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Trial registered on ANZCTR
Registration number
ACTRN12616001590459
Ethics application status
Approved
Date submitted
31/10/2016
Date registered
17/11/2016
Date last updated
20/02/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
A study comparing 2 different systems for surgical fixation of broken wrists
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Scientific title
Effects of the Austofix VRP2 system and the Depuy-Synthes LCP Distal Radius System on outcomes in adult patients undergoing surgery for distal radius fractures : a randomised controlled trial.
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Secondary ID [1]
290406
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None
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Universal Trial Number (UTN)
U1111-1189-1672
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Trial acronym
POWIFF
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Linked study record
None
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Health condition
Health condition(s) or problem(s) studied:
distal radius fracture
300743
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Condition category
Condition code
Injuries and Accidents
300575
300575
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0
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Fractures
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention group will have fixation with the Austofix VRP2 distal radius plate.
Surgery will take place at the routine time and in the routine manner, undertaken by any operating surgeon from the department (at all surgical levels). The VRP2 sytem is lower profile, has more variable locking options for the screws, and is universal (ie no left or right)
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Intervention code [1]
296237
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Treatment: Surgery
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Intervention code [2]
296404
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Treatment: Devices
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Comparator / control treatment
The control group will have fixation in the same overall environment, but using the Depuy-Synthes LCP distal radius plate system.
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Control group
Active
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Outcomes
Primary outcome [1]
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PRWE Score - includes wrist pain and function
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Assessment method [1]
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Timepoint [1]
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6 weeks, 3 months, 12 months
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Secondary outcome [1]
328768
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Complications - prospectively recorded at each clinic visit / phone interview.
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Assessment method [1]
328768
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Timepoint [1]
328768
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Up to 1 year
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Secondary outcome [2]
328770
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Delayed union rates, recorded prospectively at clinic visits. Delayed union is defined as fracture not fully healed by 3 months, judged clinically and on radiographs.
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Assessment method [2]
328770
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Timepoint [2]
328770
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3 months
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Secondary outcome [3]
328771
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Fracture reduction acheived at surgery and maintained at 1 year - measured against normal values on plain radiographs
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Assessment method [3]
328771
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Timepoint [3]
328771
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immediate post-op, and 1 year
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Secondary outcome [4]
328772
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DASH Scores - disability / symptoms only
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Assessment method [4]
328772
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Timepoint [4]
328772
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6 weeks, 3 months, 1 year
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Secondary outcome [5]
328773
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EQ5D - health status score
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Assessment method [5]
328773
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Timepoint [5]
328773
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3 months, 1 year
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Secondary outcome [6]
328774
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Wrist Active ROM, as measured clinically - flexion/extension, rotation, abduction/adduction, compared to the opposite side. If this is not possible (eg pathology affecting opposite side) then standard ranges will be applied for the comparison.
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Assessment method [6]
328774
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Timepoint [6]
328774
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3 months, 1 year
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Secondary outcome [7]
328775
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Time to resumption of work, recorded at clinic visits.
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Assessment method [7]
328775
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Timepoint [7]
328775
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6 weeks, 3 months, 1 year
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Secondary outcome [8]
329305
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Operative time - from theatre operation record, time knife to skin to dressing applied.
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Assessment method [8]
329305
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Timepoint [8]
329305
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End of surgery
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Secondary outcome [9]
329306
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Number of screws used - from operative records
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Assessment method [9]
329306
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Timepoint [9]
329306
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End of surgery
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Secondary outcome [10]
329307
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Flouroscopy time - from operative records
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Assessment method [10]
329307
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Timepoint [10]
329307
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End of surgery
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Secondary outcome [11]
329309
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Patient perceived percentage global return of function, recorded at clinic reviews as a simple question
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Assessment method [11]
329309
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Timepoint [11]
329309
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3 months, 12 months
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Eligibility
Key inclusion criteria
1. Traumatic Distal radius fracture
2. Closed injury
4. Patient medically fit for surgery
5. Ability to be followed for up to 12 months
6. Presentation within 14 days of injury
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Minimum age
18
Years
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Maximum age
80
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
1. Patients with concomitant injuries affecting treatment and rehabilitation of the affected arm
2. Patients with associated neurovascular injuries requiring immediate surgery
3. Patients with associated significant carpal injuries, including scaphoid fractures
4. Patient unlikely or unhappy to attend for follow up
5. Patient with limited English proficiency
6. Patient without cognitive capacity to consent and participate
7. Patients with impaired upper limb function prior to injury enough to have a DASH score of more than 30 points.
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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)
Yes - sealed envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation.
Stratified by Age group (under or over 60), Gender, and surgical consultant
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people analysing the results/data
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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
Safety/efficacy
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Statistical methods / analysis
Continuous data will be summarised as means with standard deviations and medians with range. Categorical measures will be summarized as percentages. Treatment effects will be assessed using a two way (treatment group by time) repeated measures analysis of variance (ANOVA) and/or a linear mixed effects model as required. Post hoc comparisons will be made using t-tests. An intention-to-treat and a per-protocol analysis will be considered. All tests will be two-tailed and assessed at the 5% alpha level.
