<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT04501510</url>
  </required_header>
  <id_info>
    <org_study_id>61.610.022-110</org_study_id>
    <nct_id>NCT04501510</nct_id>
  </id_info>
  <brief_title>Ultrasonography in Fracture Management</brief_title>
  <acronym>UFrac</acronym>
  <official_title>The Use of Ultrasonography as a Diagnostic Tool for the Fracture Management</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>University of Warmia and Mazury</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>University of Warmia and Mazury</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      The bone fracture is usually diagnosed using an X-ray examination (the method of choice).&#xD;
      However, in the case of the youngest patients (children and adolescents), it carries a&#xD;
      potential risk of X-ray radiation exposure. What is important, an X-ray examination often&#xD;
      fails to detect occult fractures or the early stages of a fracture with or without bone&#xD;
      fusion. The literature emphasizes that from 2 to 36% of fractures may be unnoticed on X-ray&#xD;
      images (false negative results). Therefore, additional possibilities are sought to improve&#xD;
      the initial diagnosis.&#xD;
&#xD;
      It was shown that ultrasound could be used instead of the conventional imaging. The most&#xD;
      important advantages of the usg are the absence of radiation exposure and greater&#xD;
      availability. Moreover, the evaluator is able to show neovascularization during usg&#xD;
      examination, which is important in bone healing process.&#xD;
&#xD;
      The aim of this study is (1) to validate the ultrasound imaging method for the fracture&#xD;
      management; (2) to use an ultrasound imaging to assess the bone fracture and healing process&#xD;
      during 8 weeks post injury.&#xD;
&#xD;
      This study consists of 50 patients aged 10-18 years old. The forearm fracture will be&#xD;
      diagnosed using an X-ray imaging as well as an ultrasound imaging in the first 3 days post&#xD;
      injury (initial study). It is planned to assess the healing process after 2, 4, 6 and/or 8&#xD;
      weeks post injury (comparative study).&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      The physiological fracture healing is based on the proper facilitation of regeneration and&#xD;
      proliferation process. The bone fracture is usually diagnosed using an X-ray examination.&#xD;
      However, an ultrasound imaging could be used instead of the conventional imaging. It is&#xD;
      important in the case of the youngest patients. In these cases, the Hubner protocol/algorithm&#xD;
      is often used. The patients with suspected fracture are advised to perform an ultrasound&#xD;
      examination. Only after the confirmation of a suspected fracture, an X-ray examination should&#xD;
      be performed.&#xD;
&#xD;
      Bone structure show typical characteristics, which make an ultrasonography an attractive&#xD;
      medical diagnostic tool. Highly dense tissues such as bone reflect echoes and, therefore,&#xD;
      appear bright white on an ultrasound (reflection from the cortical surface of the bone). This&#xD;
      allows bone to be clearly distinguished from the surrounding soft tissues.&#xD;
&#xD;
      It was shown that ultrasound is a good diagnostic tool to assess the fracture healing&#xD;
      process. The advantage of usg is that it is non-invasive, does not use ionizing radiation and&#xD;
      is performed in a real-time.&#xD;
&#xD;
      The first study about the ultrasound in the diagnosis of fracture was carried out in 1988 in&#xD;
      a group of 41 newborns with suspected clavicle fractures after complicated delivery. In all&#xD;
      cases, the collarbone fracture was easily identifiable by an ultrasound in the first few days&#xD;
      after the injury. Moreover, these data correlated with the conventional X-ray imaging.&#xD;
&#xD;
      It was also shown that the ultrasound method in pediatric patients can be used to visualize&#xD;
