Clinical Trial: Investigations of Mechanisms and Treatment in Post-traumatic Joint Contractures

Study Status: Active, not recruiting
Recruit Status: Active, not recruiting
Study Type: Interventional

Official Title: Randomized, Double Blind, Placebo Controlled Trial of Ketotifen in Patients With Elbow Fractures or Dislocations

Brief Summary: Injured joints, especially at the elbow, are at risk for permanent motion loss, also known as joint contractures. Joint contractures limit the function of an elbow and are a recognized complication that occurs often after a traumatic injury. The benefits of early motion after injury has helped in preventing joint contractures but there are still several patients that develop debilitating joint contractures. Current research suggests that mast cells, which are found in the joint, are key in causing joint contractures. Research has been done using a medication called Ketotifen. Ketotifen has been linked to stabilizing mast cells and preventing the joint contracture. It is hoped that short-term use of this medication after an injury will prevent the contracture from occurring.

Detailed Summary:

Individuals ≥ 18 years old with isolated distal 1/3 humerus and/or proximal 1/3 ulna and/or proximal 1/3 radius fractures and/or elbow dislocations (open fractures with or without nerve injury may be included) and presented to Peter Lougheed Centre (PLC), Foothills Medical Center (FMC), or South Health Campus (SHC).

Participants were required to take Ketotifen 5mg by mouth twice a day for 6 weeks or placebo twice a day by mouth for 6 weeks. Neither the participant nor the physician knew if the participant was taking Ketotifen or placebo. Sometimes this type of injury requires surgery. This study invited both patients that do and do not require surgery to participate.

We took a sample of blood to measure tryptase (normally found in the body). We predicted people with high levels of tryptase were more likely to develop stiffening in the joint.

Participants were asked to return for follow up visits 2, 6, 12, 24, and 52 weeks after surgery or date of initial injury if surgery was not required. These visits were part of normal care for this type of injury.

At the visit participants were asked to do the following, some of which was not part of normal care.

At each visit: Range of motion of the elbow was assessed, DASH score was completed- form helping the research group understand the level of disability from this injury, X-rays until the fracture was considered healed (this was normal treatment), SF12 - questionnaire about how the patient was feeling and coping with their injury, Additional information was collected about how the injury was healing and weight was measured.

The participant was required to have physiotherapy wh
Sponsor: University of Calgary

Current Primary Outcome: Joint range of motion [ Time Frame: 12 months post-injury ]

Extension-flexion arc of motion


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Range of motion [ Time Frame: 2,6,12,24 and 52 weeks post injury ]
  • Patients requiring (re)operation for elbow-related causes [ Time Frame: 12 months ]
  • Radiographic evaluation for fracture healing/non-union [ Time Frame: 12-52 weeks ]


Original Secondary Outcome:

  • Range of motion [ Time Frame: 2,4,12,14 and 52 weeks post injury ]
  • Patients requiring (re)operation for elbow-related causes [ Time Frame: 12 months ]
  • Radiographic evaluation for fracture healing/non-union [ Time Frame: 12-52 weeks ]


Information By: University of Calgary

Dates:
Date Received: July 10, 2013
Date Started: June 2013
Date Completion: November 2017
Last Updated: April 7, 2017
Last Verified: April 2017