Clinical Research Directory

Conservative Treatment of Trigger Finger

This study is to analyze the effectiveness of a nighttime extension orthosis after receiving a cortisone injection for the treatment of trigger finger to improve pain and restore functional outcomes. The investigators hypothesize that the extension orthosis will improve pain and functional outcomes compared to those without a digital night extension orthosis in those with trigger finger at 12 weeks from the injection.

Ultrasonographic Analysis of Post-Traumatic Shoulder Lesions After Hand Trauma

The purpose of the study is to reveal whether there are concurrent shoulder lesions in patients with hand injuries. Its importance is that it will shed light on whether not only the hand but also the shoulder should be included in the treatment program in hand rehabilitation.

Health Literacy Level and Functional Outcomes in Patients With Hand and Forearm Injuries

The aim of this study is to examine the association between health literacy, patient-reported outcome measures, and grip strength in a cohort of patients with hand injuries.

Perceived Ability and Hand Function

Patient-reported outcome measures, which are subjective by nature, need to be correlated with clinician-administered professional measurements as a further step toward expanding their clinical utility. Therefore, this study aimed to investigate the relationship between perceived manual dexterity and functional measurements in patients with hand-forearm injuries.

The Cognitive-Functional Relationship in Geriatric Hand-Forearm Injuries

Considering the complex structure of hand-forearm injuries and the long rehabilitation process, it is important to investigate factors associated with recovery in geriatric individuals. Therefore, this study aimed to examine the relationship between cognitive status and functional outcomes in geriatric individuals with hand-forearm injuries.

Turkish Adaptation and Validation of the Burnt Hand Outcome Tool (BHOT)

The goal of this observational study is to evaluate the validity and reliability of the Turkish adaptation of the Burnt Hand Outcome Tool (BHOT) in adults with a history of hand burns. The participant population will include adults aged 18 years and older who have experienced unilateral or bilateral hand burns and can read and understand Turkish.The main questions this study aims to answer are: Does the Turkish version of the BHOT demonstrate high internal consistency, test-retest reliability, and construct validity? How strongly are BHOT scores associated with objective hand function measures such as grip strength and sensory evaluation? Participants will not be assigned to comparison groups, as this is a methodological validation study. Participants will: Complete a sociodemographic information form. Complete the Turkish version of the BHOT and the QuickDASH questionnaire. Undergo objective assessments including hand grip strength using a dynamometer and sensory evaluation using Semmes-Weinstein monofilaments. Participate in repeated assessments at baseline, 1 month, 3 months and 6 months for reliability analyses.

Craniomaxillofacial and Upper Extremity Allotransplantation

The purpose of this study is to evaluate functional and aesthetic outcomes of combined facial and upper extremity composite tissue allografts on patients who have not achieved functional and aesthetic outcomes with conventional reconstructive surgical strategies and prosthetic devices.

CAT BITE Antibiotic Prophylaxis for the Hand/Forearm (CATBITE)

Cat bites are puncture wounds that have the potential to seed bacteria deep within the joint capsule, periosteum, and bone. The hand is the most common site of bite injuries. Pasteurella multocida is the is the most common organism isolated from the mouths of cats that can cause infections after a bite. Prophylactic antibiotics are often recommended with amoxicillin-clavulanate for 3-5 days to decrease the incidence of developing an infection. However, only one randomized controlled clinical trial consisting of 12 patients has been performed to justify this course of treatment, raising the possibility that the use of antibiotics could be reduced or even eliminated. Investigators will compare different durations of prophylactic antibiotics and a placebo control for cat bites to the hand/forearm presenting to the Emergency Department, Urgent Care, Plastic Surgery Clinic using a randomized, controlled, double-blind clinical trial. Participants presenting to the University of Missouri Hospital Emergency Department, Missouri University (MU) Healthcare Urgent Care, Plastic Surgery Clinic over the next year will be offered the chance to enroll if they meet the inclusion/exclusion criteria. For inclusion, participants will be \>18 years of age, have cat bites to the hand or distal to elbow, and present within 24 hours of the cat bite injury. Participants must not present with active local or systemic infections, have received antibiotics within the past 30 days, or be immunocompromised (primary and secondary immunodeficiencies). Participants will be randomized to one of three treatment arms (placebo; amoxicillin-clavulanate 1 day; amoxicillin-clavulanate 5 days). Outcomes are the development of an infection at the location of the cat bite and/or systemic infection, adverse effects of interventions, disability assessed by Quick Disabilities of Arm, Shoulder and Hand (QuickDASH) scores, and quality of life (QOL) assessed by HAND Questionnaire (HAND-Q) scores. Infection will be assessed at day 0, day 2, day 7+/-2, day 14+/-2, and day 30+/-2 by vital signs, laboratory values, physical examination and with an infrared and digital camera. All measures will be within the standard of care, apart from the infrared camera, QuickDASH, and HAND-Q scores. The anatomic locations of cat bites to the hand/forearm will be assessed for correlations with infections.

