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Trial registered on ANZCTR
Registration number
ACTRN12607000478415
Ethics application status
Approved
Date submitted
24/08/2007
Date registered
21/09/2007
Date last updated
21/09/2007
Type of registration
Retrospectively registered
Titles & IDs
Public title
Optimal timing for femoral fracture fixation in multiple trauma patients
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Scientific title
Optimal timing for femoral fracture fixation in multiple trauma patients
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Multi-system trauma with femoral shaft fracture
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Condition category
Condition code
Surgery
2384
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0
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Other surgery
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Musculoskeletal
2385
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0
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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
Damage Control Orthopaedics (DCO) – primary fixation using an external fixator followed by secondary definitive intramedullary nailing between 3 (i.e., greater than 48 hours) and 6 days post-injury
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Intervention code [1]
2004
0
Treatment: Devices
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Comparator / control treatment
• Early Total Care (ETC) – definitive intramedullary nailing within 24 hours of injury
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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- the incidence of adult respiratory distress syndrome (ARDS);
- the incidence of acute lung injury (ALI);
- the percentage of patients developing new organ failure using a standard and well established organ failure scoring system (Sequential Organ Failure Assessment [SOFA] score).
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Assessment method [1]
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Timepoint [1]
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Whilst in Intensive Care Unit up to 14 days post-injury
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Secondary outcome [1]
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- time on mechanical ventilation,
- the inflammatory response to surgery measured using markers for proinflammatory cytokines, including interleukin-6,
- Acute Physiology And Chronic Health Evaluation (APACHE) II and APACHE III score from first 24 hours in intensive care unit (ICU),
- ICU length of stay,
- hospital length of stay, and
- mortality.
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Assessment method [1]
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Timepoint [1]
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up to 14 days post-injury
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Eligibility
Key inclusion criteria
• Fractured femoral shaft with a blunt mechanism of injury, suitable for intramedullary nailing
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• Significant injury to another body region
- post-injury pre-intubation Glasgow Coma Scale (GCS) 3 – 12
- multiple facial fractures
- chest trauma (> 2 rib fractures, mediastinal injury, pulmonary contusion, aortic injury, sternal fracture)
- abdominal trauma (need for laparotomy/embolisation)
- spine or spinal cord trauma
- 2 or more long bone fracture’s (or the presence of bilateral femoral shaft fractures)
- pelvic ring fracture
- need for urgent surgery/procedure including:
• craniotomy
• external ventricular drain (EVD)/intracranial pressure (ICP)
• thoracotomy
• planned spinal fixation
• planned pelvic fixation
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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
• Peri-prosthetic femoral shaft fractures
• Medical contraindication to surgery (e.g., intracranial pressure (ICP) > 25, hypothermic, coagulopathic, acidotic)
• Surgeon or anaesthetist judges that the patient is too unstable for the intramedullary nailing procedure (e.g., risk of disturbing contained solid-organ injuries or aortic disruptions by changes in patient position or by movement during the femoral nailing procedure)
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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)
Sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
27/08/2007
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Actual
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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
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Sample size
Target
40
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
233
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3181
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Transport Accident Commission
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Address [1]
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Lvl 17, 222 Exhibition St
Melbourne VIC 3000
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
The Alfred
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Address
Commercial Road
Prahran VIC 3181
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
2305
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Country [1]
2305
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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The Alfred
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Ethics committee address [1]
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Commercial Road Prahran VIC 3181
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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22/12/2006
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Ethics approval number [1]
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257/06
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Summary
Brief summary
It is not known at what time definitive femoral shaft intramedullary nailing (IMN) should be performed to result in fewer complications for the patient. The trial will investigate the optimal timing of femoral shaft IMN in a single-centre phase II randomised trial. The null hypothesis is that there is no difference in organ dysfunction outcomes between multitrauma patients having a femoral shaft fracture nailed immediately (within 24 hours) or nailed 3-6 days later secondary to external fixation.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Adam Dowrick
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Address
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NTRI - The Alfred
PO Box 315
Prahran VIC 3181
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Country
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Australia
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Phone
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+61 3 9076 8035
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Fax
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+61 3 9076 8811
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Email
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[email protected]
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Contact person for scientific queries
Name
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Adam Dowrick
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Address
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NTRI - The Alfred
PO Box 315
Prahran VIC 3181
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Country
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Australia
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Phone
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+61 3 9076 8035
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Fax
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+61 3 9076 8811
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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