The Wire Study-a protocol for a multi-stage feasibility study evaluating K-wire fixation of hand fractures in the UK.

Autor: Wormald JCR; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), Botnar Research Centre, University of Oxford, Oxford, OX3 7LD, UK.; Department of Plastic, Reconstructive and Burns Surgery, Stoke Mandeville Hospital, Aylesbury, HP21 8AL, UK., Mikhail MM; Department of Plastic Surgery, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, SL2 4HL, UK., Rodrigues JN; Department of Plastic, Reconstructive and Burns Surgery, Stoke Mandeville Hospital, Aylesbury, HP21 8AL, UK. J.Rodrigues@warwick.ac.uk.; Warwick Clinical Trials Unit, University of Warwick, Coventry, CV4 7AL, UK. J.Rodrigues@warwick.ac.uk., Gardiner S; Department of Plastic, Reconstructive and Hand Surgery, Royal Free London NHS Foundation Trust, Pond St, Hampstead, London, NW3 2QG, UK., Pezas T; Department of Plastic, Reconstructive and Hand Surgery, St. George's University Hospital NHS Trust, London, SW17 0QT, UK., Lloyd-Hughes H; Department of Plastic, Reconstructive and Hand Surgery, Guys and St. Thomas' NHS Foundation Trust, London, SE1 7EH, UK., Issa F; Department of Plastic, Reconstructive and Burns Surgery, Stoke Mandeville Hospital, Aylesbury, HP21 8AL, UK.; Nuffield Department of Surgical Sciences, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, UK., Jain A; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), Botnar Research Centre, University of Oxford, Oxford, OX3 7LD, UK.; Department of Plastic, Reconstructive and Hand Surgery, Imperial College Healthcare Trust, London, W2 1NY, UK., Gardiner MD; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), Botnar Research Centre, University of Oxford, Oxford, OX3 7LD, UK.; Department of Plastic Surgery, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, SL2 4HL, UK.
Jazyk: angličtina
Zdroj: Pilot and feasibility studies [Pilot Feasibility Stud] 2021 Jun 17; Vol. 7 (1), pp. 128. Date of Electronic Publication: 2021 Jun 17.
DOI: 10.1186/s40814-021-00858-4
Abstrakt: Background: Hand fractures are common and sometimes require surgery to restore function. Placement of Kirschner wires (K-wires) is the most common form of surgical fixation. After placement, a key decision is whether to bury the end of a K-wire or leave it protruding from the skin (exposed). A recent systematic review found no evidence to support either approach and a national clinician and surgeon survey demonstrated further uncertainty. We aim to determine the design of a definitive randomised controlled trial assessing the cost and clinical effectiveness of buried versus exposed Kirschner wires for adults with metacarpal or phalangeal fractures.
Methods: We will employ three methodologies: a national service evaluation of current clinical practice, patient and surgeon focus groups and a consensus meeting to finalise the protocol for a randomised controlled trial. For the service evaluation, all outcomes will be summarised using descriptive statistics overall and split by group (buried versus exposed K-wires). Information collected in the patient focus groups will be analysed thematically. The surgeon consensus meeting will address each part of the design in turn and through discussion agree a final protocol.
Discussion: The study may be monitored, or audited in accordance with the current approved protocol, Good Clinical Practice (GCP), relevant regulations and standard operating procedures. The Chief Investigator will submit and, where necessary, obtain approval from the above parties for all substantial amendments to the original approved documents. A feasibility study report will be published by the Wire Study Steering committee. Additional members of the steering group and citable collaborators will be listed within the manuscript and their roles identified.
Databáze: MEDLINE
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