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NCT06737237
Clavicle fractures are the most common fracture of the shoulder girdle, with young men being the most affected demographic. The incidence of clavicle fracture among military service members is 1.5-3x higher than the general adult population. While many clavicle fractures may be managed non-operatively, surgical intervention for clavicular fractures has shown improved functional outcomes in the active-duty Marine Corps population and an overall satisfactory return-to-duty rate. However, surgical fixation of the clavicle is associated with significant postoperative pain when no local anesthetic techniques are employed. Several regional anesthetic and local infiltrative analgesic regimens have been studied to improve postoperative pain control for clavicle ORIF with the authors concluding that intermediate cervical plexus block is the regional anesthesia therapy of choice for post-operative analgesia. A retrospective study by the same group determined that an intermediate cervical plexus block resulted in lower postoperative pain scores and opioid requirements than surgeon-administered local infiltration analgesia. This retrospective study unfortunately lacked participant blinding, randomization, a standardized anesthetic, consistent block technique, and protocolized postoperative analgesia. To date, no prospective trial has been performed directly comparing these two techniques. We propose, given the significance of clavicle fractures and corrective surgery in the military population, to study the efficacy of ultrasound-guided intermediate cervical plexus blocks as compared to local infiltration analgesia.
NCT05454306
The goals of this multi-site study are to evaluate the union rate, patient satisfaction, and functional results of the Section 510(K) approved Anser Clavicle Pin in a prospective 50 patient clinical trial in a U.S. population.
NCT07414654
1. Study identification Study title: PSEUDO-CLAV - Single-center retrospective descriptive study of clavicle nonunion (pseudarthrosis): epidemiology, surgical management, and functional outcomes PSEUDO-clav\_Notice non oppositi… Study type: Observational study (retrospective, single-center) using existing medical records and imaging Study sponsor / data controller: CHU de Brest Scientific lead (principal investigator): Dr Agathe YVINOU (Orthopaedic \& Trauma Surgery, CHU de Brest) Data Protection Officer (DPO) contact: protection.donnees@chu-brest.fr 2. Why is this study being done? A clavicle nonunion (pseudarthrosis) is when a broken collarbone does not heal as expected and may cause pain, reduced shoulder function, and lower quality of life. Surgery is often used, but because this condition is uncommon, the investigators want to better understand: who is affected, which surgical strategies are used, how often the bone heals after surgery, what functional recovery and complications look like in real-life practice. 3. Goal of the study (use/keep this "fill-in" format) The goal of this observational study is to describe clavicle nonunion cases treated surgically at CHU de Brest and to estimate how often the clavicle heals after surgery, using information already collected during routine care. The main questions it aims to answer are: How often does the clavicle heal ("consolidate") after surgery? Main measure: union rate at \~6 months after surgery (assessment window approximately 4-8 months). PSEUDO-clav\_Protocole\_scientifi… How do patients recover in terms of function and symptoms, and what complications occur? Examples: shoulder function scores (Constant and/or DASH), pain, return to work/sport, complications and re-operations. PSEUDO-clav\_Protocole\_scientifi… If there is a comparison group (optional wording): Researchers may compare different surgical strategies (for example, plate fixation alone vs. plate fixation plus bone graft, and other techniques when used) to explore whether results differ for healing, recovery, or complications. PSEUDO-clav\_Protocole\_scientifi… 4. Who may be included? (participant population) This study may include adults who: were treated at CHU de Brest, and had surgery for clavicle nonunion between January 1, 2000 and December 31, 2024, and were 18 years or older at the time of the nonunion surgery, and have enough information in the medical record/imaging to evaluate outcomes. PSEUDO-clav\_Protocole\_scientifi… Estimated number of participants: up to about 30 cases in this center (because the condition is rare). PSEUDO-clav\_Protocole\_scientifi… 5. What will participants have to do? Nothing extra. This study: uses existing information already in the medical record and imaging systems, involves no additional visits, no extra tests, and no change to treatment, and does not require direct contact with patients. 6. What information will be used? Information may include (examples): medical history related to the injury and health conditions, details of the surgery (type of fixation, whether a bone graft was used), lab results (including microbiology if relevant), radiology/imaging reports and images, follow-up notes about pain, function, healing, complications, and re-operations. 7. Risks and benefits Risks to for the patients : Since no new procedures are done, the main risk is related to privacy/confidentiality of data. The study team puts protections in place to reduce this risk (see below). Benefits: the patients should not expect a direct personal benefit, because care is not changed. Results may help improve understanding of clavicle nonunion surgery, follow-up practices, and future care decisions. 8. How will privacy be protected? Data used for analysis will be pseudonymized (coded). Name and first name are not included in the research dataset. Only authorized members of the research team can access the data, using secure access (e.g., password-protected files and restricted hospital systems). Study results will be presented as grouped data, so individuals cannot be identified in publications or conference presentations. Data retention: research data are kept and archived for a limited duration (e.g., up to 5 years after the end of the study, per the study documentation). 9. Voluntary nature and patient's rights Because this is a retrospective study using existing records, participation is based on non-opposition (opt-out). The patient can: object to the use of data for this study, and request access, correction, or limitation of processing as permitted by data protection rules. How to object (opt out) of PSEUDO-CLAV: Email the DPO: protection.donnees@chu-brest.fr, or use the CHU Brest transparency portal (as listed in the notice), or contact the study scientific lead, or write to CHU Brest (address listed in the notice). Choosing not to participate will not affect patient's medical care now or in the future
NCT04250415
Investigators from eight tertiary care, level 1 pediatric trauma centers have developed a protocol for the establishment of a formal, prospective multi-center adolescent clavicle registry, with designs for standardized radiographic assessment and the prospective collection of validated outcome measures and complications data, for all patients, ages 10-18, treated for clavicle shaft fractures, operatively and non-operatively. Eventually, the investigators would like to do comparative analysis for the operative and non-operative treatment arms, with additional sub-stratified analyses performed within these treatment arms by age and activity level. Among the primary goals of research projects stemming from the first arm of this registry, FACTS A, is to explore the hypothesis that non-operative treatment is associated with lower costs, greater safety, and equivalent or superior outcomes, compared with operative treatment, despite a national trend towards increasing surgical treatment. The second arm of the registry, FACTS B, will continue to investigate the same hypotheses, excluding cost outcomes, in patients only with completely displaced midshaft clavicle fractures.
