Fast Track for Wrist and Scaphoid Fractures

Ente Ospedaliero Cantonale, Bellinzona

Status: Terminated

Conditions: Wrist Fracture; Scaphoid Fracture

Treatments: Other: normal pathway; Other: fast track

Study type: Interventional

Funder types: Other

Identifiers

NCT05183477

2021-02140

Details and patient eligibility

About

This is a mono centric, prospective, randomised trial on the implementation and assessment of a shortened pathway for mono-trauma of the wrist and suspected fracture of distal radius and/or ulna and/or scaphoid bone.

Full description

Patients will be randomised into two groups: fast track and normal pathway. At the arrival in the Emergency Department a triage will be performed. In case of met inclusion criteria the patient will sign the informed consent and will be randomised in one of the two study groups.

The fast track group will be straightforwardly evaluated for absence of exclusion criteria (in case of exclusion criteria present the investigators will follow the normal pathway and the patient will not be included in the study). Then, patients will be assessed with an ad hoc checklist and then sent for x-ray performance, if necessary. After the x-ray the patients will be examined by an emergency physician that will have the opportunity to request new x-ray views if necessary.

The normal pathway group will go straight to medical examination as soon as possible, depending on waiting times in the Emergency Department.

Investigators will collect anagraphical data, waiting times, time to x-ray, overall length of stay in the Emergency Department, patients' and staff's satisfaction for the two groups.

Enrollment: 196 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• adults patients presenting at the emergency dept with suspected scaphoid or wrist fracture
• monotrauma
• written informed consent

Exclusion criteria

• patients younger than 18 yr
• pregnant women
• either vascular or neural impairment
• signs of open fracture
• multiple trauma patient

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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196 participants in 2 patient groups

fast track

Experimental group

Description:

patients arriving at Emergency Department with suspected wrist or scaphoid fracture, randomly allocated to the fast track pathway (xray requested at triage by nurse)

Treatment:

Other: fast track

normal pathway

Active Comparator group

Description:

patients arriving at Emergency Department with suspected wrist or scaphoid fracture, randomly allocated to waiting room and than medical examination before asking for xrays

Treatment:

Other: normal pathway