Point-of-care Ultrasound, Distal Radius Fracture
Conditions
Brief summary
Distal radius (Colle's) fractures in adult patients are commonly reduced in the emergency department before casting. Standard of care currently requires that x-rays be performed before and after fracture reduction, and inadequate reductions may be subject to repeat attempts and are at a higher risk to require surgery. This study will assess the use of point-of-care ultrasound (POCUS) in addition to standard care as a tool to decrease the angulation at the fracture site after a reduction is performed. If this angulation is decreased, it would suggest that POCUS for distal radius fracture reduction could decrease the number of failed reduction attempts and therefore the number of repeated reduction attempts.
Interventions
DEVICEPoint-of-care ultrasound
After the fracture reduction maneouver, the physician will assess residual dorsal angulation using point-of-care ultrasound. If deemed adequate, the physician will progress to immobilization. If the reduction is not adequate, the physician will attempt further reduction at their discretion.
PROCEDUREClosed fracture reduction
The distal radius fracture will be reduced with using a combination of local anesthetic, sedation, reduction maneouvers and immobiliazation at the discretion of the treating physician
Sponsors
London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's
Marcus Van Aarsen
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* radiographically confirmed distal radius fracture
Exclusion criteria
* patients who do not consent * patients with multiple acute injuries, open fractures, or other local fractures evident (a simple ulnar styloid fracture will not be considered an exclusion criterion) * patients with neurovascular compromise * patients with bilateral distal radius fractures * patients with minimally displaced distal radius fractures that do not require closed reduction before casting
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Residual dorsal angulation | Collected at the same-day post-reduction xray. Data will be aggregated over 1 year |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Need for orthopaedic surgery within 6 weeks of injury | To be assessed 6 weeks post-injury. Data will be aggregated over the 1 year study period | To be acquired via electronic patient charting |
| Physician satisfaction: post-reduction questionnaire | Questionnaire to be administered immediately after reduction. Data to be aggregated during the 1 year study period | — |
Countries
Canada
Outcome results
None listed