Power calculations:
Sample size calculations were based on the requirement that effects be assessed at the 5% alpha level with 90% statistical power. It was assumed that the minimum clinically important difference on the PRWE is 11.5 points and the standard deviation would be 20 points. Under these assumptions, a sample of 65 patients per group would be required; following the application of a variance inflation factor of 1.5 to account for repeated measurements over time, a sample of 98 patients per group would be required.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
23/01/2017
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Actual
1/03/2017
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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
196
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Accrual to date
70
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Funding & Sponsors
Funding source category [1]
294830
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Hospital
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Name [1]
294830
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Royal Adelaide Hospital
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Address [1]
294830
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North Terrace
Adelaide SA5000
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Country [1]
294830
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Australia
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Primary sponsor type
Individual
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Name
Mark Rickman
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Address
Level 4 Bice Building
Royal Adelaide Hospital
North Terrace
Adelaide SA5000
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Country
Australia
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Secondary sponsor category [1]
293672
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None
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Name [1]
293672
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Address [1]
293672
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Country [1]
293672
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296218
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HREC Royal Adelaide Hospital
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Ethics committee address [1]
296218
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North Terrace Adelaide SA5000
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Ethics committee country [1]
296218
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Australia
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Date submitted for ethics approval [1]
296218
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13/09/2016
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Approval date [1]
296218
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27/10/2016
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Ethics approval number [1]
296218
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R20160909 HREC/16/RAH/373
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Summary
Brief summary
Wrist fractures in patients are commonly managed using internal fixation. At the Royal Adelaide Hospital last year, 175 distal radius plating procedures were performed. Austofix have designed a new plate, the “VRP 2.0”, with the following proposed advantages over the current commonly available volar radial plate systems : 1. The plate is universal and not “sided” – this has beneficial effects in simplifying implant choice in theatre, as well as minimising hospital stock / inventory 2. The Locking mechanism is unique, and patented 3. The plate is lower profile than many on the market 4. The available angle for the variable angle screws has a range of 40 degrees, compared to 30 degrees for other systems. This may allow more accurate fragment specific fixation, and thus improve maintenance of fracture reduction, and hence eventual functional outcome. 5. The system offers improved instrumentation over currently used systems To confirm the clinical benefits of the Austofix VRP 2.0 plate system a combined prospective randomised controlled trial is proposed. This trial will compare outcomes of patients managed with the Austofix VRP 2.0 vs those managed with a conventional alternative. The VRP 2.0 plate is TGA registered, and on the approved list of implants with SA Health. Study Hypothesis: Adults with closed distal radius fractures who are managed operatively using the VRP 2.0 plate will perform at least 10 points better on the Patient-rated Wrist Evaluation (PRWE) score than those managed operatively using a conventional distal radius locking plate. Null hypothesis: There is no difference in clinical outcome up to one year post injury between patients managed with these 2 different plating systems. Aim: This study aims to provide high quality evidence for the effectiveness of surgical treatment of distal radius fractures using 2 different plating systems. It is proposed that the study will be conducted using a randomised controlled trial. Results will support and influence the future treatment of this common injury for optimal patient outcome.
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Trial website
None
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Trial related presentations / publications
None
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Public notes
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Contacts
Principal investigator
Name
69986
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A/Prof Mark Rickman
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Address
69986
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Level 4, Bice Building
Royal Adelaide Hospital
North Terrace
Adelaide SA5000
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Country
69986
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Australia
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Phone
69986
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+61 8 82225535
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Fax
69986
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Email
69986
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[email protected]
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Contact person for public queries
Name
69987
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Mark Rickman
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Address
69987
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Level 4, Bice Building
Royal Adelaide Hospital
North Terrace
Adelaide SA5000
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Country
69987
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Australia
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Phone
69987
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+61 8 82225535
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Fax
69987
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Email
69987
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[email protected]
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Contact person for scientific queries
Name
69988
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Mark Rickman
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Address
69988
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Level 4, Bice Building
Royal Adelaide Hospital
North Terrace
Adelaide SA5000
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Country
69988
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Australia
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Phone
69988
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+61 8 82225535
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Fax
69988
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Email
69988
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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
Source
Title
Year of Publication
DOI
Embase
POWIFF- Prospective study of wrist internal fixation of fracture: A protocol for a single centre, superiority, randomised controlled trial to study the efficacy of the VRP (2.0) distal radius plate (Austofix) versus the VA-LCP (Depuy-Synthes) for distal radius fractures.
2018
https://dx.doi.org/10.1186/s12891-018-2052-4
N.B. These documents automatically identified may not have been verified by the study sponsor.
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