The CARBO CARBON Study
Trial statusRecruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18+
SponsorKarolinska Institutet
About this trial
This study examines the environmental impact of two common treatment pathways for hand fractures (metacarpal shaft fractures): surgical and non-surgical management. Healthcare contributes significantly to climate change, and orthopedic surgery in particular generates substantial greenhouse gas emissions. Although surgical treatment is frequently favored for these fractures, it is not always superior to 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 environmental impact of each treatment pathway, from inclusion to twelve months follow-up. This includes environmental impact related to single-use material, medical equipment, energy use, medications, and waste. A Life Cycle Assessment (LCA) will be performed and a mean difference in environmental impact between treatments pathways will be calculates. A Hotspot analysis will also be performed to highlight key sources of environmental impacts. The findings may help guide more sustainable healthcare practices without compromising patient care.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
None
Disqualifiers
None
Trial population
The observational cohorts will include all patients enrolled in the CARBO trial, where participants are randomized to either surgical or non-surgical management. The intervention cohort will consist of patients allocated to non-surgical management, whereas the control cohort will comprise patients allocated to surgical management.
Trial design
Design model
Cohort
Time perspective
Prospective
Treatments tested in this trial
Non-operative treatment
Procedure/SurgeryNon-operative treatment through immediate unrestricted mobilization with optional buddy taping or removable splinting for comfort.
Surgical fixation
Procedure/SurgeryOpen reduction and internal fixation with plate and screws or screws only, followed by postoperative imobilisation and rehabilitation.
Treatment groups
30 Participants
are divided into 2 treatment groupsGroup A: Non operative treatment, early mobilisation1 intervention
Group B: Operative treatment, open reduction and surgical fixation1 intervention
Trial outcomes
Primary outcomes
1
Global warming potential
The primary outccome is global warming potential expressed as the mean carbon dioxide equivalent (CO₂e) emissions between the treatment pathways early rehabilitation without surgery and surgical treatment followed by rehabilitation of metacarpal shaft fractures. Our functional unit is defined as the full treatment pathway from inclusion in the study to 12 months post-treatment
Time frame
12 monthsSecondary outcomes
1
Ambient air pollution
The mean emission of ambient air pollution expressed as fine particle matter formation (PM2.5) for the two treatment pathways.
Time frame
12 months2
Water comsumption
The mean water comsumption in cubic meters for the two treatment pathways.
Time frame
12 months3
Waste
Include the total weight of combustible waste generated at each healthcare visit, measured in kilograms using a calibrated hanging scale
Time frame
12 months4
Direct costs
Difference in direct costs within our study boundary between the treatment methods.
Time frame
12 monthsOther outcomes
1
Emission hotspots
Identification of major emission hotspots (e.g., operating room energy use, single-use materials, pharmaceuticals, transport).
Time frame
12 months2
Environmental impact categories
All other environmental impact categories covered by the selected LCIA method
Time frame
12 monthsSponsors and contacts
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Source ClinicalTrials.gov