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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT01380444
Registration number
NCT01380444
Ethics application status
Date submitted
20/06/2011
Date registered
27/06/2011
Titles & IDs
Public title
Intramedullary Nail Versus Sliding Hip Screw Inter-Trochanteric Evaluation
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Scientific title
A Multi-Center Randomized Controlled Trial of Intramedullary Nails Versus Sliding Hip Screws in the Management of Intertrochanteric Fractures of the Hip
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Secondary ID [1]
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96308751
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Secondary ID [2]
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14032012_INSITE_v2.0
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Universal Trial Number (UTN)
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Trial acronym
INSITE
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Femoral Neck Fractures
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Intertrochanteric Fracture
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Condition category
Condition code
Injuries and Accidents
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Fractures
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Musculoskeletal
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Surgery - Gamma3 Intramedullary Nails (Stryker)
Treatment: Surgery - Sliding Hip Screws
Active comparator: 1 - Gamma3 Intramedullary Nails
Active comparator: 2 - Sliding Hip Screws
Treatment: Surgery: Gamma3 Intramedullary Nails (Stryker)
The Gamma3 nail is cannulated for Guide-Wire-controlled insertion, and features a conical tip for optimal alignment with the inner part of the cortical bone. A single distal Locking Screw is provided to stabilize the nail in the medullary canal and to help to prevent rotation in complex fractures.
Treatment: Surgery: Sliding Hip Screws
The sliding hip screw is a single larger diameter partially threaded screw, which is affixed to the proximal femur with a side plate (with a minimum of two holes and a maximum of four holes) and no supplemental fixation.
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Intervention code [1]
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Treatment: Surgery
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Health Related Quality of Life
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Assessment method [1]
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To assess the impact of Gamma3 intramedullary nails versus sliding hip screws on health-related quality of life as measured by the EuroQol-5D at 52 weeks in individuals with trochanteric fractures.
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Timepoint [1]
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Up to 104 weeks
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Secondary outcome [1]
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Health Related Quality of Life
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Assessment method [1]
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To assess the impact of Gamma3 intramedullary nails versus sliding hip screws on health-related quality of life as measured with the Parker mobility score and the Harris Hip Score.
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Timepoint [1]
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Up to 104 weeks
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Secondary outcome [2]
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Fracture healing rates
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Assessment method [2]
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A fracture is to be considered healed when there is obliteration of the fracture lines by newly formed bone along the cortices and within the trabecular bone on anteroposterior and lateral (or oblique) radiographs.
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Timepoint [2]
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Up to 104 weeks
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Secondary outcome [3]
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Fracture-related adverse events
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Assessment method [3]
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Including mortality, femoral shaft fracture, avascular necrosis (although rare in trochanteric fractures), nonunion, malunion (shortening, varus deformity, valgus deformity and rotational malunion), implant breakage or failure, and infection (i.e., superficial and deep).
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Timepoint [3]
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Up to 104 weeks
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Secondary outcome [4]
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Revision surgery rates
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Assessment method [4]
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Any unplanned surgery after the initial fixation to promote fracture healing (non-union), relieve pain (avascular necrosis, early or late implant failure), treat infection, or improve function will be considered a study event.
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Timepoint [4]
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Up to 104 weeks
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Eligibility
Key inclusion criteria
1. Adult men or women aged 18 years and older (with no upper age limit).
2. An intertrochanteric fracture (stable or unstable), AO Type 31-A1 or 31-A2, confirmed with anteroposterior and lateral hip radiographs, computed tomography, or magnetic resonance imaging (MRI).
3. Low energy fracture (defined as a fall from standing height).
4. No other major trauma.
5. Patient was ambulatory prior to fracture, though they may have used an aid such as a cane or a walker.
6. Anticipated medical optimization of the patient for operative fixation of the proximal femur.
7. Operative treatment within 7 days after the trauma.(Operative treatment should take place as soon as possible as permitted by each institution's standard of care.)
8. Provision of informed consent by patient or proxy.
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Minimum age
18
Years
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Maximum age
No limit
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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. Associated major injuries of the lower extremity (i.e., ipsilateral and/or contralateral fractures of the foot, ankle, tibia, fibula, or knee; dislocations of the ankle, knee, or hip).
