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加拿大前瞻性实用舟月关节预后(C3PO)试验;方案

The Canadian Prospective Pragmatic Perilunate Outcomes (C3PO) trial; a protocol.

作者信息

Mitchell Eric C, Tottenham Isabelle, Grewal Ruby, Curran Matthew W T, White Neil J

机构信息

Division of Plastic Surgery, Western University, London, Canada.

Cumming School of Medicine, University of Calgary, Calgary, Canada.

出版信息

BMC Musculoskelet Disord. 2025 Jan 31;26(1):93. doi: 10.1186/s12891-024-08227-x.

Abstract

BACKGROUND

Perilunate spectrum injuries (PSI) are uncommon, but high-energy injuries that result in significant functional implications for patients. The existing literature on PSI is limited to small case-series and there are no evidence-based guidelines for management.

METHODS

This manuscript outlines a protocol for a three-armed, national, multi-centre study, which includes a patient injury registry for PSI, as well as associated retrospective and prospective arms. The primary objective is to establish a national injury registry for patients who present with PSI. The secondary objectives are to examine the long-term clinical and radiographic outcomes of PSI, evaluate progression of these outcomes over time, and to examine the impact of specific operative and injury related factors on outcomes.

DISCUSSION

This paper describes the protocol for a three-armed, multi-centre study of PSI. It outlines the rationale for the study as well as the relevant methodological details. An injury registry involving multiple centres is valuable given this is an uncommon injury with many potential variables affecting outcomes. Registry-based retrospective and prospective studies will benefit from the large clinical database provided by the registry and could be used to guide evidence-based treatment guidelines which are currently lacking in the literature.

TRIAL REGISTRATION

Clinicaltrials.gov identifier: NCT04370626.

摘要

背景

月骨周围谱系损伤(PSI)并不常见,但属于高能损伤,会给患者带来严重的功能影响。关于PSI的现有文献仅限于小型病例系列,且尚无基于证据的管理指南。

方法

本手稿概述了一项三臂、全国性、多中心研究的方案,其中包括一个PSI患者损伤登记处,以及相关的回顾性和前瞻性研究分支。主要目标是为出现PSI的患者建立一个全国性损伤登记处。次要目标是检查PSI的长期临床和影像学结果,评估这些结果随时间的进展情况,并研究特定手术和损伤相关因素对结果的影响。

讨论

本文描述了一项针对PSI的三臂、多中心研究的方案。它概述了研究的基本原理以及相关的方法学细节。鉴于这是一种不常见的损伤,有许多潜在变量会影响结果,因此涉及多个中心的损伤登记处很有价值。基于登记处的回顾性和前瞻性研究将受益于登记处提供的大型临床数据库,并可用于指导目前文献中缺乏的基于证据的治疗指南。

试验注册

Clinicaltrials.gov标识符:NCT04370626。

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本文引用的文献

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Outcomes of acute perilunate injuries-a systematic review.急性月骨周围损伤的结局:系统评价
Eur J Trauma Emerg Surg. 2023 Oct;49(5):2071-2084. doi: 10.1007/s00068-023-02222-y. Epub 2023 Feb 7.
2
Epidemiology of carpal fractures: is it only about the scaphoid?腕骨骨折的流行病学:仅仅与舟状骨有关吗?
Eur J Trauma Emerg Surg. 2023 Jun;49(3):1499-1503. doi: 10.1007/s00068-022-02213-5. Epub 2023 Jan 17.
4
Perilunate Injury Timing and Treatment Options: A Systematic Review.月骨周围损伤的时机与治疗选择:一项系统综述
J Wrist Surg. 2021 Oct 5;11(2):164-176. doi: 10.1055/s-0041-1735841. eCollection 2022 Apr.
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Current national hand surgery registries worldwide.当前全球各国的手外科登记系统。
J Hand Surg Eur Vol. 2021 Jan;46(1):103-106. doi: 10.1177/1753193420970155. Epub 2020 Nov 17.
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The PRWE/PRWHE update.PRWE/PRWHE更新。
J Hand Ther. 2019 Apr-Jun;32(2):292-294. doi: 10.1016/j.jht.2019.01.001. Epub 2019 Mar 25.
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Developing a national quality registry for hand surgery: challenges and opportunities.建立全国手外科质量登记系统:挑战与机遇
EFORT Open Rev. 2017 Mar 13;1(4):100-106. doi: 10.1302/2058-5241.1.000045. eCollection 2016 Apr.

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