      fractures, e.g. of the ribs or the sternum. In the acute phase, disturbances in the cortical&#xD;
      layer of the bone as well as recent hematoma are easily observed. In the later phase, the&#xD;
      formation of a callus (callus hypertrophy) could be diagnosed.&#xD;
&#xD;
      The aim of this study is (1) to validate the ultrasound imaging method using variables such&#xD;
      as repeatability, interclass correlation coefficient (Qw), relative standard deviation (rSD)&#xD;
      etc.; (2) to use an ultrasound imaging to assess the bone fracture and healing process during&#xD;
      8 weeks post injury.&#xD;
&#xD;
      This study consists of 50 patients aged 10-18 years old. The forearm fracture will be&#xD;
      diagnosed using an X-ray imaging as well as an ultrasound imaging in the first 3 days post&#xD;
      injury (initial study). It is planned to assess the proper healing process after 2, 4, 6&#xD;
      and/or 8 weeks post injury (comparative study).&#xD;
&#xD;
      Ultrasound examination:&#xD;
&#xD;
        -  the measurement of the humerus in two different projections (a-p and lateral). The&#xD;
           distance from the acromion localized on the shoulder blade will be measured in order to&#xD;
           repeat the examination in the same area.&#xD;
&#xD;
        -  radial bone examination in two different projections (a-p and lateral). The distance&#xD;
           from the radiocarpal joint space will be measured in order to repeat the examination in&#xD;
           the same area.&#xD;
&#xD;
        -  additionally, POWER Doppler assessment of callus neovascularization will be performed&#xD;
           (each recording of the Doppler frame parameters for a given patient in order to repeat&#xD;
           the examination at subsequent controls)&#xD;
&#xD;
      Experimental Design:&#xD;
&#xD;
      The fracture diagnosis is planned to be performed on the day of the injury, or at an interval&#xD;
      of no more than 2-3 days post the injury as an initial examination and approx. during 8 weeks&#xD;
      after the injury as a comparative examination (during the first control in an orthopedic&#xD;
      clinic after 14 days, 4 weeks, 6 weeks and/or 8 weeks).&#xD;
&#xD;
      All the procedures performed in this study involving human participants will conform to the&#xD;
      ethical guidelines of the 1975 Declaration of Helsinki (and its later amendments or&#xD;
      comparable ethical standards, revised in 2013) and follow the Adapted Physical Activity (APA)&#xD;
      Ethics Standard.&#xD;
&#xD;
      The protocol was approved by the Ethics Committee of Stanislaw Popowski Regional Specialized&#xD;
      Children's Hospital in Olsztyn, Poland (number of approval: 6 ZE//2020/WSSD; date of&#xD;
      approval: 22 May 2020).&#xD;
&#xD;
      The experiment will be conducted with the understanding of each subject. All subjects as well&#xD;
      as their parents will give written informed consent before children's participation in this&#xD;
      study.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Unknown status</overall_status>
  <last_known_status>Recruiting</last_known_status>
  <start_date type="Actual">November 2, 2020</start_date>
  <completion_date type="Anticipated">July 2021</completion_date>
  <primary_completion_date type="Anticipated">February 2021</primary_completion_date>
  <study_type>Observational [Patient Registry]</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <observational_model>Case-Crossover</observational_model>
    <time_perspective>Prospective</time_perspective>
  </study_design_info>
  <target_duration>12 Months</target_duration>
  <primary_outcome>
    <measure>Mean Change from Baseline in fracture management using x-ray imaging and medical ultrasound within 8 weeks post-injury</measure>
    <time_frame>through study completion, an average of 1 year</time_frame>
    <description>The confirmation of fracture and healing process</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Mean Change from Baseline in adhesions development using medical ultrasound within 8 weeks post-injury</measure>
