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Trial registered on ANZCTR
Registration number
ACTRN12616001313426
Ethics application status
Approved
Date submitted
6/09/2016
Date registered
19/09/2016
Date last updated
8/04/2021
Date data sharing statement initially provided
9/11/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Efficacy of two splint treatment protocols of tendinous mallet finger Injuries
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Scientific title
Efficacy of two splint treatment protocols for tendinous mallet finger injuries.
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Secondary ID [1]
289967
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Nil known
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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:
Tendinous Mallet finger injuries
299966
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Condition category
Condition code
Physical Medicine / Rehabilitation
299858
299858
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0
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Occupational therapy
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Injuries and Accidents
300134
300134
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0
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Other injuries and accidents
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Musculoskeletal
300135
300135
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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
Current literature supports the conservative management over surgical management for type one tendinous mallet injuries (ie full or partial rupture of the terminal insertion of the extensor tendon in the finger). However the gold standard of conservative treatment
is still under development and a topic for debate amongst researchers and clinicians.
This study will include two groups: the 'Standard Care Group' will follow the 'standard' tendinous mallet splint protocol of a custom-made thermoplastic splint including and blocking the DIP joint in extension/hyperextension with the PIP joint free for eight weeks full time wear followed by four weeks of intermittent day wear and nocturnal wear. The 'Standard Care Group' data will be collected retrospectively.
The 'PIP protocol group', will wear a custom-made thermoplastic splint which blocks the PIP joint in a controlled flexion range for the initial two-four weeks (determined by the natural laxity of the volar plate and hyperextension of the PIP joint) together with the DIP joint blocked in extension/hyperextension, before continuing with the 'standard' protocol for up to eight weeks of continuous splint wear followed by a further four weeks of protective and nocturnal wear. It is proposed that the 'PIP Protocol Group' data will be followed prospectively. All subjects will be asked at each treatment intervention regarding their adherence to the treatment protocol, and any diversions or changes noted.
Proposed methodology:
Quantitative methods will be used to compare the outcomes for the two treatment groups. Approximately 30 people will be recruited retrospectively to analyse outcomes of the standard treatment group. Approximately 30 people will be recruited prospectively for the PIP protocol group.
Patients with a Zone One tendinous mallet finger injury, who fit the selection criteria and agree to participation in the study, will be allocated to a group – 'Standard care' or 'PIP protocol' care.
In the initial phase all patients will be treated using the 'Standard care' group. This phase will continue for a period of three months or until a total of 30 patients is reached and will include retrospective clients who provide consent to access their records.
Following completion of this phase, all subsequent patients will be allocated to the 'PIP protocol' group for a period of three months or until a total of 30 patients is reached for this group.
The Occupational Therapy staff at Specialised Hand Therapy Service will conduct the standard treatment trial at any of their nine practice locations in Western Australia, with Dr Janet Richmond from ECU School of Medical and Health Sciences taking the chief investigator role. Data analysis will be conducted using SPSS. Correlations of outcomes
will be investigated. Standard deviation and t-test statistics will be calculated to determine effect size and significance of the treatment protocol.
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Intervention code [1]
295656
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Treatment: Devices
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Intervention code [2]
295657
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Rehabilitation
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Intervention code [3]
295658
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Prevention
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Comparator / control treatment
The 'Standard care group' (control group) will follow the 'standard' tendinous mallet splint
protocol of a splint including the DIP joint in extension/hyperextension with the PIP joint free for eight weeks full time wear followed by four weeks of intermittent day wear and nocturnal wear.
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Control group
Active
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Outcomes
Primary outcome [1]
299335
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DIP joint extensor lag, assessed using a finger goniometer
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Assessment method [1]
299335
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Timepoint [1]
299335
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At Initial appointment prior to treatment and at 8 weeks, 10 weeks and at Discharge (12+ weeks) post commencement of treatment.
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Primary outcome [2]
299616
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PIP joint hyperextension range, assessed using a finger goniometer
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Assessment method [2]
299616
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Timepoint [2]
299616
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At Initial appointment prior to treatment and at 8 weeks, 10 weeks and at Discharge (12+ weeks) post commencement of treatment.
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Primary outcome [3]
299617
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Total active range of motion of the DIP joint, assessed using a finger goniometer and calculated by subtracting the achievable extension range of the DIP joint from the achievable flexion range of the DIP joints,
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Assessment method [3]
299617
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Timepoint [3]
299617
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At Initial appointment prior to treatment and at 8 weeks, 10 weeks and at Discharge (12+ weeks) post commencement of treatment.
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Secondary outcome [1]
326865
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Satisfaction with treatment outcome, assessed using Satisfaction VAS
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Assessment method [1]
326865
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Timepoint [1]
326865
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Assessed at Discharge (12+ weeks) post commencement of treatment.
