The COMET Study

The COMET Study is trying to improve the treatment of children who have a broken bone in the elbow called an ‘medial epicondyle fracture’

The COMET study is trying to find out the best way to treat a broken bone in the elbow of children and young people.

In North America, doctors care for this condition with one of two common treatments.

Some recommend wearing a cast.

Some recommend an operation before wearing a cast to put the bone back in its original place.

Having an operation may help the bone heal in its original position, but has some risks that can cause problems.

Using a cast or splint to let the bone heal avoids an operation, but there may be problems with the healing which can cause pain or problems in the future.

At major medical centers across North America, both treatments have been found to have good results, and surgeons like yours are not sure which treatment heals the injury best.

We want to find out if one treatment is better than the other at helping your bone heal.

In the COMET study half the children and young people will have their broken bone treated with a cast or splint only.

And half will have the operation before getting a cast.

You won’t be able to choose which treatment you have and neither can your doctors. This is called randomization.

When randomization is done we will have two groups of children who are as similar as possible, and we can compare them fairly.

If you join the COMET study, we will ask some questions about using your arm, any pain you feel, and if you have missed any school.

We will send these questions by text or by email, or can call your phone.

We will ask you the questions 4 times in the first year and we will contact you once a year for three years after your injury.

The doctors, nurses, and research team are happy to answer any questions that you may have about joining the COMET study.

COMET Participant Information Animation

This study will compare treating a broken elbow by:

Surgery to fix the bone usually with a screw and placing the arm in a cast or splint. This procedure is called an open reduction and internal fixation
Placing the arm in a cast to allow the bone to heal on its own

Please watch our animation to find out more about the COMET study.

Background

Fractures of the medial epicondyle are a common pediatric injury, with an estimated annual incidence of 40-60/100,000 per year.

Some doctors advise to rest the elbow in a cast or splint and allow it to heal by itself, whilst others advise surgery to fix the bone. Despite the number of these injuries, doctors are not sure whether one way of treating them is better than the other because it has never been researched.