the patient and assess up to 6 moths after the procedure
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Secondary outcome [1]
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complications rate
Neurovascular deficit was assessed clinically. Radiographs were checked for the presence of myositis ossificans.
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Assessment method [1]
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Timepoint [1]
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3 months follow-up
however if the patient does not present to the clinic we try to call the patient and assess up to 6 moths after the procedure
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Eligibility
Key inclusion criteria
all consecutive patients admitted to the orthopaedic unit of Port Moresby General Hospital with diagnosed displaced (type II and III Gartland classification) supracondylar fracture of the humerus
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Minimum age
No limit
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Maximum age
16
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Children with type I undisplaced supracondylar fracture of the humerus
open fractures, intrarticular fractures, associated ipsilateral limb fractures, any visceral or head injury, or any previous treatment at a hospital elsewhere for the same injury
over 16 years of age
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
doctor enrolling the patient draw an opaque sealed envelope from a single box, after opening the envelope the patient is allocated to the tretment group and the allocation group is marked on the research paper
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
simple hand drawing by chance from a single box containing 60 opaque, sealed and identical envelopes containg allocation to the group (30 for each group)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
strict intention-to-treat analysis with mean/median imputation
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/04/2009
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Actual
12/04/2009
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Date of last participant enrolment
Anticipated
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Actual
8/12/2012
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Date of last data collection
Anticipated
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Actual
26/05/2013
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Sample size
Target
133
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Accrual to date
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Final
133
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Recruitment outside Australia
Country [1]
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Papua New Guinea
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State/province [1]
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Central Province (Port Moresby) and Madang Province
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Funding & Sponsors
Funding source category [1]
256202
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Self funded/Unfunded
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Name [1]
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Jerzy Kuzma
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Address [1]
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PO Box 1317, Boroko, NCD (no post code in PNG) Koneva Pl lot 8 sec 83
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Country [1]
256202
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Papua New Guinea
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Primary sponsor type
Individual
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Name
Jerzy Kuzma
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Address
PO Box 1317, Boroko, NCD (no post code in PNG) Koneva Pl lot 8 sec 83
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Country
Papua New Guinea
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
251543
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Other collaborator category [1]
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University
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Name [1]
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University of Papua New Guinea (UPNG)
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Address [1]
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UPNG School of Medicine and Health Sciences PO Box 5623 Boroko, NCD, Port Moresby (no postcode in PNG)
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Country [1]
919
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Papua New Guinea
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Other collaborator category [2]
280220
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University
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Name [2]
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Divine Word University
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Address [2]
280220
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DWU PO Box 483
Madang
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Country [2]
280220
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Papua New Guinea
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Ethics Committee of UPNG
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Ethics committee address [1]
244063
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School of Medicine & Health Sciences PO Box 5623, Boroko, NCD (no postcode in PNG)
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Ethics committee country [1]
244063
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Papua New Guinea
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Date submitted for ethics approval [1]
244063
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10/03/2009
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Approval date [1]
244063
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30/03/2009
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Ethics approval number [1]
244063
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Summary
Brief summary
The primary aim of this study is to compare the outcome of 2 different methods of managing displaced supracondylar fractures of humerus applicable in the setting of a tropical hospital characterized by lack of access to the image intensifier as well as limited access to specialized orthopaedic services. Although current literature supports percutaneous pinning of displaced supracondylar fractures of the humerus as preferable method rending the best results, one should notice that this method is not easily applicable in the developing counties. This study may provide good evidence for the development of clinical practice guidelines for the management of supracondylar fracture of the humerus in developing countries characterized by both lack of image intensifier and specialized orthopaedic services.
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Trial website
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Trial related presentations / publications
Kuzma J. (2014). A Comparison of Skin vs. Skeletal Traction in the Management of Childhood Humeral Supracondylar Fractures: Randomized Clinical Trial. The Internet Journal of Orthopedic Surgery, 22 (1).
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Public notes
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Contacts
Principal investigator
Name
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Prof Jerzy Kuzma
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Address
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Divine Word University
PO Box 483, Madang 511
Papua New Guinea
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Country
30442
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Papua New Guinea
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Phone
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+675 70057603
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Jerzy Kuzma
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Address
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Divine Word University
PO Box 483, Madang 511
Papua New Guinea
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Country
13689
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Papua New Guinea
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Phone
13689
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+675 70057603
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Fax
13689
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675 3233855
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Email
13689
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[email protected]
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Contact person for scientific queries
Name
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Jerzy Kuzma
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Address
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Divine Word University
PO Box 483, Madang 511
Papua New Guinea
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Country
4617
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Papua New Guinea
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Phone
4617
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+675 71776130
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Fax
4617
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675 3233855
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Email
4617
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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