UDiReCT
Research type
Research Study
Full title
Ultrasound Directed Reduction of Colles Type distal radial fractures in ED
IRAS ID
251149
Contact name
Andrew Appelboam
Contact email
Sponsor organisation
Royal Devon & Exeter Hospital
Clinicaltrials.gov Identifier
Duration of Study in the UK
0 years, 9 months, 0 days
Research summary
Patients frequently come to the Emergency Department (ED) with a broken (fractured) wrist. These injuries most frequently result from a fall onto an outstretched hand and can result in deformity ('displacement') of the broken bone. These displaced (Colles' type) fractures can result in long term deformity and problems using the wrist. To prevent this, patients with displaced fractures often undergo manipulation of their fractures in ED, to straighten the wrist, using local anaesthetic or sedation (manipulation under anaesthetic or MUA) before the application of a plaster cast.
Unfortunately, if the ED fracture manipulation is inadequate or the position later ‘slips’, which can occur in the first 1-2 weeks, even in a cast, the patient often needs admission to hospital for an operation to fix the fracture with a metal plate or wires. This may affect up to a third of patients who undergo ED MUA and is a significant additional social and economic cost for patients and healthcare services.
Reducing these fractures as precisely as possible might reduce the subsequent need for surgery. However, ED fracture manipulations are typically done ‘blind’ with x-rays after casting to check the bone position, making re-manipulation time consuming and difficult for patients. Portable, bedside ultrasound is available in most departments and has been used to guide fracture reduction but we don't know how effective this is and it is not in routine use. Proving the benefits of ultrasound used in this way compared with standard practice would require a large, expensive study.
This study aims to see if such a trial would be justified and feasible. We plan to run a feasibility trial in two hospitals to test how many patients might take part and assess the trial procedures which would otherwise mirror the full trial.
REC name
South Central - Oxford C Research Ethics Committee
REC reference
19/SC/0277
Date of REC Opinion
12 Jul 2019
REC opinion
Favourable Opinion