Botox Injection for Lower Extremity Lengthening and Deformity Correction Surgery
| Status: | Completed |
|---|---|
| Conditions: | Orthopedic, Women's Studies |
| Therapuetic Areas: | Orthopedics / Podiatry, Reproductive |
| Healthy: | No |
| Age Range: | 5 - 21 |
| Updated: | 10/14/2017 |
| Start Date: | January 2007 |
| End Date: | December 2012 |
Safety and Efficacy of Botox Injection in Alleviating Post-Operative Pain and Improving Quality of Life in Lower Extremity Limb Lengthening and Deformity Correction
The purpose of this six site multi-center study is to determine if BTX-A can alleviate the
post-operative pain and improve the functional and quality of life outcomes of children with
limb length discrepancy or angular deformity undergoing limb lengthening or deformity
correction.
post-operative pain and improve the functional and quality of life outcomes of children with
limb length discrepancy or angular deformity undergoing limb lengthening or deformity
correction.
The specific aims are to determine if BTX-A will:
- 1a. Reduce pain post operatively and during the distraction and consolidation process,
- 1b. Reduce the amount, frequency and duration of narcotics taken in the postoperative
period.
- 2. Improve the quality of life during the distraction and consolidation process.
- 3 Decrease muscular spasm and subsequent muscle contracture during the distraction and
consolidation process and accelerate earlier return to pre-operative mobility function
including earlier weight bearing.
- 4. To develop clinical practice guidelines for the interdisciplinary care of children
undergoing limb lengthening or deformity correction.
Methodology: A randomization process for this one time injection will be used to determine
who will receive the BTX-A or the placebo. 150 subjects will be recruited; 75 to the BTX-A
group and 75 to the placebo group. There will be an equal number of subjects in each group at
each site. The medication will be injected intraoperatively into specific major muscles in
the lower limb adjacent to the bone or soft tissue being lengthened or corrected at a dose of
10 U/kg with a maximum of 50 U per site, not to exceed a total maximum dose of 400 units.
Pain scores, medication dosages, range of motion and an ambulation scale will be measured
post-operatively and during the distraction and consolidation phases.
In addition families will be asked to complete six different questionnaires related to pain,
quality of life and psycho-social issues at various times during the process. The children
will receive standard nursing care and physical therapy and will be followed for three months
after the external fixator is removed, for a total time of approximately one year.
- 1a. Reduce pain post operatively and during the distraction and consolidation process,
- 1b. Reduce the amount, frequency and duration of narcotics taken in the postoperative
period.
- 2. Improve the quality of life during the distraction and consolidation process.
- 3 Decrease muscular spasm and subsequent muscle contracture during the distraction and
consolidation process and accelerate earlier return to pre-operative mobility function
including earlier weight bearing.
- 4. To develop clinical practice guidelines for the interdisciplinary care of children
undergoing limb lengthening or deformity correction.
Methodology: A randomization process for this one time injection will be used to determine
who will receive the BTX-A or the placebo. 150 subjects will be recruited; 75 to the BTX-A
group and 75 to the placebo group. There will be an equal number of subjects in each group at
each site. The medication will be injected intraoperatively into specific major muscles in
the lower limb adjacent to the bone or soft tissue being lengthened or corrected at a dose of
10 U/kg with a maximum of 50 U per site, not to exceed a total maximum dose of 400 units.
Pain scores, medication dosages, range of motion and an ambulation scale will be measured
post-operatively and during the distraction and consolidation phases.
In addition families will be asked to complete six different questionnaires related to pain,
quality of life and psycho-social issues at various times during the process. The children
will receive standard nursing care and physical therapy and will be followed for three months
after the external fixator is removed, for a total time of approximately one year.
Inclusion Criteria:
- Age: 5 to 21 years.
- Aetiology of the deformity: congenital or acquired.
- Amount of lengthening or deformity correction: any amount.
- Site of lengthening or deformity correction: lower extremity.
- Type of fixator: circular or uniplanar.
Exclusion Criteria:
- Children younger than 5 years of age.
- Associated neuromuscular conditions that may hinder weight bearing.
- Individuals on aminoglycosides, as aminoglycosides can potentiate the effect of
Botulinum toxin A.
We found this trial at
5
sites
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