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Does the Geko nerve stimulator reduce Deep Vein Thrombosis (DVT) and improve healing in ankle fractures
ISRCTN ISRCTN95441725
DOI 10.1186/ISRCTN95441725
ClinicalTrials.gov identifier
EudraCT number
Public title Does the Geko nerve stimulator reduce Deep Vein Thrombosis (DVT) and improve healing in ankle fractures
Scientific title A randomised controlled trial investigating the effect of the Geko nerve stimulator to reduce DVT rates and improve healing in ankle fractures
Acronym N/A
Serial number at source 12/NW/0083
Study hypothesis The null hypothesis is that there is no alteration in the rates of DVT or the time to clinical and radiological union following open reduction and internal fixation of the ankle when using the Geko peroneal nerve stimulator.
Lay summary Background and study aims
There has been a recent trend amongst athletes to use peroneal (leg) nerve stimulators to reduce swelling after training or competition. The Geko peroneal nerve stimulator is a piece of equipment that sits on the skin at the side of the leg and sends electrical impulses through the skin so that the leg muscles can be stimulated to different levels. There is evidence that these nerve stimulators reduce the rates of leg clots and improves the circulation to the leg.
The aims of are study are to find out if the Geko peroneal nerve stimulator reduces the rate of leg clots and improves the bone healing in patients who have had their ankles fixed after fracture.

Who can participate?
Adults both male and female, with closed ankle fractures who present to Wirral University Hospital.

What does the study involve?
The study participants would be approached by a member of the clinical team and the research team and then after the appropriate consent is obtained, they would be included into the trial. Each patient would then be randomised into one of two groups i.e. those who receive the stimulator for a two week period post operative period and those who do not. The treatment of patients will not be affected by this trial. Patients in the treatment group would receive the stimulator for 2 weeks after being counselled by the research team. At the normal two week follow up patients in both groups will have their leg circumference measured and a vascular ultrasound performed to exclude the presence of a leg clot. Normal follow up is then at the six week period where X rays are taken and leg circumference is yet again measured. At the three month period patients answer a questionnaire.

What are the possible benefits and risks of participating?
The benefits of participating in the study would include a reduction in post operative swelling, time to healing and rates of leg clots.
The possible risks include minor discomfort from the stimulator or allergic reaction to the stimulator pad, a delay in healing of the bone.

Where is the study run from?
The study will be run from Wirral University Teaching Hospital. This is where the surgery and follow up procedures take place.

When is the study starting and how long is it expected to run for?
The study started in November 2012 and is expected to run until we have enough patients in each arm or run out of Geko stimulators.

Who is funding the study?
The study is being funded by Wirral University Hospital primarily. Skymed limited are providing the Geko stimulators for free and we are applying from external funding from the British Orthopaedic Foot and Ankle Association (BOFAS) for the ultrasound funding.

Who is the main contact?
The main contacts for the study are:
1. Mr Michael Hennessy (Consultant Orthopaedic Surgeon)
mchenno@btinternet.com
2. Mr Peter Kenyon (Specialist Registrar)
dr_kenyon@hotmail.com
Ethics approval NRES Committee North West - Liverpool Central, 02/04/12, ref: 12/NW/0083
Study design Randomised controlled trial
Countries of recruitment United Kingdom
Disease/condition/study domain Ankle fracture
Participants - inclusion criteria 1. Adults aged 18 years or older, either sex
2. Patients with closed ankle fractures that have required open reduction and internal fixation
3. Patients who are able to consent for themselves
Participants - exclusion criteria 1. Open fractures
2. Diabetics
3. Those with peripheral neuropathy, metabolic bone disorders and immunological disorders
4. Patients undergoing revision procedures
5. Patients with syndesmotic injury requiring screw removal prior to mobilisation
6. Those unable to use the Geko device
Anticipated start date 01/11/2012
Anticipated end date 01/11/2013
Status of trial Ongoing
Patient information material Not available in web format, please use the contact details below to request a patient information sheet
Target number of participants 400
Interventions Each patient randomised into one of two groups i.e. those who receive the stimulator for a two week period post operative period and those who do not.

The treatment of patients will not be affected by this trial. Patients in the treatment group would receive the stimulator for 2 weeks after being counselled by the research team. At the normal two week follow up patients in both groups will have their leg circumference measured and a vascular ultrasound performed to exclude the presence of a leg clot. Normal follow up is then at the six week period where x rays are taken and leg circumference is yet again measured. At the three month period patients answer a Manchester - Oxford Foot and Ankle Questionnaire.
Primary outcome measure(s) 1. DVT rate
2. Time to Union
Secondary outcome measure(s) 1. Manchester - Oxford Foot and ankle questionnaire at end of 3 months
2. Time to return work
Sources of funding Skymed Ltd (UK)
Trial website
Publications
Contact name Mr  Michael  Hennessy
  Address Wirral University Teaching Hospital
Arrowe Park Road
Upton
Wirral
  City/town Merseyside
  Zip/Postcode CH49 5PE
  Country United Kingdom
Sponsor Wirral University Teaching Hospital (UK)
  Address Arrowe Park Road
Upton Wirral
  City/town Merseyside
  Zip/Postcode L176GD
  Country United Kingdom
  Sponsor website: http://www.whnt.nhs.uk
Date applied 17/07/2012
Last edited 07/01/2013
Date ISRCTN assigned 07/01/2013
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