    <time_frame>through study completion, an average of 1 year</time_frame>
    <description>The assessment of the development of adhesions (changes in soft tissue image)</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Mean Change from Baseline in vascularization on POWER Doppler within 8 weeks post-injury</measure>
    <time_frame>through study completion, an average of 1 year</time_frame>
    <description>Mean Change from Baseline in vascularization on POWER Doppler within 8 weeks post-injury</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Mean Change from Baseline in Pain Scores on the Visual Analog Scale within 8 weeks post-injury</measure>
    <time_frame>through study completion, an average of 1 year</time_frame>
    <description>The changes in pain scale will be assessed using Visual Analogue Scale (VAS) and other specific for the selected injuries. The Visual Analogue Scale (VAS) consists of a straight line with the endpoints defining extreme limits such as 'no pain at all' and 'pain as bad as it could be' (from mild to severe pain).</description>
  </primary_outcome>
  <number_of_groups>2</number_of_groups>
  <enrollment type="Anticipated">50</enrollment>
  <condition>Fractures, Bone</condition>
  <condition>Upper Extremity Injury</condition>
  <condition>Healing Fracture of Bone</condition>
  <condition>Vascularization</condition>
  <arm_group>
    <arm_group_label>HumerusFracture</arm_group_label>
    <description>Patients with humerus fracture</description>
  </arm_group>
  <arm_group>
    <arm_group_label>RadiusFracture</arm_group_label>
    <description>Patients with radial bone fracture</description>
  </arm_group>
  <intervention>
    <intervention_type>Diagnostic Test</intervention_type>
    <intervention_name>Ultrasonographic examination validation and testing</intervention_name>
    <description>X-ray imaging as well as the ultrasonographic examination of the fracture and healing process in children will be performed. The validation of an usg will be done.</description>
    <arm_group_label>HumerusFracture</arm_group_label>
    <arm_group_label>RadiusFracture</arm_group_label>
  </intervention>
  <eligibility>
    <study_pop>
      <textblock>
        50 patients admitted to the Orhopaedics and Trauma Ward of Prof. dr Stanislaw Popowski&#xD;
        Regional Specialized Children's Hospital in Olsztyn, Poland with trauma to the upper&#xD;
        extremity (from the proximal of the wrist to distal of the glenohumeral joint with evidence&#xD;
        of pain, tenderness or swelling of the limb). Patients will be devided into two groups of&#xD;
        radius or humerus bone (RadiusFracture and HumerusFracture groups). All patients will be&#xD;
        recruited starting from July 2020. In all patients, first ultrasound and then standard&#xD;
        plain radiography will be performed.&#xD;
      </textblock>
    </study_pop>
    <sampling_method>Non-Probability Sample</sampling_method>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  the proximal end of the humerus and the distal end of the radius bones fractures&#xD;
&#xD;
          -  voluntary participation and consent to participate in the study signed by the parent&#xD;
             and patient&#xD;
&#xD;
          -  declaration of participation in an X-ray and ultrasound examination during all 8 weeks&#xD;
             post-injury&#xD;
&#xD;
          -  no medical contraindications to participate in the study program&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  previous injuries of a similar body area&#xD;
&#xD;
          -  plaster immobilization&#xD;
&#xD;
          -  fractures referred for surgery&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>10 Years</minimum_age>
    <maximum_age>18 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Anna M Kamelska-Sadowska, PhD</last_name>
    <role>Study Chair</role>
    <affiliation>Department of Rehabilitation and Orthopedics, Collegium Medicum, Faculty of Medicine, University of Warmia and Mazury in Olsztyn</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Anna M Kamelska-Sadowska, PhD</last_name>
