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Study of Nerve Repair and Reconstruction Associated With Major Extremity Trauma

Completed
Conditions
Peripheral Nerve Injury(Ies)
Registration Number
NCT02718768
Lead Sponsor
Major Extremity Trauma Research Consortium
Brief Summary

This is a multi-center prospective observational study that will capture detailed information about the treatment and long term outcomes of 250 patients with PNI resulting from upper extremity trauma. The study will focus on a young adult population to include individuals ages 18-65. Patients with PNI will be recruited during the hospitalization for initial treatment of the upper extremity injury. Additional patients may be identified during clinic visits for on-going treatment of upper extremity injuries as nerve injuries evolve or upon referral from outside physicians. However, all eligible nerve injuries must be treated within 6 months of the initial upper extremity trauma. Outcomes will be assessed at 3, 6, 12, 18 and 24 months following diagnosis of the nerve injury. All assessments will take place in the clinic and will include a patient interview and a brief exam to evaluate sensory and motor function.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
242
Inclusion Criteria
  1. Ages 18-65

  2. Sustained a peripheral nerve injury (including iatrogenic injuries and partial nerve injuries) resulting from upper extremity trauma meeting the following criteria:

    1. Involves injury or dysfunction to motor, or motor and sensory function of the axillary, radial, median, ulnar, or musculocutaneous nerve with injury localized distal to the brachial plexus cord level and proximal to the distal flexion crease of the wrist
    2. Involves a "mixed" nerve segment (i.e. involves a location of any of the above specified nerves that can be expected to have both sensory and motor axons present) but does not include sensory only distal terminations of the same nerves.
  3. Receiving surgical treatment (i.e. exploration, neurolysis, repair or reconstruction, nerve or tendon transfer) within 6 months of the initial injury.

Exclusion Criteria
  1. Injuries to the brachial plexus roots, trunks, divisions and cords
  2. Injuries to the nerves distal to the distal flexion crease of the wrist
  3. Injuries that involve a distal extension of the parent nerve that is considered sensory only (superficial radial nerve, lateral ante brachial cutaneous nerve, etc)
  4. Previous motor or sensory deficit prior to injury (e.g. resulting from trauma, stroke, muscular, neurologic, neuromuscular disorder, etc.)
  5. Documented psychiatric disorder that limits ability to consent and maintain follow-up
  6. Unable to speak either English or Spanish
  7. Severe problems with maintaining follow up (e.g patients who are prisoners or homeless at time of injury or who are intellectually challenged without adequate family support).

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Incidence of Peripheral Nerve Injury (PNI) resulting from upper extremity trauma admitted across multiple trauma centers.2 years
Type of PNI resulting from upper extremity trauma admitted across multiple trauma centers.2 years
Treatment type of PNI resulting from upper extremity trauma admitted across multiple trauma centers.2 years
Treatment timing of PNI resulting from upper extremity trauma admitted across multiple trauma centers.2 years
Secondary Outcome Measures
NameTimeMethod
Pain Score2 years

Self reported outcomes using the Brief Pain Inventory.

Global Hand Function2 years

Global hand function will be measured using grip strength.

Surgical Complications2 years

Surgical complications includes surgical site infections, wound dehiscence/breakdown, exposure of nerves and/or their repairs and reconstructions, breakdown of nerve repair and reconstruction, seroma/hematoma, and other local wound complications.

Disability2 years

Self reported outcomes using the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH).

Sensory Function2 years

Sensory function will be evaluated using the the touch test mono-filament hand evaluation kit.

Depression2 years

Self reported outcomes using the Patient Health Questionnaire (PHQ-9).

Return to Work or Duty2 years

Self reported outcomes using the Work Productivity and Activity Impairment (WPAI) questionnaire.

Motor Function2 years

Motor function will be evaluated using range of motion and the British Medical Research Council motor grading scale.

Post Traumatic Stress Disorder (PTSD)2 years

Self reported outcomes using the standard PTSD Checklist.

Trial Locations

Locations (17)

Pennsylvania Hospital

🇺🇸

Philadelphia, Pennsylvania, United States

Ryder Trauma Center

🇺🇸

Miami, Florida, United States

Methodist Hospital

🇺🇸

Bloomington, Indiana, United States

University of Maryland Medical Center Shock Trauma Center

🇺🇸

Baltimore, Maryland, United States

The Curtis National Hand Center, Medstar Union Memorial Hospital

🇺🇸

Baltimore, Maryland, United States

University of New Mexico Health Sciences Center

🇺🇸

Albuquerque, New Mexico, United States

Carolinas Medical Center

🇺🇸

Charlotte, North Carolina, United States

MetroHealth

🇺🇸

Cleveland, Ohio, United States

University of Texas Health Science Center

🇺🇸

Houston, Texas, United States

Hennepin County Medical Center

🇺🇸

Minneapolis, Minnesota, United States

University of Oklahoma Medicine

🇺🇸

Oklahoma City, Oklahoma, United States

San Antonio Military Medical Center

🇺🇸

San Antonio, Texas, United States

Vanderbilt Medical Center

🇺🇸

Nashville, Tennessee, United States

Denver Health

🇺🇸

Denver, Colorado, United States

Walter Reed National Military Medical Center

🇺🇸

Bethesda, Maryland, United States

Wake Forest Baptist Health

🇺🇸

Winston-Salem, North Carolina, United States

Virginia Commonwealth University Medical Center

🇺🇸

Richmond, Virginia, United States

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