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The purpose of this study is to evaluate whether standard volume computed tomography (CT) has impact on treatment in patients with suspicion of fractures of the wrist and carpus.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Adult, clinical suspicion fractures wrist or carpus | - Patients (18 years and older) who are referred to our hospital for conventional radiography of the wrist and carpus |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Volume Computed Tomography of the wrist and carpus | Radiation |
|
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of patients with prospectively documented treatment changes after CT | This endpoint is defined as presence of difference in predefined treatment regimens before and after CT. These regimens include: -Conservative treatment on the emergency ward (functional, immobilization with bandage, cast, or closed reduction and cast), closed operative treatment (reduction and cast on operation room, percutaneous pinning, or external fixation), open surgical treatment (dorsal, radial, or palmar exposure with reduction and internal fixation). Additional regimens include: Second opinion from a colleague or consulting a different specialism. | within same visit (i.e. in one day) |
| Measure | Description | Time Frame |
|---|---|---|
| Diagnostic performance of CT and conventional radiography (CR) for fracture pattern | Fracture patterns are classified according to presence and type of fractured bones, presence of intra-articular components of distal radius fractures (including sigmoid notch involvement), presence of (fracture) dislocation or avulsion fractures of carpal bones. Standard of reference is presence of injuries at imaging, at surgery, and disability complains at 1-year follow up. In case of discrepancy, consensus will be reached at the end of the study by a panel of trauma surgeons and radiologists. |
| Measure | Description | Time Frame |
|---|---|---|
| Radiological feasibility | Image quality (5-point scale), artifacts (5-point scale) noise (standard deviation Hounsfield Units), radiation dose, and presence of technical problems | Within an average of three days after CT |
| Patient outcome: Pain and disability |
Inclusion Criteria:
Exclusion Criteria:
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All consecutive patients who enter the emergency or radiology department of the Radboud University Nijmegen Medical Centre for suspicion on fractures of the wrist and study are eligible for this study.
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| Name | Affiliation | Role |
|---|---|---|
| Mathias Prokop, MD, PhD | Radboud University Medical Center | Principal Investigator |
| Monique Brink, MD, PhD | Radboud University Medical Center | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Radboud University Nijmegen Medical Centre | Nijmegen | 6500 HB | Netherlands |
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| ID | Term |
|---|---|
| D014947 | Wounds and Injuries |
| D014954 | Wrist Injuries |
| D011885 | Radius Fractures |
| ID | Term |
|---|---|
| D001134 | Arm Injuries |
| D005543 | Forearm Injuries |
| D050723 | Fractures, Bone |
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| within the same visit (one day) |
Pain and disability according to the "Patient rated wrist and hand evaluation (PRWHE) score" 6 weeks, 6 months, and 12 months after trauma
| one year |