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Secondary outcome [2]
327693
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Grip strength comparison injured to non-injured hand, assessed using Jamar Dynamometer
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Assessment method [2]
327693
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Timepoint [2]
327693
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Assessed at Discharge (12+ weeks) post commencement of treatment.
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Eligibility
Key inclusion criteria
Inclusion criteria: Only people fitting the following criteria will be recruited:
> only people aged 18 to 65 years
>Zone One extensor tendon tendinous mallet injuries of the fingers
>less than three weeks post injury at the time of the initial assessment
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Minimum age
18
Years
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Maximum age
65
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
Exclusion criteria:
>bony avulsion fracture mallet injuries
>aged below 18 or older than 65 years
>Previous mallet injury at the same joint
> Previous injury to the same finger that may impact outcomes e.g. Swan Neck deformity, fixed flexion
deformity, pre-existing reduced range of motion.
> laceration or open tendon mallet injuries
> surgical repairs
>a patient who experienced the injury more than three weeks prior to the initial presentation
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation is not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people analysing the results/data
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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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
1/10/2016
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Actual
17/02/2016
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Date of last participant enrolment
Anticipated
1/06/2019
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Actual
11/10/2019
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Date of last data collection
Anticipated
11/04/2020
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Actual
20/03/2020
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Sample size
Target
60
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Accrual to date
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Final
66
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Recruitment in Australia
Recruitment state(s)
WA
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Funding & Sponsors
Funding source category [1]
294340
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Other
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Name [1]
294340
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Specialised Hand Therapy Services
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Address [1]
294340
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17 Colin St
West Perth WA 6005
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Country [1]
294340
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Australia
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Primary sponsor type
Other
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Name
Specialised Hand Therapy Services
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Address
17 Colin St
West Perth WA 6005
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Country
Australia
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Secondary sponsor category [1]
293179
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None
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Name [1]
293179
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Address [1]
293179
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Country [1]
293179
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Other collaborator category [1]
279167
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University
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Name [1]
279167
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Edith Cowan University
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Address [1]
279167
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Dr Janet Richmond
School of Medical and Health Sciences
270 Joondalup Drive
Joondalup wa 6027
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Country [1]
279167
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
295758
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Human Research Ethics Committee
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Ethics committee address [1]
295758
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Research Ethics Office Edith Cowan University 270 Joondalup Drive Joondalup WA 6027
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Ethics committee country [1]
295758
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Australia
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Date submitted for ethics approval [1]
295758
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10/11/2015
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Approval date [1]
295758
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17/02/2016
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Ethics approval number [1]
295758
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Project code 13869 RICHMOND
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Summary
Brief summary
Specialised Hand Therapy Services is conducting research in conjunction with Edith Cowan University into outcomes following treatment of tendinous Mallet finger injuries. The aim is to determine whether long term outcomes can be improved by providing an additional splint to the usual standard splint protocol that is currently used. The project is being conducted by Taryn Post, Jessica Mirabile, Cathy Thomas and staff at Specialised Hand Therapy Services and also with Dr. Janet Richmond from Edith Cowan University. This project will help us find out if positioning the finger differently (i.e. with the PIP joint in flexion as well as the DIP joint in extension/hyperextension) improves results/ outcomes for our clients. We are currently evaluating the protocol and splint type that we use for the treatment of acute tendinous mallet injuries. We are collecting data and evaluating the outcomes to better aid in the protocol that we use in the treatment for these diagnoses. We wish to study whether an additional splint that keeps the PIP (middle) joint of the injured finger in a slightly flexed (bent) position while wearing the splint for the injured DIP (end) joint improves long term outcomes and results with conservative/nonsurgical management of Mallet finger injuries.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
68370
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Dr Janet Richmond
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Address
68370
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Edith Cowan University
270 Joondalup Drive
Joondalup WA 6027
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Country
68370
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Australia
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Phone
68370
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+61 8 6304 3575
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Fax
68370
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Email
68370
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[email protected]
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Contact person for public queries
Name
68371
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Cathy Thomas
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Address
68371
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Specialised Hand Therapy Services
17 Colin St
West Perth WA 6005
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Country
68371
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Australia
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Phone
68371
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+61 8 9324 2881
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Fax
68371
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Email
68371
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[email protected]
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Contact person for scientific queries
Name
68372
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Cathy Thomas
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Address
68372
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Specialised Hand Therapy Services
17 Colin St
West Perth WA 6005
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Country
68372
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Australia
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Phone
68372
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+61 8 9324 2881
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Fax
68372
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Email
68372
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Sharing of data was not covered in our ethics information and consent form. In addition, we are not bound by any funding body to share the IPD with other researchers. If a particular participant requests their own information, that can be shared with them via the therapist conducting the treatment
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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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