    <phone>+48 508163209</phone>
    <email>kamelskamedical@gmail.com</email>
  </overall_contact>
  <location>
    <facility>
      <name>University of Warmia and Mazury in Olsztyn</name>
      <address>
        <city>Olsztyn</city>
        <zip>10-719</zip>
        <country>Poland</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>Anna M Kamelska-Sadowska, PhD</last_name>
      <phone>+48 508-163-209</phone>
      <email>kamelskamedical@gmail.com</email>
    </contact>
    <investigator>
      <last_name>Anna M Kamelska-Sadowska, PhD</last_name>
      <role>Principal Investigator</role>
    </investigator>
  </location>
  <location_countries>
    <country>Poland</country>
  </location_countries>
  <link>
    <url>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5105360/</url>
    <description>Erik Beek and Rick R van Rijn (eds). Diagnostic Pediatric Ultrasound</description>
  </link>
  <reference>
    <citation>Maffulli N, Hughes T, Fixsen JA. Ultrasonographic monitoring of limb lengthening. J Bone Joint Surg Br. 1992 Jan;74(1):130-2. doi: 10.1302/0301-620X.74B1.1732241.</citation>
    <PMID>1732241</PMID>
  </reference>
  <reference>
    <citation>Cho KH, Lee SM, Lee YH, Suh KJ. Ultrasound diagnosis of either an occult or missed fracture of an extremity in pediatric-aged children. Korean J Radiol. 2010 Jan-Feb;11(1):84-94. doi: 10.3348/kjr.2010.11.1.84. Epub 2009 Dec 28.</citation>
    <PMID>20046499</PMID>
  </reference>
  <reference>
    <citation>Malahias MA, Manolopoulos PP, Kadu V, Shahpari O, Fagkrezos D, Kaseta MK. Bedside Ultrasonography for Early Diagnosis of Occult Radial Head Fractures in Emergency Room: A CT-Comparative Diagnostic Study. Arch Bone Jt Surg. 2018 Nov;6(6):539-546.</citation>
    <PMID>30637310</PMID>
  </reference>
  <reference>
    <citation>Hubner U, Schlicht W, Outzen S, Barthel M, Halsband H. Ultrasound in the diagnosis of fractures in children. J Bone Joint Surg Br. 2000 Nov;82(8):1170-3. doi: 10.1302/0301-620x.82b8.10087.</citation>
    <PMID>11132281</PMID>
  </reference>
  <verification_date>November 2020</verification_date>
  <study_first_submitted>July 28, 2020</study_first_submitted>
  <study_first_submitted_qc>August 3, 2020</study_first_submitted_qc>
  <study_first_posted type="Actual">August 6, 2020</study_first_posted>
  <last_update_submitted>November 3, 2020</last_update_submitted>
  <last_update_submitted_qc>November 3, 2020</last_update_submitted_qc>
  <last_update_posted type="Actual">November 5, 2020</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>University of Warmia and Mazury</investigator_affiliation>
    <investigator_full_name>Anna Malwina Kamelska-Sadowska</investigator_full_name>
    <investigator_title>PhD</investigator_title>
  </responsible_party>
  <keyword>ultrasonography</keyword>
  <keyword>bone</keyword>
  <keyword>fracture</keyword>
  <keyword>x-ray</keyword>
  <keyword>injury</keyword>
  <keyword>upper extremity</keyword>
  <keyword>humerus</keyword>
  <keyword>radius</keyword>
  <keyword>vascularization</keyword>
  <keyword>Doppler</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Neovascularization, Pathologic</mesh_term>
    <mesh_term>Fractures, Bone</mesh_term>
    <mesh_term>Arm Injuries</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>Undecided</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT04501510
org study id: 61.610.022-110
nct id: NCT04501510
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
The bone fracture is usually diagnosed using an X-ray examination (the method of choice).
      However, in the case of the youngest patients (children and adolescents), it carries a
      potential risk of X-ray radiation exposure. What is important, an X-ray examination often
      fails to detect occult fractures or the early stages of a fracture with or without bone
      fusion. The literature emphasizes that from 2 to 36% of fractures may be unnoticed on X-ray
      images (false negative results). Therefore, additional possibilities are sought to improve
      the initial diagnosis.