NCT05810129
The immobilization process after an operation or injury in the upper extremity causes a loss of muscle mass and strength of 0.2% and 1.3% per day, respectively. Currently, the use of cross-education, which is unilateral training in the uninjured limb, during the immobilization period, is expanding, demonstrating a magnitude of strength gain in the immobilized limb from 8% to 77% of the mean of strength of the trained limb. Despite the evidenced benefits of cross-education in unilateral injuries such as distal radius fracture, anterior cruciate ligament injury, and knee replacement, very little is known about this effect in shoulder immobilization after clavicle fracture.
NCT06078371
Analgesic drug study that will compare pain outcomes of opioid analgesia and opioid-free analgesia in post-operative orthopedic patients.
NCT06276218
A randomized control trial was conducted to compare the outcomes of conservative management for closed midshaft clavicular fractures using self-adjustable clavicular brace and standard clavicular brace.
NCT03402269
Clavicle fractures in children are common. Typical treatment includes nonoperative treatment with a sling. Operative treatment is usually limited to open, unstable, fractures with either epidermal risks or neurovascular compromise. Orthopaedic literature has many studies that report the need for additional research for this prevalent fracture. This is an observational study evaluating the functional and patient reported outcomes of displaced clavicle fractures in adolescents. The results from this study will help the orthopedist understand the expected outcomes for a given pediatric patient with a clavicle fracture.
NCT04332497
The pain after clavicle fracture surgery may be managed with combined superficial cervical plexus-interscalene block and recently clavipectoral fascia plane block (CPB). CPB was defined by Valdes in 2017 firstly. It may be used for postoperative analgesia after clavicle surgery. CPB may be an alternative to interscalene brachial plexus block. The aim of this study is to compare the efficacy of the US-guided CPB and ISCB for postoperative analgesia management after clavicle surgery. The primary aim is to compare perioperative and postoperative opioid consumption and the secondary aim is to evaluate postoperative pain scores (VAS), adverse effects related with opioids (allergic reaction, nausea, vomiting).
NCT04622137
This is a multicenter prospective randomized controlled study. Forty patients in whom conservative treatment for clavicle midshaft fractures was indicated between January 2018 and July 2019 were included. The investigators aimed to evaluate the effectiveness of the kinesiotaping technique for the conservative treatment of clavicle midshaft fractures. The investigators hypothesized that kinesiotaping reduces the disadvantages of conservative treatment, such as early-phase pain, high nonunion rates, and a prolonged time to return to work, and yields better clinical and functional outcomes by providing good mechanical support and neutralizing the deforming muscle forces around the fractured clavicle.
NCT04343118
Little is known about the beneficial aspects of elective implant removal following plate osteosynthesis of displaced clavicle fractures.
NCT03094481
The optimal analgesic peripheral nerve block (or combinations thereof) are undefined for clavicle fractures, the most frequent fracture in the human population. This goal of this study is to determine whether interscalene block (ISB), superficial cervical plexus block (SCPB), or both provide the best analgesia for lateral and midshaft clavicular fractures, respectively.
NCT00871468
The anterior-inferior clavicle plate position will have a lower rate of soft tissue irritation that limits activity and/or requires hardware removal compared to superior plate position.
NCT01405703
This is a prospective, level II evidence comparison between two cohorts. This study is designed to compare the percutaneous versus open approach for plate fixation of diaphyseal clavicle fractures. This study includes questionnaires and measurements that will collect data on incision-related numbness, union rates, overall outcomes, complication rates of the two methods, infection rates, and overall satisfaction. The surgical procedure, all radiographs and follow-up visits to a minimum of one year are the principle investigators (PI's) standard of care for this injury. Measurements and questionnaires are related to the study.
NCT01297439
Shoulder dystocia is a major obstetric emergency defined as a delivery requiring maneuver in addition to downward traction on the fetal head for delivery of the shoulders. Shoulder dystocia is a major obstetrical complication, occurring in approximately 0.2 to 3% of deliveries, principally due to fetal macrosomia. The obstetrical and neonatal complications associated with shoulder dystocia include newborn mortality occurring in 21 to 290 per 1000 deliveries, generalized asphyxia, fractures, neurological damages (brachial plexus injury) and hematoma. The objective of this study was to evaluate the "pushing" maneuver, that is performed gently on the fetal head since the crowning of the head (appearance of the fetal scalp at the introitus between pushes), aiming to facilitate the anterior shoulder to slip off behind the symphysis pubis, reducing thus the risk of shoulder dystocia. This preventive maneuver may reduce the power (energy/time unit) exerted on the perineal tissues and give the shoulders time to enter the pelvic cavity. The "pushing" maneuver will be evaluated in comparison with either an expectative attitude or a suctioning of fetal nose and mouth.
NCT01015924
The purpose of this study is to compare two widely used operative techniques on displaced midshaft clavicular fractures. The hypothesis is that there is no difference in functional outcome.