Supracondylar Humerus Fracture
Conditions
Brief summary
There are two common and concurrently used strategies for pain management following surgical treatment of supracondylar humerus (elbow) fractures in children: opioids vs over the counter pain medications. The purpose of this study is to determine if ibuprofen and acetaminophen can provide similar or better pain relief compared to ibuprofen and hydrocodone/acetaminophen (also known as Hycet) for this population of children after they have been discharged. If over the counter medications can provide adequate pain relief, then fewer opioid prescriptions would be necessary. This reduces early opioid exposure and decreases unnecessary opioids in circulation.
Detailed description
Prior to surgery, participants will be randomly assigned to a group that will determine whether they are prescribed an opioid vs non-opioid pain management plan at discharge. Each participants' parent or guardian will be given a journal to keep track of their child's pain severity and the pain medications taken. The journal will updated daily until participants no longer require pain medication. Participants will follow up with their surgeon per usual at their post-operative visits.
Interventions
Sponsors
Baylor College of Medicine
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
3 Years to 12 Years
Healthy volunteers
No
Inclusion criteria
* Closed, Gartland type III supracondylar humerus fracture * Fractures treated with closed reduction and percutaneous pinning (CRPP) * Patients expected to follow up at Texas Children's Hospital * Patients/guardians must speak English or Spanish
Exclusion criteria
* Fractures associated with open skin wounds, polytrauma, neurologic deficit, or vascular deficit * Patients who have impaired ability to report pain severity such as intellectual delay. * Patients who have a problem with bone healing such as osteogenesis imperfecta. * Patients who are unable to take the standard dose of acetaminophen, ibuprofen, or hydrocodone (allergy, severe kidney disease, etc). * Patients who are on chronic NSAID or opioid medication prior to injury. * Patients with injury from suspected non-accidental trauma.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Daily Pain Scores on the FACES Scale | from discharge until pain medication is no longer required (assessed up to 3 weeks) | A parent/guardian will ask participants to rate their pain severity using the Wong-Baker FACES scale, which ranges from 0 (no pain) to 10 (worst pain). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Days Pain Medication Required | from discharge until pain medication is no longer required (assessed up to 3 weeks) | A parent/guardian will record the doses of pain medications given to the participant each day. |
| Number of Pain Medication Doses Required Per Day | from discharge until pain medication is no longer required (assessed up to 3 weeks) | A parent/guardian will record the doses of pain medications given to the participant each day. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORScott Rosenfeld, MD
Baylor College of Medicine
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Continuous | 6.5 Years STANDARD_DEVIATION 1.8 |
| Race/Ethnicity, Customized Black | 1 Participants |
| Race/Ethnicity, Customized Hispanic | 7 Participants |
| Race/Ethnicity, Customized Unknown | 1 Participants |
| Race/Ethnicity, Customized White | 16 Participants |
| Sex: Female, Male Female | 13 Participants |
| Sex: Female, Male Male | 10 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 14 | 0 / 15 |
| other Total, other adverse events | 0 / 14 | 0 / 15 |
| serious Total, serious adverse events | 0 / 14 | 0 / 15 |
Outcome results
None listed