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Clinical Trial to Evaluate Three Systems of Osteosynthesis for Fixation of Olecranon Osteotomies in Adults

Phase 4
Not yet recruiting
Conditions
Olecranon Fracture
Registration Number
NCT07014358
Lead Sponsor
Fundacion para la Investigacion Biomedica del Hospital Universitario Ramon y Cajal
Brief Summary

Surgery of the elbow joint is often made difficult by the highly constrained nature of the elbow joint. This is why it is often necessary to perform an osteotomy of the olecranon, the proximal part of the ulna, which allows perfect exposure of the entire articular surface. After performing the osteotomy, access to the joint is obtained, the articular problem is solved as appropriate and, upon completion, the osteotomized bone is fixed with a stable fixation system that allows the osteotomy to heal without problems. It is a safe, reproducible procedure that is associated with low associated morbidity. The main problems associated with this procedure are the lack of consolidation of the osteotomy or the need for removal of the osteosynthesis material at a later stage.

Detailed Description

The incidence of these complications is around 4% for the former and 20-50% for the latter. Both complications usually require a second surgical procedure to solve the problem, so the reoperation rates for these procedures are around 40-50%.

However, there is discussion in the literature as to the most appropriate fixation system to ensure fracture healing. There are, broadly speaking, three frequently used fixation systems: the placement of two steel pins and a wire in an obenque configuration, the placement of a screwed plate or the placement of a compression screw.

It is not clear which is the best fixation system among these three. Biomechanical studies suggest that, from this point of view, all three procedures are adequate. The choice of which is ideal should therefore be based on the ease of use and the complications associated with the procedure, in particular the reoperation rate.There are no clinical trials in the literature comparing these three fixation techniques, so there is a clear lack of knowledge in this field.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
105
Inclusion Criteria
  • Patients who, after receiving information about the design, the purposes of the study, the possible risks that may arise from it and the fact that they may refuse to collaborate at any time, give their written consent to participate in the study.
  • Be over 18 years of ag
  • Have an elbow disorder that is to be treated surgically through an olecranon osteotomy approach.
  • That the olecranon osteotomy is amenable to synthesization with the three proposed systems.
  • Understand the purpose of the study and be available for routine hospital visits.
Exclusion Criteria
  • Patients who have undergone ipsilateral elbow surgery.
  • Presence of ulnar fractures
  • Patients with an active infection at any site at the time of elbow surgery.
  • Inability to understand the procedure or information related to the study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Define which of the three fixarion systems is safer based on the number of patients with each fixation system that need to be reintervened.12 Months

The main evaluation criterion will be the need for reoperation for any cause related to the olecranon osteotomy in the first year of follow-up.

Secondary Outcome Measures
NameTimeMethod
Number of patients suffering Adverse Events related or not, with the medical product, within a year12 months

Fracture

Number of patients suffering Adverse Events related or not with the medical product within a year12 months

Complications in the healing process of the surgical wound

Number of patients suffering: Adverse Events related or not with the medical product within a year12 months

Mechanical complications with the implant

Number of patients suffering Adverse Events related or not with the medical product, within a year12 months

Reintervention

Number of patients suffering Adverse Events, related or not with the medical product, within a year12 months

Residual pain

Efficacy measured usimg the evaluation of different scales and tests performed by the patient, that altogether provide the needed information about the efficacy of the medical product.24 months

Measured by Pain leveld (BPI test)

Efficacy, measured usimg the evaluation of different scales and tests performed by the patient that altogether provide the needed information about the efficacy of the medical product.24 months

Measured by Mayo Elbow Score Scale (MEPS)

Efficacy, measured usimg the evaluation of different scales and tests performed by the patient, that altogether provide the needed information about the efficacy of the medical product24 months

Measured by pasive and active movility range

Trial Locations

Locations (5)

Hospital Mutua Montañesa Santander

🇪🇸

Santander, Cantabria, Spain

Clínica CEMTRO

🇪🇸

Madrid, Comunidad De Madrid, Spain

Hospital La Fe

🇪🇸

Valencia, Comunidad Valenciana, Spain

Hospital de Manises

🇪🇸

Valencia, Manises, Spain

Hospital Universitario de Móstoles

🇪🇸

Madrid, Spain

Hospital Mutua Montañesa Santander
🇪🇸Santander, Cantabria, Spain

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