Occupational Therapy-led Services for Adults Presenting Acutely With a Hand Condition

Traumatic hand injuries account for up to one third of acute hospital presentations. Current guidelines and standards of care recommend patients with hand trauma are seen by hand therapists, typically occupational therapists. The proposed study aims to explore the effectiveness of occupational therapy-led hand therapy services for the adult population presenting acutely to an injury unit or emergency department setting with a hand condition. The research project will consist of an analytical study, involving four different sites in Ireland to enrich findings, and to aid future service development. One site will be the comparison site, as it does not have access to occupational therapy, and will offer patients 'care as usual' upon attendance. Outcome measures will be used for all participants and will be completed at initial patient contact, at week eight and at six months. It is hoped the current proposed study will help shape future service development for those with hand injury including provision of evidence based occupational therapy assessment and intervention.

The Swedish Hockey League Hand and Wrist Injury Tracking Trial

This study, titled Hand and Wrist Injuries in Professional Hockey Players in Sweden: A Nationwide Observational Cohort Study from the Swedish Hockey League (SHL-HITT), aims to deliver a comprehensive national overview of hand and wrist injuries among professional hockey players. These injuries are relatively common-accounting for approximately 16% of all hockey-related injuries-and can range from minor issues to severe conditions that jeopardize player performance and careers due to prolonged absences or lasting impairment. Despite their significance, there is limited detailed knowledge regarding the specific patterns, mechanisms, and consequences of hand and wrist injuries at the elite level. Utilizing data from a nationwide injury registry, this observational cohort study will cover three full SHL seasons: 2022/23, 2023/24, and 2024/25. The dataset is expected to include approximately 2,300 games, encompassing both regular season and playoff matches. The study will examine injury characteristics such as type (e.g., fractures, soft tissue damage), player position, in-game timing, and additional contextual factors. Statistical analyses will be conducted to identify trends, correlations, and potential risk profiles among different player groups or positions. The findings are expected to support the development of enhanced protective equipment and targeted prevention strategies, ultimately contributing to reduced injury incidence and improved athlete health and career sustainability. The study timeline includes preparation in late 2024, with data collection already ongoing and ethical approval obtained. The analysis will begin following the publication of the study protocol, and we aim for final publication of results in the second half of 2025.

Effect of Instrument Assisted Soft Tissue Mobilization on Hand Post Surgical Scars in Primary Flexor Tendons Repair in Zone v

this study will be conducted to investigate the effect of instrument assisted soft tissue mobilization on hand post surgical scars in primary flexor tendons repair in zone v

Percutaneous Pinning vs Orthosis and Early Mobilization

This study aims at investigating if splinting and early mobilization is a better method, regarding range of motion, for treating fractures of the base phalanx of the fingers compared to surgery with pinning. This will be achieved through a randomised clinical trial comparing the two methods.

Human Upper Extremity Allotransplantation: F/U Protocol

Upper extremity allotransplantation is a new procedure which is becoming more common in the United States. Ongoing data collection for research purposes is vital to the long-term assessment as to the safety of the procedure and accompanying immunosuppression protocol, as well as quantifying patient outcomes and changes in quality of life. For these reasons, The Johns Hopkins Hand/Arm Transplantation Team is interested in enrolling transplanted patients in a follow-up protocol to continue collecting informative data to further the field of vascularized composite allotransplantation.

