Effect of a Novel Reamer-Irrigator-Aspirator on the Incidence of Fat Embolism (RIA)
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Purpose
The purpose of this study is to determine the effect on the incidence of fat emboli when using a Reamer-Irrigator Aspirator during reamed IM nail fixation of femoral shaft fractures
| Condition | Intervention |
|---|---|
|
Embolism Femoral Fractures |
Device: Reamer Irrigator Aspirator |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Subject) Primary Purpose: Treatment |
| Official Title: | A Prospective Randomized Trial Investigating the Effect of a Novel Reamer-Irrigator-Aspirator on the Incidence of Fat Embolism and Respiratory Function During Intramedullary Nailing of Femoral Shaft Fractures |
- Extent of intra-operative embolic events. [ Time Frame: Duration of surgical procedure. ] [ Designated as safety issue: No ]
- Measured pulmonary responses. [ Time Frame: Duration of surgical procedure. ] [ Designated as safety issue: No ]
| Enrollment: | 22 |
| Study Start Date: | January 2005 |
| Study Completion Date: | January 2013 |
| Primary Completion Date: | January 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: 1
Standard reamer
|
Device: Reamer Irrigator Aspirator
Use of standard reamer vs reamer irrigator-aspirator during IM nailing of tibial shaft fractures
|
|
Active Comparator: 2
Use of the Reamer-Irrigator Aspirator
|
Device: Reamer Irrigator Aspirator
Use of standard reamer vs reamer irrigator-aspirator during IM nailing of tibial shaft fractures
|
Detailed Description:
The current practice of reaming the medullary canal for the fixation of femur fractures is recommended, however, there is an associated increase in the level of embolic events which confers morbidity and, occasionally, mortality.
The RIA is a single device which is able to ream the medullary canal, irrigate the canal and subsequently aspirate the reamed medullary contents in order to get rid of medullary fat and other contents responsible for these adverse embolic events.
A novel Reamer-Irrigator-Aspirator (RIA) (Synthes, Inc) will be evaluated in a randomized study, to determine its effect on the incidence of fat emboli events during reamed IM nail fixation of consecutive femoral shaft fractures as measured by intra-operative transesophageal echocardiogram and pulmonary function.
Eligibility| Ages Eligible for Study: | 16 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Participant aged 16 to 65 years of age
- Skeletally mature
- Isolated, closed femoral shaft fracture (participant may also have sustained a distal radius/wrist, distal tibia/ankle, hand, and/or foot fractures for eligible inclusion)
- Fracture amenable to an antegrade I.M. nail
- Fracture amenable to insertion of a 12 mm RIA
- Fracture ≤ 48 hrs post injury
- Participant has a 'Thorax' Abbreviated Injury Score (AIS) of < 2
- Participant has a 'Head & Neck' AIS score of < 2
- Provision of informed consent
Exclusion Criteria:
- Fracture proximal to the lesser trochanter
- Open fracture
- Participant has a humeral, tibial, contralateral femoral, spinal,and/or pelvic fracture
- Pathological fracture
- Fractures > 48 hrs post injury
- Limited life expectancy due to significant medical co-morbidities
- Previous history of esophageal/gastric surgery
- Previous history of esophageal/gastric tumor
- Previous history of esophageal varices
- Medical contraindication to surgery
Contacts and Locations| Canada, Ontario | |
| St. Michael's Hospital | |
| Toronto, Ontario, Canada, M5C 1R6 | |
| Principal Investigator: | Jeremy A Hall, MD, FRCSC | St. Michael's Hospital, Toronto |
| Principal Investigator: | Emil Schemitsch | St. Michael's Hospital, Toronto |
More Information
No publications provided
| Responsible Party: | Jeremy Hall, MD, FRCS(C), St. Michael's Hospital, Toronto |
| ClinicalTrials.gov Identifier: | NCT00509171 History of Changes |
| Obsolete Identifiers: | NCT00753376 |
| Other Study ID Numbers: | R-6-30-MAR-07 |
| Study First Received: | July 30, 2007 |
| Last Updated: | April 30, 2013 |
| Health Authority: | Canada: Health Canada |
Keywords provided by St. Michael's Hospital, Toronto:
|
embolism femur fracture lavage |
TEE reamer IM nail |
Additional relevant MeSH terms:
|
Embolism Embolism, Fat Femoral Fractures Fractures, Bone Embolism and Thrombosis |
Vascular Diseases Cardiovascular Diseases Wounds and Injuries Leg Injuries |
ClinicalTrials.gov processed this record on June 17, 2013