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DIFFIR - Geriatric Distal Femur Fixation Versus Replacement

RecruitingNAAges 65 Years - anyAllUnity Health Toronto
NCT04076735 on ClinicalTrials.gov ↗
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In plain words

What the trial is, and whether it could suit you

The current standard of care for most intra-articular distal femur fractures (above the knee joint) in geriatric patients is a surgical fixation using plates and screws to hold the fracture pieces in the correct position, until the fracture as healed. However, surgical fixation of these complex fractures in geriatric patients, is associated with significant complications, such as non-union (when the broken bone does not heal properly), infection and the need for revision surgery. Additionally, surgical fixation requires prolonged immobilization of of the affected limb (typically around 6-12 weeks post-operatively), which can lead to disability and other complications. Geriatric patients, especially those frail and with cognition impairment, are unable to adhere to the immobilization restrictions, which leads to an increased risk of fixation failure (broken bone does not heal). Another

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📋 Eligibility rules (as published)
Inclusion Criteria: * Male and female patients * 65 years and older * Isolated fracture of the distal femur (Classification 33) * Fracture is amendable to both treatments * Fracture is acute (within 2 weeks from time of injury) * Patient was ambulatory (with or without walking aids) prior to the injury * Independent or moderately frail with score of 3 to 6 on the Clinical Frailty Scale * Patient is able to read and understand English, French, or Spanish * Patient or substitute decision maker is able to provide written informed consent to participate in the study Exclusion Criteria: * Active or previous infection around the fracture (soft tissue or bone) * Open fracture * Bilateral femur fractures * Major vascular injuries requiring intervention, compartment syndrome and major neurologic injuries * Pathological fracture excluding osteoporosis * Previous surgical fixation or total knee replacement of the distal femur or proximal tibia * Previous surgical fixation or hemi/total replacement of the hip * Current or previous extensor mechanism (patellar tendon, quadriceps tendon, or patella fracture) disruption or repair * Polytrauma (Injury Severity Score \> 15) or any associated major injuries of the lower extremities * Previous medical diagnosis of dementia * Medical or surgical contra-indication to surgery
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What it tests

  • Distal femoral replacement
  • Surgical Fixation (ORIF)
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Where

1 site
St Michael's Hospital - Unity Health Toronto
Toronto, Canada
🤝 Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible — always decide together with your own doctor.
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