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Trial registered on ANZCTR
Registration number
ACTRN12612001238864
Ethics application status
Approved
Date submitted
16/11/2012
Date registered
23/11/2012
Date last updated
14/03/2016
Type of registration
Retrospectively registered
Titles & IDs
Public title
Can splinting and early mobilization in the dart-throwers plane of motion improve functional outcomes and reduce postoperative complications in people after scapho-lunate ligament repairs? (Pilot Study)
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Scientific title
Can splinting and early mobilization in the dart-throwers plane of motion improve functional outcomes and reduce postoperative complications in people after scapho-lunate ligament repairs? (Pilot Study)
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Secondary ID [1]
281557
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n/a
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
scapho-lunate ligament injury
287838
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Condition category
Condition code
Injuries and Accidents
288181
288181
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0
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Other injuries and accidents
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Musculoskeletal
288214
288214
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
When the surgeon decides it is safe to remove the post-operative plaster cast (usually at 6 weeks, but can vary from 4-10 weeks depending on complexity of surgery) participants are randomised to 2 groups: intervention and control.
For the intervention group, a 2-part hinged splint will be fabricated which allows wrist motion in the Dart Throwing Plane. This is the normal motion the wrist would go through when thowing a dart or using a hammer, and involves a comination side-to-side and flexion / extension.
The splint is to be removed only for hygiene and for exercise program every 2 hours during the day for the first 4 weeks, beginning with:
- gentle wrist movement within patient's pain limits: wrist in mid-prone extension and flexion (no flexion beyond 30 degrees); wrist in supination ulnar and radial deviation; tenodesis exercise; dart-throw motion. These will be taught in the clinic, with correction of technique if necessary, then the participant continues the program at home. Participants are reviewed weekly to check progress until week 6.
After first week:
- add gentle isometric activation of flexor carpi radialis
After third week:
- add gentle isometric activation of: flexor carpi ulnaris, abductor pollicis longus, extensor carpi radialis longus and brevis.
After 4 weeks, the splint can be removed for light activity (e.g. dressing, grooming, eating) but should be worn if pain flares or when doing more strenuous tasks. It should cease completely by week 6.
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Intervention code [1]
286073
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Rehabilitation
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Intervention code [2]
286097
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Treatment: Other
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Comparator / control treatment
Static splint which allows no wrist motion. This is custom fabricated at 4-10 weeks post surgery, and is to be removed only for hygiene and exercise program every 2 hours as described above for 4 weeks.
After 4 weeks, the splint can be removed for light activity (e.g. dressing, grooming, eating) but should be worn if pain flares or when doing more strenuous tasks. It should cease completely by week 6.
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Control group
Active
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Outcomes
Primary outcome [1]
288382
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Pain (as measured on Patient rated wrist and hand evaluation)
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Assessment method [1]
288382
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Timepoint [1]
288382
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12 weeks post commencement of treatment
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Secondary outcome [1]
300004
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Function (as measured on Patient rated wrist and hand evaluation)
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Assessment method [1]
300004
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Timepoint [1]
300004
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12 weeks post commencement of treatment
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Secondary outcome [2]
300077
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Time taken to return to usual activities (including self-care, work and recreation)
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Assessment method [2]
300077
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Timepoint [2]
300077
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Weekly up until 12 weeks
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Secondary outcome [3]
300078
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whether a larger trial is feasible
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Assessment method [3]
300078
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Timepoint [3]
300078
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on completion of recruitment of 20 participants, and analysis of final results
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Eligibility
Key inclusion criteria
All people who have had surgery to repair the scapho-lunate ligament in the previous 8 weeks
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Minimum age
16
Years
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Maximum age
No limit
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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
- significant other injuries to the same limb,
- co-existing rheumatological illness,
- if they (or their carer / guardian) are not able to provide informed consent, or
- if they are not able to speak or comprehend the English language.
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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)
Those agreeing to enrol will have an appointment scheduled with one of the senior hand therapists when their plaster cast is removed after surgical review and written informed consent will be obtained when they attend this appointment. Group information will be contained in opaque, consecutively numbered sealed envelopes prepared by the research supervisor.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Allocated according to a randomised computer sequence.
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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
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
11/01/2012
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Actual
11/01/2012
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
20
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
286339
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Hospital
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Name [1]
286339
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The Alfred Small Project Grants
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Address [1]
286339
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The Alfred
55 Commercial Rd
Melbourne 3004
Victoria
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Country [1]
286339
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Australia
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Primary sponsor type
Hospital
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Name
The Alfred
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Address
55 Commercial Rd
Melbourne 3004
Victoria
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Country
Australia
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Secondary sponsor category [1]
285131
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None
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Name [1]
285131
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Address [1]
285131
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Country [1]
285131
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
288416
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Alfred Hospital Ethics Committee
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Ethics committee address [1]
288416
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55 Commercial Rd Melbourne 3004 Victoria
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Ethics committee country [1]
288416
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Australia
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Date submitted for ethics approval [1]
288416
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Approval date [1]
288416
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08/09/2011
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Ethics approval number [1]
288416
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1/11/0206
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Summary
Brief summary
Research Question: Does splinting and early mobilization in the dart-throwers plane of motion improve functional outcomes and reduce postoperative complications in people after scapho-lunate ligament repairs? Hypothesis: A dynamic splint configured to allow motion only in the dart thrower’s plane applied after plaster cast removal (this is determined by the surgeon according to operative technique, and is usually 6 weeks post surgery, but can be 4-10 weeks post surgery)will result in faster return to usual activities (including self-care, work and recreation) better patient ratings of function, less pain, and less post-operative complications than a static splint. Aim/s: To compare outcomes between two groups of patients – one of whom received the dynamic splint, the other the static splint at 12 weeks post scapho-lunate ligament repair - to determine whether patients recover more quickly, and rate their function and pain differently; and To see if a larger multi-centre study is feasible. Both groups will be advised that splints are to be removed only for hygiene and 2 hourly exercise program for 4 weeks, after which time it is phased out over the following 2 weeks. This means it is taken off for light activity at first, then ceased altogether.
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Trial website
n/a
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Trial related presentations / publications
n/a
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Public notes
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Contacts
Principal investigator
Name
34964
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Dr Lisa O'Brien
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Address
34964
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Occupational Therapy Department
The Alfred
55 Commercial Rd
Melbourne 3004
Victoria
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Country
34964
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Australia
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Phone
34964
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+61390763526
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Fax
34964
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Email
34964
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[email protected]
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Contact person for public queries
Name
18211
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Sharon Goldby
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Address
18211
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Occupational Therapy
The Alfred
55 Commercial Rd
Melbourne 3004
Victoria
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Country
18211
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Australia
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Phone
18211
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+61390763526
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Fax
18211
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+61390762920
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Email
18211
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[email protected]
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Contact person for scientific queries
Name
9139
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Sharon Goldby
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Address
9139
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Occupational Therapy
The Alfred
55 Commercial Rd
Melbourne 3004
Victoria
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Country
9139
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Australia
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Phone
9139
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+61390763526
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Fax
9139
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+61390762920
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Email
9139
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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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