Educational Videos for Broken Bones

(HM-PBF Trial)

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Carilion Clinic

Disqualifiers: Other fractures, Metabolic bone disease, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

Duration: 6 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if video education at home can effectively replace in-person doctor visits for children with a specific type of wrist fracture, known as a distal radius buckle fracture. The study will compare patient satisfaction, time spent on healthcare, and overall costs between those using the video education plan at home (Home Management with Video Education) and those visiting the doctor in person. Children aged 5-17 with this type of fracture and internet access may be suitable candidates. Participants will either follow a home management plan or continue in-person visits and will complete a satisfaction survey and a health assessment at the start and end of the study. As an unphased trial, this study offers a unique opportunity to explore innovative home-based care, potentially enhancing convenience and satisfaction.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on managing broken bones with video education, so it's unlikely to require changes to your medication.

What prior data suggests that this home management plan with video education is safe for children with distal radius buckle fractures?

Research has shown that treating buckle fractures in children at home with video guidance is generally safe and effective. Studies indicate that home care works as well as in-person doctor visits for recovery. The healing process remains similar whether children receive treatment at home or through regular doctor visits.

One study found that managing these fractures at home can simplify care and ease the burden on families. During the COVID-19 pandemic, more families opted for home management, and it proved successful with various healthcare providers.

Although the study details aren't specified, the consistent results suggest that home management with video guidance is a well-accepted option for children with buckle fractures. This method may reduce the inconvenience of doctor visits without compromising safety. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the trial for home management with video education for buckle fractures because it offers a fresh approach to treating broken bones. Unlike standard care, which typically involves in-person visits to an orthopedic surgeon, this method leverages educational videos to guide patients in managing their condition from home. This could make treatment more convenient and accessible, allowing for better patient engagement and potentially reducing the need for frequent clinic visits. Moreover, the use of MyChart for asynchronous communication adds a layer of personalized care, enabling patients to get timely advice without leaving their homes. As a result, this approach could enhance patient satisfaction and streamline the recovery process.

What evidence suggests that home management with video education is effective for managing distal radius buckle fractures?

This trial will compare home management with video education to in-person management for treating children's wrist fractures. Research has shown that videos teaching parents how to care for their child's wrist fracture can be as effective as in-person doctor visits. One study found that online videos and lessons helped parents manage their child's fracture pain. Another study demonstrated that virtual clinics, using similar video methods, are safe and effective for most stable fractures in children. Additionally, videos can help avoid unnecessary treatments, like hard casts, and reduce healthcare resource use. This suggests that video education might replace some in-person visits without compromising care quality. ^{3 4 6 7 8}

Who Is on the Research Team?

Peter J Apel, MD, PhD

Principal Investigator

Carilion Clinic Orthopaedic Surgery

Are You a Good Fit for This Trial?

This trial is for children aged 7-17 with distal radius buckle fractures. It's designed to see if managing their treatment at home with educational videos is as good as in-person care. Kids must be able to follow the video instructions and have a caregiver who can help them.

Inclusion Criteria

I have a specific type of wrist fracture without a break on the opposite side.

My child has a broken wrist or forearm.

Access to internet to download or view videos

Exclusion Criteria

Family/caregiver inability to speak or read English or Spanish

I have a metabolic bone disease.

Inability to utilize technology to view videos or follow instructions

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 week

1 visit (in-person)

Randomization

Participants are randomized to either the in-person management group or the video-based home management group

1 day

Treatment

Participants receive either in-person management or video-based home management for buckle fractures

6 weeks

In-person group: multiple visits; Home management group: video education

Follow-up

Participants are monitored for safety and effectiveness after treatment, including completion of a satisfaction survey and PROMIS assessment

6 weeks

Asynchronous communication via MyChart

What Are the Treatments Tested in This Trial?

Interventions

• Home Management with Video Education

Trial Overview Researchers are testing whether a home management plan using educational videos for kids' broken bones is just as satisfying for patients and more efficient than visiting doctors. They're checking if it saves time, reduces missed school or work, prevents unnecessary treatments, and cuts healthcare costs.

How Is the Trial Designed?

Group I: Home management Experimental Treatment 1 Intervention

Home-management group will be given access to an educational video explaining the nature of buckle fractures and treatment. all participants will enroll in MyChart to allow for asynchronous messages. Participants will complete a pediatric PROMIS assessment at baseline and 6 weeks. Patients/guardians will complete a satisfaction survey.

Group II: In-person management Active Control 1 Intervention

In-person group will be followed with standard-of-care clinic visits scheduled with an pediatric orthopaedic Surgeon at Carilion Clinic Institute for Orthopaedics and Neurosciences. Participants will complete a pediatric PROMIS assessment at baseline and 6 weeks for . Patients/guardians will complete a satisfaction survey.

Who Is Running the Clinical Trial?

Carilion Clinic

Lead Sponsor

Trials

85

Recruited

15,400+

Virginia Polytechnic Institute and State University

Collaborator

Trials

162

Recruited

26,900+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5902745/

Buckling down on torus fractures: has evolving evidence ... The purpose of this study was to evaluate the management of paediatric torus fractures of the distal forearm in current practice.

2. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/29041997/

A Web-based module and online video for pain ... A Web-based module and online video for pain management education for caregivers of children with fractures: A randomized controlled trial.

3. cureus.com cureus.com/articles/274056-improving-patient-care-and-streamlining-follow-up-compliance-with-national-institute-for-health-and-care-excellence-nice-guidelines-for-pediatric-distal-radius-buckle-fractures

Improving Patient Care and Streamlining Follow-Up Results: This study looked at the management of pediatric distal radius buckle fractures in a cohort of 152 patients, of which 65 and 87 ...

4. thelancet.com thelancet.com/journals/lancet/article/PIIS0140-6736(22)01015-7/fulltext

Immobilisation of torus fractures of the wrist in children ... This trial supports the strategy to de-escalate the treatment of children with a torus fracture of the distal radius by offering a bandage and ...

5. frontiersin.org frontiersin.org/journals/digital-health/articles/10.3389/fdgth.2023.1261035/full

How safe and effective are paediatric virtual fracture clinics ... VFCs have shown to be safe and effective at managing most stable, low operative risk paediatric fractures.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10521341/

Enhancing Patient Management and Financial Efficiency Results: This study assessed the management of pediatric distal radius buckle fractures in a cohort of 84 patients. 39/84 (46.4%) of patients ...

7. annemergmed.com annemergmed.com/article/S0196-0644(20)30640-5/abstract

Home Management Versus Primary Care Physician Follow ... In patients with distal radius buckle fractures, home management is at least as good as primary care physician follow-up with respect to functional recovery.

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12088341/

Impact of the COVID-19 Pandemic on Buckle Fracture ... The COVID-19 pandemic was associated with a significant increase in BEST practice utilization for buckle fracture management across all provider types.