2. Retained hardware around the affected proximal femur.
3. Infection around the proximal femur (i.e., soft tissue or bone).
4. Patients with disorders of bone metabolism other than osteoporosis (i.e., Paget's disease, renal osteodystrophy, or osteomalacia).
5. Patients with Parkinson's disease severe enough to increase the likelihood of falling or severe enough to compromise rehabilitation.
6. Patients with a subtrochanteric fracture.
7. Patients with a pathologic fracture.
8. Patients with a reverse oblique fracture pattern, fracture AO Type 31-A3.
9. Obesity in the judgment of the attending surgeon.
10. Off-label use of the implant.
11. Patients with a previous history of frank dementia that would interfere with assessment of the primary outcome (i.e., EQ-5D at 1 year).
12. Likely problems, in the judgment of the Site Investigators, with maintaining follow-up. We will, for example, exclude patients with no fixed address, those who report a plan to move out of town in the next year, or intellectually challenged patients without adequate family support.
13. Patient is enrolled in another ongoing drug or surgical intervention trial.
14. If the attending surgeon believes that there is another reason to exclude this patient from INSITE. This reason will be documented on the case report forms (CRFs).
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
NA
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/12/2011
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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
1/03/2017
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Sample size
Target
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Accrual to date
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Final
880
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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The Royal Melbourne Hospital - Parkville
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Recruitment postcode(s) [1]
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3039 - Parkville
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Recruitment outside Australia
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United States of America
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State/province [1]
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California
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United States of America
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Massachusetts
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United States of America
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Pennsylvania
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United States of America
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Texas
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United States of America
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Virginia
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Canada
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Manitoba
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Canada
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Ontario
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China
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Beijing
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China
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Shanghai
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China
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Zhejiang
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Colombia
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Antioquia
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Colombia
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Cundinamarca
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Denmark
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Aarhus
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Germany
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Lübeck
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Germany
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Stuttgart
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Japan
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Ibaraki
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Netherlands
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Amsterdam
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Norway
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State/province [18]
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Alesund
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South Africa
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Parktown
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United Kingdom
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Bristol
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United Kingdom
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Liverpool
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United Kingdom
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Reading
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United Kingdom
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State/province [23]
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Southampton
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Stryker Trauma and Extremities
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Address
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Other collaborator category [1]
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Commercial sector/industry
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Name [1]
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Global Research Solutions
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Address [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study is to assess the impact of Gamma3 intramedullary nails versus sliding hip screws on health-related quality of life as measured by the EuroQuol-5D at 52 weeks in individuals with trochanteric fractures. Secondary outcomes include revision surgery rates, fracture healing rates, fracture related adverse events, and health-related quality of life, including the Parker mobility score and Harris Hip Score.
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Trial website
https://clinicaltrials.gov/study/NCT01380444
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Trial related presentations / publications
Ahrengart L, Tornkvist H, Fornander P, Thorngren KG, Pasanen L, Wahlstrom P, Honkonen S, Lindgren U. A randomized study of the compression hip screw and Gamma nail in 426 fractures. Clin Orthop Relat Res. 2002 Aug;(401):209-22. doi: 10.1097/00003086-200208000-00024. Bhandari M, Schemitsch E, Jonsson A, Zlowodzki M, Haidukewych GJ. Gamma nails revisited: gamma nails versus compression hip screws in the management of intertrochanteric fractures of the hip: a meta-analysis. J Orthop Trauma. 2009 Jul;23(6):460-4. doi: 10.1097/BOT.0b013e318162f67f. Parker MJ, Handoll HH. Gamma and other cephalocondylic intramedullary nails versus extramedullary implants for extracapsular hip fractures in adults. Cochrane Database Syst Rev. 2008 Jul 16;(3):CD000093. doi: 10.1002/14651858.CD000093.pub4.
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Public notes
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Contacts
Principal investigator
Name
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Mohit Bhandari, MD, PhD, FRCSC
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Address
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Global Research Solutions
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Contact person for public queries
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT01380444