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| Name | Class |
|---|---|
| London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's | OTHER |
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard of care | Active Comparator | Patients will undergo standard closed fracture reduction. The sedation type, reduction method, and immobilization method will be at the discretion of the treating physician. Point-of-care ultrasound will not be used. |
|
| Experimental Group | Experimental | Patients will undergo standard closed fracture reduction with the addition of point-of-care ultrasound use to assess post-reduction dorsal angulation. The sedation type, reduction method, and immobilization method will be at the discretion of the treating physician. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Point-of-care ultrasound | Device | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Residual dorsal angulation | Collected at the same-day post-reduction xray. Data will be aggregated over 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Need for orthopaedic surgery within 6 weeks of injury | To be acquired via electronic patient charting | To be assessed 6 weeks post-injury. Data will be aggregated over the 1 year study period |
| Physician satisfaction: post-reduction questionnaire |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| St. Joseph's Health Care London | London | Ontario | N6A 4V2 | Canada | ||
| London Health Sciences Centre |
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| ID | Term |
|---|---|
| D000092503 | Wrist Fractures |
| ID | Term |
|---|---|
| D014954 | Wrist Injuries |
| D001134 | Arm Injuries |
| D014947 | Wounds and Injuries |
| D050723 | Fractures, Bone |
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| ID | Term |
|---|---|
| D000070628 | Closed Fracture Reduction |
| ID | Term |
|---|---|
| D005592 | Fracture Fixation |
| D019637 | Orthopedic Procedures |
| D013812 | Therapeutics |
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| Closed fracture reduction | Procedure | 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 |
|
| Questionnaire to be administered immediately after reduction. Data to be aggregated during the 1 year study period |
| London |
| Ontario |
| N6A 5W9 |
| Canada |