Rock-Paper-Scissors-OK in Nerve Examination

Ankara City Hospital

Status: Completed

Conditions: Supracondylar Humerus Fractures; Nerve Examination

Treatments: Other: Conventional Neurological Examination; Other: Preoperative video-based training module

Study type: Interventional

Funder types: Other

Identifiers

NCT07480798

TABED 1-24-83 13 March 2024;

Details and patient eligibility

About

Patients presenting to the Orthopedics and Traumatology Clinic of Ankara Bilkent City Hospital with supracondylar humerus (elbow) fractures will initially undergo closed reduction. Following the reduction procedure, radiographic imaging will be obtained and patients will be re-evaluated. If surgical intervention is deemed necessary based on this assessment, operative treatment will be recommended.

The surgical technique will consist of closed reduction followed by percutaneous Kirschner wire (K-wire) fixation. In cases where adequate fracture reduction cannot be achieved by closed means, open reduction will be performed through an anterior incision. In these patients, K-wires will again be inserted percutaneously.

Fixation will be achieved using one medial (ulnar side) and two lateral K-wires. Postoperatively, a neurological examination will be performed. In patients who are shown a video and taught the game beforehand, neurological assessment will be conducted using the "rock-paper-scissors" game. In other patients, the examination will be performed by demonstrating and requesting specific hand movements.

If ulnar nerve deficit is detected during postoperative neurological evaluation, the medial K-wire will be removed. The time interval between the patient's emergence from anesthesia and the neurological examination will be recorded.

Enrollment: 102 patients

Sex: All

Ages: 4 to 10 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Children aged 4 to 10 years
• Underwent surgical treatment for supracondylar humerus fracture
• Willing to participate (assent/parental consent as applicable)

Exclusion criteria

• Cognitive inability to understand or perform the rock-paper-scissors-OK movements
• Declined participation (patient and/or parent/guardian refusal, as applicable)

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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102 participants in 2 patient groups

Smartphone-Assisted Neurological Examination

Other group

Description:

Participants undergo neurological examination using a smartphone-assisted application (preoperatively and postoperatively). Examination duration and patient satisfaction are recorded.

Treatment:

Other: Preoperative video-based training module

Conventional Neurological Examination

Other group

Description:

Participants undergo neurological examination using conventional bedside clinical assessment methods (preoperatively and postoperatively). Examination duration and patient satisfaction are recorded.

Treatment:

Other: Conventional Neurological Examination