ISRCTN ISRCTN18006607
DOI https://doi.org/10.1186/ISRCTN18006607
Secondary identifying numbers 18642
Submission date
19/11/2015
Registration date
19/11/2015
Last edited
22/08/2016
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Musculoskeletal Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English Summary

Background and study aims
Metacarpal fractures, commonly called broken fingers, account for about 40% of all hand injuries. Although generally surgery isn’t needed, when the break is particularly serious surgery may be required. In these cases, the broken sections of bone need to be surgically moved back into the correct place. They are then held in place by fixing a metal plate to the bone with screws, which stabilises the bone while it heals. Traditionally, the plate is held in place by fixing the screws above and below the fracture (bicortical fixation). Although this procedure is generally very reliable, the excess drilling could cause damage to the soft tissue of the hand. In this time of procedure it is very important that the screws are the correct size, as if they are not then this could also damage the surrounding soft tissue. Unicortical fixation is a new technique where the screw is only fixed to one side of the broken bone. This technique is much less complex than bicortical fixation, and so it could potentially cause less damage to the surrounding soft tissues in the hand. As only one hole is drilled, there are also less likely to be complications if the screw is not the right size. The aim of this study is to find out whether bicortical or unicortical fixation is better for patients in terms of recovery.

Who can participate?
Adults who have broken their fingers within 72 hours and are having plate fixation

What does the study involve?
Participants are randomly allocated to one of two groups who will each have a different type of ORIF surgery. Those in the first group have the bicortical fixation procedure, in which the plate screws into both sides of the broken bone. Those in the second group have the unicortical fixation procedure, in which the plate screws only onto one side of the bone. At 6 weeks and 6 months, participants attend follow-up appointments in order to assess how well their fracture has healed.

What are the possible benefits and risks of participating?
Not provided at time of registration

Where is the study run from?
University Hospitals Birmingham NHS Foundation Trust (UK)

When is the study starting and how long is it expected to run for?
June 2015 to April 2018

Who is funding the study?
Royal Centre for Defence Medicine (UK)

Who is the main contact?
Mr Mark Foster

Contact information

Mr Mark Foster
Public

University Hospital Birmingham NHS Foundation Trust
Plastic Surgery Department
Mindelson Way
Edgbaston
B15 2WB
United Kingdom

Study information

Study designRandomised; Interventional; Design type: Not specified, Treatment
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Other
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleStability of unicortical vs bicortical metacarpal internal fixation trial (SUBMIT)
Study acronymSUBMIT
Study hypothesisThe aim of this trial is to compare the functional outcomes and complications of patients having unicortical versus bicortical fixation for diaphyseal metacarpal fractures.
Ethics approval(s)First Medical Research Ethics Committee, 19/11/2015, ref: 14/WM/1212
ConditionTopic: Surgery; Subtopic: Surgery; Disease: All Surgery
InterventionParticipants are randomly allocated to one of two groups, who will receive a different type of open reduction internal fixation (ORIF) surgery.

Group 1: Participants undergo bicortical fixation (standard practice), in which both the dorsal and palmar cortices of the metacarpal are drilled though
Group 2: Participants undergo unicortical fixation, in which only the near cortex is drilled

Participants in both groups are followed up for 6 months to monitor recovery.
Intervention typeProcedure/Surgery
Primary outcome measureFracture union is assessed at 6 weeks and 6 months
Secondary outcome measures1. Complication rate is monitored continually throughout study
2. Fluroscopy exposure is measured during surgery
3. Implant failure is measured at 6 weeks and 6 months
4. Post operative stiffness is measured at 6 weeks and 6 months
5. Surgical time is measured during surgery
Overall study start date01/06/2015
Overall study end date06/04/2018

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participantsPlanned Sample Size: 290; UK Sample Size: 290
Participant inclusion criteria1. Aged 18 or over
2. Metacarpal diaphyseal fractures that require plate fixation
3. Patients undergoing anaesthesia with axillary brachial plexus regional blocks
4. Acute injury (within 72 hours)
Participant exclusion criteria1. Under 18 years of age
2. Deemed not competent to sign the consent forms
3. Pathologic fracture or a previous fracture of the same metacarpal
4. Other injury to the same upper limb requiring surgery
5. Major nerve injury (e.g., median, ulnar or radial)
6. Multi-trauma or -fractured patient
7. Revision procedure
8. Pregnant patient
9. Current or prior history of malignancy
Recruitment start date01/06/2015
Recruitment end date06/04/2018

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

University Hospital Birmingham NHS Foundation Trust
Plastic Surgery Department
Mindelson Way
Edgbaston
Birmingham
B15 2WB
United Kingdom

Sponsor information

University Hospital Birmingham NHS Foundation Trust
Hospital/treatment centre

NIHR SRMRC, Research and Development
Queen Elizabeth Hospital
Edgbaston
Edgbaston
B15 2TH
England
United Kingdom

ROR logo "ROR" https://ror.org/014ja3n03

Funders

Funder type

Hospital/treatment centre

Royal Centre for Defence Medicine

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 18/08/2016 Yes No
HRA research summary 28/06/2023 No No

Editorial Notes

22/08/2016: Publication reference added.