{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:24:14Z","timestamp":1792819454755,"version":"4.5.0"},"reference-count":25,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"unspecified","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"AO Foundation via the AO Innovation Translation Center"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,7,10]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>An objective way to monitor bone healing in real time could provide major benefits for the rehabilitation of fracture patients. The fracture monitor T1 is a novel biofeedback sensor system designed to provide continuous data of the relative implant load, that is, a measure inversely correlated to bone healing progression as well as patient\u2019s physical activities. The primary objective of this first-in-human study is to evaluate the safety, that is, the incidence of adverse device effects (ADEs), of the investigational device fracture monitor T1 in femoral fracture patients within the first 6-months postsurgery. Secondary objectives are to collect information on clinical performance, other safety parameters and device handling and usability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>37 adult patients with femoral fractures to be treated with a plate, which is compatible with having the fracture monitor T1 mounted on it, will be prospectively enrolled in this multicentre, interventional first-in-human study. The fracture monitor T1 will be implanted together with the osteosynthesis plate for femoral fracture fixation as well as femoral instabilities, such as post-traumatic non-unions. Standard of care will be followed for femoral fracture treatment and patients will be followed up for 6-months. Demographic data, comorbidities, prior medication, prior treatment details, injury details, treatment details and outcome measures will be documented in a cloud-based database. The primary outcome measure is ADEs. Secondary outcome measures include clinical and functional outcomes, safety outcomes, device removal, patient-reported outcomes (pain, Numeric Rating Scale, EQ-5D-5L), device handling and usability, number of visits and radiographic assessments, radiographic outcomes, relative implant load and technical performance parameters. A statistical analysis plan will be prepared before final analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethics approval is obtained at each site before patient enrolment, which follows an informed consent process approved by the responsible ethics committee. Data from this first-in-human study will be compiled into a clinical evaluation report for the application of CE (Conformit\u00e9 Europ\u00e9enne, certification mark indicating conformity with European Union health, safety and environmental protection standards) marking of the device. The results of this first-in-human study will be published in a peer-reviewed journal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" specific-use=\"clinicaltrial \" xlink:href=\"NCT05410587\">NCT05410587<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-102749","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T03:56:38Z","timestamp":1754884598000},"page":"e102749","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Prospective first-in-human clinical investigation to evaluate the safety of the fracture monitor T1 in patients with femur fractures treated with a locking compression plate: a study protocol"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct05410587","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7575-0568","authenticated-orcid":false,"given":"Benedikt J","family":"Braun","sequence":"first","affiliation":[{"name":"Klinik f\u00fcr Unfall- und Wiederherstellungschirurgie an der Eberhard Karls Universit\u00e4t T\u00fcbingen, BG Klinik T\u00fcbingen, T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J","family":"Raschke","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Unfall-, Hand- und Wiederherstellungschirurgie, Universit\u00e4tsklinikum M\u00fcnster, M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konrad","family":"Sch\u00fctze","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Unfallchirurgie, Hand- und Wiederherstellungschirurgie, Universit\u00e4tsklinikum Ulm, Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Pohlemann","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Unfall-, Hand- und Wiederherstellungschirurgie, Universit\u00e4tsklinikum des Saarlandes, Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7748-7115","authenticated-orcid":false,"given":"Alexander","family":"Joeris","sequence":"additional","affiliation":[{"name":"AO Innovation Translation Center, AO Foundation, Davos, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Ernst","sequence":"additional","affiliation":[{"name":"ARI Biomedical Development, AO Research Institute Davos, Davos, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"key":"2025102205000563000_15.7.e102749.1","doi-asserted-by":"crossref","first-page":"1823","DOI":"10.3928\/0147-7447-19841201-08","article-title":"Twenty years experience in fracture healing measurement with strain gauges","volume":"7","author":"Burny","year":"1984","journal-title":"Orthopedics"},{"key":"2025102205000563000_15.7.e102749.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-002-0306-x"},{"key":"2025102205000563000_15.7.e102749.3","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1302\/0301-620X.76B3.8175839","article-title":"Measuring stiffness can define healing of tibial fractures","volume":"76","author":"Richardson","year":"1994","journal-title":"J Bone Joint Surg Br"},{"key":"2025102205000563000_15.7.e102749.4","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/0268-0033(92)90018-Y","article-title":"Fracture stiffness measurement in the assessment and management of tibial fractures","volume":"7","author":"Richardson","year":"1992","journal-title":"Clin Biomech (Bristol)"},{"key":"2025102205000563000_15.7.e102749.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2003.12.025"},{"key":"2025102205000563000_15.7.e102749.6","doi-asserted-by":"crossref","first-page":"S101","DOI":"10.1016\/j.injury.2020.09.026","article-title":"Smart implants in fracture care - only buzzword or real opportunity?","volume":"52 Suppl 2","author":"Ernst","year":"2021","journal-title":"Injury"},{"key":"2025102205000563000_15.7.e102749.7","doi-asserted-by":"crossref","unstructured":"Windolf M , Ernst M , Schwyn R , et al . 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