Lurie Children’s Awarded $6.8 Million To Study Best Treatments For Pediatric Upper Extremity Injuries

December 06, 2021

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Drs. Joseph Janicki, left, and Jamie Burgess, right

The Division of Orthopaedic Surgery at Ann & Robert H. Lurie Children’s Hospital of Chicago is leading two large research studies that seek to determine which current treatments for upper extremity fractures have the best outcomes reported by pediatric patients.

Lurie Children’s Joseph Janicki, MD, MS, and Jamie Burgess, PhD, along with the Infrastructure for Musculoskeletal Pediatric Acute Care Trials (IMPACCT) consortium, will launch two randomized clinical trials in early 2022. The effort is funded by a $6.8 million grant from the National Institutes of Health (NIH) awarded earlier this year.

The management of these two common upper extremity injuries, pediatric medial epicondyle fractures and displaced distal radius fractures, is controversial and varies among health care providers. To treat these fractures, pediatric orthopaedic surgeons either move the broken bone back into its original place while the child is under anesthesia or conscious sedation, or simply cast the bone. This variation can lead to children facing either anesthetic risks and extra costs with a procedure, or poor alignment with potential long-term functional disability without a procedure. These studies aim to determine which existing standard-of-care treatment has better patient reported outcomes for young patients.

“The results from this work will help guide clinical decision-making when physicians encounter these types of injuries,” said Dr. Janicki, orthopedic surgeon and researcher at Lurie Children’s and principal investigator of these studies. “Furthermore, the results will be useful in clinical decision-making even if a difference is not found, since one treatment strategy has greater potential morbidity and cost. In an era when the cost of medicine is being scrutinized, savings can be achieved by avoiding unnecessary interventions and complications.”

Co-investigators for the trials include Dr. Collin May at Boston Children’s Hospital, Drs. Andrew Georgiadis and Walter Truong at Gillette Children’s Hospital and Drs. Andrew Howard and James Wright at The Hospital for Sick Children in Toronto. IMPACCT’s leadership has expertise in leading multicenter clinical trials and its members represent 37 diverse centers from the Pediatric Orthopaedic Society of North America (POSNA).

The Infrastructure for Musculoskeletal Pediatric Acute Care Trials (IMPACCT) is a research consortium of researchers from hospitals across the United States and Canada with collaborators in the United Kingdom that aims to improve the quality of research in pediatric orthopaedic surgery by conducting randomized clinical trials.

Research at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through the Stanley Manne Children’s Research Institute. The Manne Research Institute is focused on improving child health, transforming pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children’s is ranked as one of the nation’s top children’s hospitals by U.S. News & World Report. It is the pediatric training ground for Northwestern University Feinberg School of Medicine. Last year, the hospital served more than 220,000 children from 48 states and 49 countries.