CM Asia Nail With AS2 Without AS2 （AS2 Study）

N/ACompletedNCT03196193

Zimmer Biomet240 enrolled

Overview

The purpose of this study is to compare reduction positon maintenance rate at 3 weeks post-operatively between patients operated with Anterior Support Screw (AS2) and without AS2 technique in RCT setting. Total 240 cases(each arm 120 cases) will be enrolled at maximum 15sites, total study duration is 22months.

Objective： To compare fracture reduction maintenance rate at 2-3weeks post-operatively between patients operated with AS2 (investigational group) and patients operated without AS2 (Control group) using same implant system (ZNN CM Asia, Zimmer Biomet). Endpoint： Primary： The rate of reduction position maintenance at 2-3 weeks post-operatively. Secondary： Surgery time / fracture type / postoperative reduction position / CT assessment / Safety information

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

QUADRUPLE

Enrollment

240

Conditions

Trochanteric Fracture of Femur

Interventions

Open Reduction and Internal FixationPROCEDURE

Fractured bone fragments are reduced and stabilized by intramedullary nail.

ZNN CM AsiaDEVICE

Reduced bone fragments are to be stabilized by Zimmer Natural Nail CM Asia System.

Anterior Support ScrewDEVICE

Experimental group will receive insertion of ACE 4.5/5.0mm cannulated lag-screw anteriorly to Zimmer Natural Nail CM Asia Lag-screw.

Eligibility

Sex: ALLMin age: 20 Years

Medical Language ↔ Plain English

Inclusion Criteria: In order to be eligible to participate in this study, a subject must meet all of the following criteria. * Eligible for intramedullary nailing. * Fracture type is classified as 3-partB or 4-part fracture in 3D-CT (Three Dimensional Computed Tomography) classification (Nakano), and combination with a subtype P in lateral classification (Ikuta) at preoperative CT (Computed Tomography) assessment.(In the case of classified in radiograph (X-ray) at preoperative: Classified as Type 4 or Type 5 in Jensen classification, and combination of subtype P in lateral classification (Ikuta)) * Japanese Male or female * \> 20 years of age * Primary closed intertrochanteric fracture of the femur * Subjects willing to return for follow-up evaluations. Exclusion Criteria: A potential subject who meets any of the following criteria will be excluded from participation in this study. * Patient who cannot take CT image within 3 days and 2-3weeks after surgery. * Uncooperative patient or patient with neurologic disorders who are incapable of following directions.

Locations (12)

Kure Kyosai Hospital

Kure, Hiroshima, Japan

Toyooka Hospital

Toyooka, Hyōgo, Japan

Kasugai Municipal Hospital

Aichi, Kasugai, Japan

Outcomes

Primary Outcomes

Number of Patient With and Without Excessive Lag Screw Sliding Distance

Number of patient was counted based on CT measurement results. Relative position of lag screw between CT images taken at both immediate and 2-3 weeks postoperatively was measured and recorded in value (e.g., 1.5 mm). This was called as "lag screw sliding distance". Four millimeter was set as threshold to define success and failure. Less than 4mm of lag screw sliding distance was recognized as Success and equal to or more than 4mm of lag screw sliding distance was recognized as Failure.

Time frame: Postoperative 2-3 week

Secondary Outcomes

Surgery Time

Surgery time from skin incision to closure

Time frame: Intraoperative, an average of 1 hour

Image Assessment Using Computed Tomography (CT)

Number of patient was counted based on CT measurement results. When the fracture reduction position achieved at surgery was maintained at 2 to 3 weeks, then the patient was categorized as success (Reduction position maintained). On the other hand, patient was categorized as failure (Reduction position changed) in the case that the fracture reduction position was changed. Fracture repair position was categorized into three; "Anterior", "Neutral" or "Posterior" based on relative position of proximal bone fragment and distal bone fragment. This analysis only includes patients whose fracture reduction position at immediate postoperative CT was either "Anterior" or "Neutral". If both immediate and 2-3 weeks postoperative CT images show same fracture reduction position (example: "Anterior" at immediate postoperatively \& "Anterior" at 2-3 weeks postoperatively), then the patient was recognized as Success (Reduction position maintained).

Time frame: 2-3 weeks postoperatively

Intraoperative Safety

This is to evaluate whether any adverse events specific to insert additional screw for AS2 technique were occurred.

Time frame: Intraoperative

Data from ClinicalTrials.gov

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