Nottingham Clinical Trials Unit
The University of Nottingham
University of Nottingham
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Trial Name: Surgery versus non-surgical splint treatment for Proximal Phalanx Shaft (PPS) finger fractures in adults (POINT): a multi-centre randomised trial

Chief Investigator: Alexia Karantana, The University of Nottingham

Trial Description: This research aims to assess the clinical effectiveness of surgery versus non-surgical splint treatment of Proximal Phalanx Shaft (PPS) finger fracture in adults.  The Proximal Phalanx Shaft bone is the finger bone closest to the knuckle.  Both methods are currently used to treat this type of fracture within the NHS; there are pros and cons to both treatments and the decision is often based on the preference of the treating clinician.

Patients who present in A&E with a finger fracture will be referred to hand fracture clinics where the PPS fracture will be confirmed.  Patients will be given information about the trial and if willing and eligible, will be randomised to receive either surgery or splinting (with a ration of 1:1).  Participants will be offered hand therapy and followed-up via online questionnaires at 6 weeks, 6 months and 12 months; data collected will focus on hand function, general health and any associated treatment costs.

Participants will attend clinic 3 months after joining the trial to provide further data on recovery and partake in various hand functionality assessments, including grip strength, pinch strength and range of motion.

The clinical effectiveness and cost-effectiveness of each treatment will be evaluated.  Follow-up will be used to assess long term effects of each treatment and the impact on day-to-day functioning and quality of life.  Recruitment is due to commence in Spring 2020.

Contact:  Jennifer White

Funding:  NIHR HTA programme

Status:  Recruiting

Further information: point@nottingham.ac.uk

 

 

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Trial Name:  Needle fasciotomy versus limited fascietomy for treatment of Dupuytren's contractures of the fingers: a feasibility study to investigate the acceptability and design of a multicentre randomised trial (HAND-1)

Chief Investigator:  Tim Davis, Nottingham University Hospitals NHS Trust

Trial Description: Dupuytren's contractures are fibrous cords under the skin in the palm of the hand. These contractures are painless but cause one or more fingers to gradullay and irreversibly curl into the palm, resulting in loss of hand function. Standard treatment is surgery to either remove or divide the contractures, allowing the finger to straighten again. The most common operation is to remove the contracture (limited fasciectomy): the fibrous cords preventing the finger(s) from straightening are cut out through a long skin incision in the hand, The alternative procedure is to divide the contracture with a needle (needle fasciotomy): a needle is put through the skin and sawing movements used to divide the fibrous cords. There is no clear evidence of the comparative benefirs and risks of these two quite different surgical procedures for Dupuytren's contractures.

The HAND-1 study aimed to assess the feasibility and acceptability to patients and clinicans of conducting a large randomised trial assessing the comparative clinical and cost effectiveness of needle fascietomy versus limited fasciectomy for Dupuytren's contractures of fingers. Recruitment took place from November 2015 to September 2016 at three sites, and the total of 71 participants were randomised.  Participant follow-up was completed in July 2017 and the feasibility outcomes were used to inform the design of a successful NIHR HTA Application (HAND-2) in 2019.

 Contact:  Ellie Harrison

 Funding:  NIHR Research to Patient Benefit

 Status: Reporting

Publications: 2017-24

 Further Information:  Ellie Harrison (Trial Manager) Hand-1@nottingham.ac.uk

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Nottingham Clinical Trials Unit

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