      It was shown that ultrasound could be used instead of the conventional imaging. The most
      important advantages of the usg are the absence of radiation exposure and greater
      availability. Moreover, the evaluator is able to show neovascularization during usg
      examination, which is important in bone healing process.

      The aim of this study is (1) to validate the ultrasound imaging method for the fracture
      management; (2) to use an ultrasound imaging to assess the bone fracture and healing process
      during 8 weeks post injury.

      This study consists of 50 patients aged 10-18 years old. The forearm fracture will be
      diagnosed using an X-ray imaging as well as an ultrasound imaging in the first 3 days post
      injury (initial study). It is planned to assess the healing process after 2, 4, 6 and/or 8
      weeks post injury (comparative study).
The physiological fracture healing is based on the proper facilitation of regeneration and
      proliferation process. The bone fracture is usually diagnosed using an X-ray examination.
      However, an ultrasound imaging could be used instead of the conventional imaging. It is
      important in the case of the youngest patients. In these cases, the Hubner protocol/algorithm
      is often used. The patients with suspected fracture are advised to perform an ultrasound
      examination. Only after the confirmation of a suspected fracture, an X-ray examination should
      be performed.

      Bone structure show typical characteristics, which make an ultrasonography an attractive
      medical diagnostic tool. Highly dense tissues such as bone reflect echoes and, therefore,
      appear bright white on an ultrasound (reflection from the cortical surface of the bone). This
      allows bone to be clearly distinguished from the surrounding soft tissues.

      It was shown that ultrasound is a good diagnostic tool to assess the fracture healing
      process. The advantage of usg is that it is non-invasive, does not use ionizing radiation and
      is performed in a real-time.

      The first study about the ultrasound in the diagnosis of fracture was carried out in 1988 in
      a group of 41 newborns with suspected clavicle fractures after complicated delivery. In all
      cases, the collarbone fracture was easily identifiable by an ultrasound in the first few days
      after the injury. Moreover, these data correlated with the conventional X-ray imaging.

      It was also shown that the ultrasound method in pediatric patients can be used to visualize
      fractures, e.g. of the ribs or the sternum. In the acute phase, disturbances in the cortical
      layer of the bone as well as recent hematoma are easily observed. In the later phase, the
      formation of a callus (callus hypertrophy) could be diagnosed.

      The aim of this study is (1) to validate the ultrasound imaging method using variables such
      as repeatability, interclass correlation coefficient (Qw), relative standard deviation (rSD)
      etc.; (2) to use an ultrasound imaging to assess the bone fracture and healing process during
      8 weeks post injury.

      This study consists of 50 patients aged 10-18 years old. The forearm fracture will be
      diagnosed using an X-ray imaging as well as an ultrasound imaging in the first 3 days post
      injury (initial study). It is planned to assess the proper healing process after 2, 4, 6
      and/or 8 weeks post injury (comparative study).

      Ultrasound examination:

        -  the measurement of the humerus in two different projections (a-p and lateral). The
           distance from the acromion localized on the shoulder blade will be measured in order to
           repeat the examination in the same area.

        -  radial bone examination in two different projections (a-p and lateral). The distance
           from the radiocarpal joint space will be measured in order to repeat the examination in
           the same area.

        -  additionally, POWER Doppler assessment of callus neovascularization will be performed
           (each recording of the Doppler frame parameters for a given patient in order to repeat
           the examination at subsequent controls)

      Experimental Design:

      The fracture diagnosis is planned to be performed on the day of the injury, or at an interval
      of no more than 2-3 days post the injury as an initial examination and approx. during 8 weeks
      after the injury as a comparative examination (during the first control in an orthopedic
      clinic after 14 days, 4 weeks, 6 weeks and/or 8 weeks).

      All the procedures performed in this study involving human participants will conform to the
      ethical guidelines of the 1975 Declaration of Helsinki (and its later amendments or
      comparable ethical standards, revised in 2013) and follow the Adapted Physical Activity (APA)
      Ethics Standard.

      The protocol was approved by the Ethics Committee of Stanislaw Popowski Regional Specialized
      Children's Hospital in Olsztyn, Poland (number of approval: 6 ZE//2020/WSSD; date of
      approval: 22 May 2020).

