Fracture, Orthopedic Devices Associated With Misadventures, Surgical Instruments, Materials and Devices (Including Sutures), Patient Satisfaction, Pediatric
Conditions
Brief summary
This study is a prospective randomized controlled trial comparing the clinical outcomes of bioabsorbable screws to conventional metal screws in pediatric patients (aged 0 to 18) undergoing surgical fixation for trauma or elective procedures. Conducted by the pediatric orthopedic department at Children's Hospital New Orleans, the study aims to evaluate the effectiveness of these screws in bone healing over key post-operative intervals (6 weeks, 6 months, and 1 year). It seeks to determine if bioabsorbable screws offer significant advantages over metal screws in terms of reducing the need for secondary surgeries, based on their hypothesized noninferiority in complication rates. Participants will be randomly assigned to receive either bioabsorbable or metal (titanium or stainless steel) screws after obtaining informed consent from a parent or guardian.
Detailed description
This study is a prospective randomized controlled trial to evaluate clinical outcomes associated with the use of bioabsorbable screws compared to conventional metal screws in children aged 0 to 18 who are undergoing surgical fixation in the setting of trauma such as medial epicondyle fractures of the elbow or elective procedures. The research will be conducted within the pediatric orthopedic department at CHNOLA, and participants will be assessed at key intervals, including 6 weeks, 6 months, and 1 year post-operation post-operation. The primary objective of this study is to assess and compare the effectiveness of conventional metal screws and bioabsorbable screws in bone healing. This study aims to determine whether bioabsorbable screws are significantly superior to conventional titanium screws. The investigators hypothesize bioabsorbable screws are significantly noninferior to conventional metal screws in terms of complications based on prior surgical constructs that demonstrate bioabsorbable screws eliminate the need for a second surgery After informed consent has been obtained from the parents of patients, eligible patients undergoing cannulated screw fixation will be randomized into two groups: one group who will receive bioabsorbable screws and the other group who will receive metal screws (titanium or stainless steel).
Interventions
DEVICEBioabsorbable Screw
Bioabsorbable screw that redissolves into the bone. Mineral fibers are composed of Silicon Dioxide (SiO2), Sodium Oxide, Calcium Oxide, Magnesium Oxide, Boron Trioxide, and Phosphorous Pentoxide
DEVICEMetal/Titanium Screw
Traditional metal screw used in fracture fixation that requires hardware removal
Sponsors
Louisiana State University Health Sciences Center in New Orleans
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Caregiver)
Intervention model description
Participants will be randomized to one of two groups which will determine the type of screw (stainless steel or bioabsorbable) in their surgery.
Eligibility
Sex/Gender
ALL
Age
No minimum to 18 Years
Healthy volunteers
Yes
Inclusion criteria
* Primary fractures requiring fixation with cannulated screws
Exclusion criteria
* Children ten years old or under with a fracture requiring screws to be fixed across the growth plate (physis) * Secondary fractures * Non-union fractures * Tibial tubercle osteotomies (TTOs) * Slipped capital femoral epiphysis (SCFEs) * Unable or unwilling to provide informed consent or parental/guardian consent for participants under 18 years of age * Allergies or contraindications to screw materials
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Computer Adaptive PROMIS (Patient-Reported Outcomes Measurement Information System) Surveys | 6 weeks, 6 months, 1 year | Pain, Upper Extremity and Mobility. These questionnaires are scored using T scores. For pain, a higher score is a worse outcome. For mobility and upper extremity, a lower score is a worse outcome. Min value is 0 and max is 100 for all. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Complications | 1 year | Any complications of surgery (infection etc) |
Countries
United States
Contacts
Primary ContactSylvia Culpepper, MS
Backup ContactCarter Clement, MD, MBA
Outcome results
None listed