Human Upper Extremity Allotransplantation

Background: Millions of people each year sustain injuries, have tumors surgically removed, or are born with defects that require complex reconstructive surgeries to repair. In the case of hand, forearm, or arm amputation, prostheses only provide less than optimal motor function and no sensory feedback. However, hand and arm transplantation is a means to restore the appearance, anatomy, and function of a native hand. Although over 70 hand transplants have been performed to date and good functional results have been achieved, widespread clinical use has been limited due to adverse effects of life-long and high-dose immunosuppression needed to prevent graft rejection. Risks include infection, cancer, and metabolic problems, all of which can greatly affect recipients' quality of life, make the procedure riskier, and jeopardize the potential benefits of hand transplantation. Study Design: This non-randomized, Phase II clinical trial will document the use of a new immunomodulatory protocol (aka - Pittsburgh Protocol, Starzl Protocol) for establishing hand transplantation as a safe and effective reconstructive treatment for upper extremity amputations by minimizing maintenance immunosuppression therapy in unilateral and bilateral hand/forearm transplant patients. This protocol combines lymphocyte depletion with donor bone marrow cell infusion and has enabled graft survival using low doses of a single immunosuppressive drug followed by weaning of treatment. Initially designed for living-related solid organ donation, this regimen has been adapted for use with grafts donated by deceased donors. The investigators propose to perform 30 human hand transplants employing this novel protocol. Specific Aims: 1) To establish hand transplantation as a safe and effective reconstructive strategy for the treatment of upper extremity amputations; 2) To reduce the risk of rejection and enable allograft survival while minimizing the requirement for long-term high dose multi-drug immunosuppression. Significance of Research: Hand transplantation could help upper extremity amputees recover functionality, self-esteem, and the capability to reintegrate into family and social life as "whole" individuals. The protocol offers the potential for minimizing the morbidity of maintenance immunosuppression, thereby beneficially shifting the risk/benefit ratio of this life-enhancing procedure and enabling widespread clinical application of hand transplantation.

3D Personalized Modelization of the Hand Using EOS Imaging System

This study aims to compare the quality of 3D hand modelization with EOS imaging with gold-standard computed tomography

Clinical Utility of ESWT in Restoring Hand Function of Patients With Nerve Injury and Hypertrophic Scars Due to Burns

Joint contractures and nerve injuries are common after hand burns. Extracorporeal shock wave therapy (ESWT) is effective not only for the regeneration of various tissues, including scar tissues, but also for reducing pain and pruritus in patients with burns. Researchers have attempted to explore the effects of ESWT on hand dysfunction caused by nerve injury following burns. The investigators planned to evaluate the effects of ESWT (compared to sham stimulation) on hands with nerve injury and hypertrophic scars and thereby on hand function. The ESWT parameters were as follows: energy flux density, 0.05-0.30 mJ/mm2; frequency, 4 Hz; 1000 to 2000 impulses per treatment; and 12 treatments, one/week for 12 weeks. Outcome measures were as follows: 10-point visual analog scale for pain, Jebsen-Taylor hand function test, grip strength, Purdue Pegboard test, ultrasound measurement of scar thickness, and skin characteristics before and immediately after 12 weeks of treatment.

Use of a Compression Device for Ring Removal: A Prospective Trial

The usual treatment for stuck rings includes a variety of techniques including use of ice to reduce swelling, use of lubricants, and sometimes the use of string or ring cutters. The success rate of these techniques is variable and cutting the ring is usually reserved as a last resort. Sometimes removal of a ring can take time, and can cause some small injury to the patient. Because of this, it is important to consider other methods for ring removal. This study is looking at using a device that uses compression to reduce swelling of the finger causing the ring to be stuck. This device has been approved for use in Canada. The purpose of this study is to evaluate how effective a compression device is at removing stuck rings. The study question is: how effective is a compression device at removing stuck rings? A Compression Device (CD) is a device that uses circumferential compression to reduce swelling around a stuck ring. The device is used by placing it near, but not over-top, the offending ring, and then is inflated compressing the finger. The device is applied, and the hand elevated, for approximately five minutes. The device is then removed, and with a small amount of lubricant, the ring is removed. All patients requiring ring removal at the QEII emergency department, if a compression device can be used safely, will be asked if they would like to be included in the study and have their ring removal attempted by a compression device. Following removal attempt, the clinician will document information about the ring removal. This will include some questions regarding the patient's experience with the removal. No identifying information or personal health information will be recorded. The investigators plan to collect information about use of the compression device for a period of one year. Following this time, the data will be analyzed to determine how effective the compression device is at removing rings including statements regarding patient experience. This information will be documented in a manuscript intended for publication and may be presented at academic conferences or other continuing education events. The investigators will be measuring the success rate of ring removal with the compression device. In addition, the investigators will record information on any side effects of use of the compression device, as well as patient experience including pain and satisfaction.