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BMJ open · 2021

Protocol of BRICS: Brazilian multicentric pragmatic randomised trial of surgical interventions for displaced diaphyseal clavicle fracture study: MIPO versus ORIF for the treatment of displaced midshaft clavicle fractures.

Протокол клинического исследованияСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Mendes Adriano Fernando, Curado Rodrigo Fleury, Dias Jair Moreira, Mota Neto José Da, Carrazzone Oreste Lemos, Pagan Alexandre Rosa, Labronici Pedro José, Labronici Gustavo José, Goes Matheus Pires De Araújo, Mouraria Guilherme Grisi, Zogbi Daniel Romano, Brigatto Rafael Mulatti, Uehara Anderson, Parro Otávio Costa, Hisano Fernando Mitsuo, Teixeira Bruno De Souza, Silva Rafael Waldolato, Lazarini Rafael Fuchs, Godinho André Couto, Godinho Pedro Couto, França Flavio De Oliveira, Godinho Glaydson Gomes, Freitas José Marcio Alves, Mariosa Carlos Alberto Menezes, Souza Bruno Gonçalves Schröder E, De Oliveira Valdeci Manoel, De Simoni Leandro Furtado, Pereira Camila Corrêa, Antunes Filho Jurandir, Matsunaga Fabio Teruo, Belloti João Carlos, Tamaoki Marcel Jun Sugawara

Аннотация

INTRODUCTION: Fractures of the diaphysis of the clavicle are common; however, treatment guidelines for this condition are lacking. Surgery is associated with a lower risk of non-union and better functional outcomes but a higher risk of complications. Open reduction and internal fixation with plates and screws are the most commonly performed techniques, but they are associated with paraesthesia in the areas of incisions, extensive surgical exposure and high rates of implant removal. Minimally invasive techniques for treating these fractures have a lower rate of complications. The aim of this study is to evaluate which surgical treatment option (minimally invasive osteosynthesis or open reduction and internal fixation) has better prognosis in terms of complications and reoperations.

METHODS AND ANALYSIS: The study proposed is a multicentric, pragmatic, randomised, open-label, superiority clinical trial between minimally invasive osteosynthesis and open reduction and internal fixation for surgical treatment of patients with displaced fractures of the clavicle shaft. In the proposed study, 190 individuals with displaced midshaft clavicle fractures, who require surgery as treatment, will be randomised. The assessment will occur at 2, 6, 12, 24 and 48 weeks, respectively. The primary outcome of the study will be the number of complications and reoperations. For sample size calculation, a moderate effective size between the techniques was considered in a two-tailed test, with 95% confidence and 90% power. Complications include cases of infection, hypertrophic scarring, non-union, refracture, implant failure, hypoesthesia, skin irritation and shoulder pain. Reoperations are defined as the number of surgeries for pseudoarthrosis, implant failure, infection and elective removal of the implant.

ETHICS AND DISSEMINATION: Study approved by the institutional ethics committee (number 34249120.9.0000.5505-V.3). The results will be disseminated by publications in peer-reviewed journals and presentations in medical meetings.

TRIAL REGISTRATION NUMBER: RBR-3czz68)/UTN U1111-1257-8953.

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