Point of Care Ultrasound (POCUS) for Diagnosis and Treatment of Fractures in the Costal Cartilage
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 100
- 主要终点
- Sensitivity and specificity of POCUS for injuries in rib cartilage compared to CT.
研究概览
简要总结
The goal of this observational study is to learn if combining ultrasound and CT scans can better diagnose cartilage fractures in the ribs, and to understand how finding these injuries affects treatment decisions for patients with injuries to the Chest wall.
The main questions it aims to answer are:
- Does using both ultrasound and CT scans find more costal cartilage fractures than CT scans alone?
- Does discovering costal cartilage fractures change how patients are treated, such as whether more patients receive surgery or if different fractures are repaired?
- How do costal cartilage fractures heal, and do they affect lung function, pain, or the risk of complications after surgery?
Patients with cartilage injuries will be followed up at 1, 3, and 12 months after their injury. They will be checked for pain, instability, and healing using ultrasound and sometimes CT scans. The study will also assess lung function, quality of life, and pain levels.
详细描述
Rib fractures occur in one tenth of patients with traumatic injuries. Our knowledge about the treatment of patients with rib fractures has increased in recent years, as interest in surgical treatment of these fractures has grown. We now know more about the healing process for both surgically and conservatively treated rib fractures than we did before. Fractures in the rib cartilage are less studied. We still know very little about how fractures in the rib cartilage heal and how to approach these fractures during surgical treatment. They are also more difficult to diagnose radiologically than fractures in the bone itself.
Computed tomography (CT) is the best radiological method for diagnosing rib fractures. CT with 3D reconstructions is also a valuable preoperative mapping tool for patients who are to undergo stabilizing surgery for rib fractures. However, CT is not as sensitive for fractures in the rib cartilage, which can therefore be missed. Ultrasound has proven to be more sensitive than CT in identifying fractures in the rib cartilage.
It is unknown whether point of care ultrasound (POCUS) performed by surgeons can identify more cartilage fractures or if this affects the treatment strategy.
The purpose of this study is to investigate whether we can find more rib fractures using POCUS in combination with CT than with CT alone. We also want to study the natural course of rib cartilage fractures using POCUS, CT, and clinical examination. We will also examine whether POCUS changes our plan for treating the patients.
The project is designed as a prospective, comparative study to evaluate a standardized protocol for POCUS for identifying cartilage injuries and for assessing radiological healing of cartilage injuries.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Trauma patients (≥18 years) treated at the Department of Surgery, Sahlgrenska University Hospital, where CT has shown at least one recent injury to the chest wall.
排除标准
- •Patients with injuries resulting from CPR, severe head injury, spinal injury, and neurological or musculoskeletal disease affecting chest mobility will be excluded.
研究组 & 干预措施
Study group
结局指标
主要结局
Sensitivity and specificity of POCUS for injuries in rib cartilage compared to CT.
时间窗: Index examination at patient inclusion.
次要结局
- Number of participants where treatment strategy is changed upon identification of cartilage fractures not seen on CT.(Assessment made at patient inclusion.)
- Clinical healing of fractures in the rib cartilage(1, 3 and 12 months after patient inclusion.)
- Healing of cartilage fractures assessed with POCUS(1, 3 and 12 months after inclusion)
- Healing of cartilage fractures assessed with CT(3 and 12 months after patient inclusion.)
- Lung function with spirometry (predicted FVC)(1, 3 and 12 months after patient inclusion.)
- To what extent do costal cartilage fractures cause pain? (opioid consumption)(1, 3 and 12 months after patient inclusion.)
- To what extent do costal cartilage fractures cause pain? (visual analogue scale)(1, 3 and 12 months after patient inclusion.)
- To what extent do costal cartilage fractures cause pain? (graphical representation)(1, 3 and 12 months after patient inclusion.)
- What are the complications of fixation of costal cartilage injuries?(1, 3 and 12 months after patient inclusion.)
研究者
Erik Öberg Westin
Principal investigator
Sahlgrenska University Hospital