The CARBO CARBON Study: a Prospective Observational Comparative Cohort Study on CO2 Emissions From Metacarpal Shaft Fracture Treatment
Karolinska Institutet
30 participants
Mar 23, 2026
INTERVENTIONAL
Conditions
Summary
This study examines the environmental impact of two common treatments for hand fractures (metacarpal shaft fractures): surgery and non-surgical care. Healthcare contributes significantly to climate change, and orthopedic surgery in particular can generate substantial greenhouse gas emissions. Although surgery is frequently used for these fractures, it is not always clearly more effective than non-surgical treatment, and the difference in environmental impact between these options is not well understood. In this study, researchers will measure and compare the carbon footprint of each treatment pathway, from injury through one year of follow-up. This includes emissions related to medical equipment, energy use, medications, and waste. The goal is to calculate the difference in environmental impact between treatments and to highlight key sources of emissions. The findings may help guide more sustainable healthcare practices without compromising patient care.
Eligibility
Inclusion Criteria8
- Age ≥18 years.
- Access to a valid e-mail.
- Injury within 10 days prior to inclusion.
- Normal bilateral hand function prior to injury.
- Ability and willingness to provide written informed consent
- Single, displaced spiral or oblique diaphyseal fracture of the second to fifth metacarpals with definition of diaphysis as described by AO 2018 (AO/OTA as 77.2-5.2A) (Meinberg et al., 2018).
- Fracture line length at least twice the diameter of the bone at the level of the fracture.
- Fractures with at least 2 mm of radiological displacement and/or malrotation of injured finger compared to uninjured side regardless of fracture displacement.
Exclusion Criteria3
- The patient is not expected to have difficulty adhering to the study protocol (e.g., due to insufficient language proficiency, dementia, substance abuse, or other reasons).
- The patient does not have an open fracture (Gustilo-Anderson grade > I) or a pathological fracture.
- The patient does not have an ipsilateral fracture of the upper extremity, polytrauma, or generalized joint dysfunction (e.g., rheumatoid arthritis).
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Interventions
Non-operative treatment through immediate unrestricted mobilization with optional buddy taping or removable splinting for comfort.
Open reduction and internal fixation with plate and screws or screws only, followed by postoperative imobilisation and rehabilitation.
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT07521943