      The experiment will be conducted with the understanding of each subject. All subjects as well
      as their parents will give written informed consent before children's participation in this
      study.
observational model: Case-Crossover
time perspective: Prospective
measure: Mean Change from Baseline in fracture management using x-ray imaging and medical ultrasound within 8 weeks post-injury
time frame: through study completion, an average of 1 year
description: The confirmation of fracture and healing process
measure: Mean Change from Baseline in adhesions development using medical ultrasound within 8 weeks post-injury
time frame: through study completion, an average of 1 year
description: The assessment of the development of adhesions (changes in soft tissue image)
measure: Mean Change from Baseline in vascularization on POWER Doppler within 8 weeks post-injury
time frame: through study completion, an average of 1 year
description: Mean Change from Baseline in vascularization on POWER Doppler within 8 weeks post-injury
measure: Mean Change from Baseline in Pain Scores on the Visual Analog Scale within 8 weeks post-injury
time frame: through study completion, an average of 1 year
description: The changes in pain scale will be assessed using Visual Analogue Scale (VAS) and other specific for the selected injuries. The Visual Analogue Scale (VAS) consists of a straight line with the endpoints defining extreme limits such as 'no pain at all' and 'pain as bad as it could be' (from mild to severe pain).
arm group label: HumerusFracture
description: Patients with humerus fracture
arm group label: RadiusFracture
description: Patients with radial bone fracture
intervention type: Diagnostic Test
intervention name: Ultrasonographic examination validation and testing
description: X-ray imaging as well as the ultrasonographic examination of the fracture and healing process in children will be performed. The validation of an usg will be done.
arm group label: HumerusFracture
arm group label: RadiusFracture
study pop: 
sampling method: Non-Probability Sample
criteria: 
gender: All
minimum age: 10 Years
maximum age: 18 Years
healthy volunteers: No
last name: Anna M Kamelska-Sadowska, PhD
role: Study Chair
affiliation: Department of Rehabilitation and Orthopedics, Collegium Medicum, Faculty of Medicine, University of Warmia and Mazury in Olsztyn
last name: Anna M Kamelska-Sadowska, PhD
phone: +48 508163209
email: kamelskamedical@gmail.com
facility: 
status: Recruiting
contact: 
investigator: 
country: Poland
url: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5105360/
description: Erik Beek and Rick R van Rijn (eds). Diagnostic Pediatric Ultrasound
citation: Maffulli N, Hughes T, Fixsen JA. Ultrasonographic monitoring of limb lengthening. J Bone Joint Surg Br. 1992 Jan;74(1):130-2. doi: 10.1302/0301-620X.74B1.1732241.
PMID: 1732241
citation: Cho KH, Lee SM, Lee YH, Suh KJ. Ultrasound diagnosis of either an occult or missed fracture of an extremity in pediatric-aged children. Korean J Radiol. 2010 Jan-Feb;11(1):84-94. doi: 10.3348/kjr.2010.11.1.84. Epub 2009 Dec 28.
PMID: 20046499
citation: Malahias MA, Manolopoulos PP, Kadu V, Shahpari O, Fagkrezos D, Kaseta MK. Bedside Ultrasonography for Early Diagnosis of Occult Radial Head Fractures in Emergency Room: A CT-Comparative Diagnostic Study. Arch Bone Jt Surg. 2018 Nov;6(6):539-546.
PMID: 30637310
citation: Hubner U, Schlicht W, Outzen S, Barthel M, Halsband H. Ultrasound in the diagnosis of fractures in children. J Bone Joint Surg Br. 2000 Nov;82(8):1170-3. doi: 10.1302/0301-620x.82b8.10087.
PMID: 11132281
responsible party type: Principal Investigator
investigator affiliation: University of Warmia and Mazury
investigator full name: Anna Malwina Kamelska-Sadowska
investigator title: PhD
mesh term: Neovascularization, Pathologic
mesh term: Fractures, Bone
mesh term: Arm Injuries
sharing ipd: Undecided