Fast Track for Wrist and Scaphoid Fractures

Not Applicable

Terminated

• Conditions: Scaphoid Fracture; Wrist Fracture
• Interventions: Other: fast track; Other: normal pathway

• Registration Number: NCT05183477
• Lead Sponsor: Ente Ospedaliero Cantonale, Bellinzona

Brief Summary

This is a mono centric, prospective, randomised trial on the implementation and assessment of a shortened pathway for mono-trauma of the wrist and suspected fracture of distal radius and/or ulna and/or scaphoid bone.

Detailed Description

Patients will be randomised into two groups: fast track and normal pathway. At the arrival in the Emergency Department a triage will be performed. In case of met inclusion criteria the patient will sign the informed consent and will be randomised in one of the two study groups.

The fast track group will be straightforwardly evaluated for absence of exclusion criteria (in case of exclusion criteria present the investigators will follow the normal pathway and the patient will not be included in the study). Then, patients will be assessed with an ad hoc checklist and then sent for x-ray performance, if necessary. After the x-ray the patients will be examined by an emergency physician that will have the opportunity to request new x-ray views if necessary.

The normal pathway group will go straight to medical examination as soon as possible, depending on waiting times in the Emergency Department.

Investigators will collect anagraphical data, waiting times, time to x-ray, overall length of stay in the Emergency Department, patients' and staff's satisfaction for the two groups.

Study Timeline

• Study First Submitted: 2021-12-07
• Study Start: 2021-12-17
• Study First Submitted QC: 2021-12-21
• Study First Posted: 2022-01-10
• Primary Completion: 2024-09-30
• Study Completion: 2024-09-30
• Status Verified: 2025-02
• Last Update Submitted: 2025-02-25
• Last Update Posted: 2025-02-27

Recruitment & Eligibility

• Status: TERMINATED
• Sex: All
• Target Recruitment: 196

Inclusion Criteria

• adults patients presenting at the emergency dept with suspected scaphoid or wrist fracture
• monotrauma
• written informed consent

Exclusion Criteria

• patients younger than 18 yr
• pregnant women
• either vascular or neural impairment
• signs of open fracture
• multiple trauma patient

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
fast track	fast track	patients arriving at Emergency Department with suspected wrist or scaphoid fracture, randomly allocated to the fast track pathway (xray requested at triage by nurse)
normal pathway	normal pathway	patients arriving at Emergency Department with suspected wrist or scaphoid fracture, randomly allocated to waiting room and than medical examination before asking for xrays

Primary Outcome Measures

Name	Time	Method
number of x rays requested	From admission to discharge, up to 2.5 hours	the number of xray requested

Secondary Outcome Measures

Name	Time	Method
waiting time before examination	From admission to discharge, up to 2.5 hours
waiting time before xray	From admission to discharge, up to 2.5 hours
patient's satisfaction	From admission to discharge, up to 2.5 hours	Patients' satisfaction will be tested with the help of the brief emergency department patient satisfaction scale (BEPSS). The questionnaire consists of 20 questions and for each item, a response scale form 1 (completely disagree) to 4 (completely agree) is used.
total length of stay in the emergency department	From admission to discharge, up to 2.5 hours

Trial Locations

Locations (1)

Ospedale Regionale di Lugano - ORL; 🇨🇭 Lugano, Ticino, Switzerland