Corticosteroid Injection With and Without Local Anesthetic for the Treatment of Trigger Finger: A Randomized Clinical Trial.

Purpose: This study aimed to report pain during and following injection for trigger finger as well as failure to resolve triggering. We hypothesized that a corticosteroid injection alone would be equally or less painful compared with the standard combination of corticosteroid and lidocaine for the treatment of trigger fingers, and there would be no difference in the resolution of triggering.

Methods: Our study was a prospective, single-blinded, randomized controlled trial at a single institution, comprising 76 patients with a diagnosis of trigger finger.

Final 1-Year Results of the TUTOR Randomized Trial Comparing Carpal Tunnel Release with Ultrasound Guidance to Mini-open Technique.

Background: Studies comparing carpal tunnel release with ultrasound guidance (CTR-US) to mini-open CTR (mOCTR) are limited. This randomized trial compared the efficacy and safety of these techniques.

Methods: In this multicenter randomized trial, patients were randomized (2:1) to unilateral CTR-US or mOCTR.

Perceptual representations mediate effects of stimulus properties on liking for music.

Perceptual pleasure and its concomitant hedonic value play an essential role in everyday life, motivating behavior and thus influencing how individuals choose to spend their time and resources. However, how pleasure arises from perception of sensory information remains relatively poorly understood. In particular, research has neglected the question of how perceptual representations mediate the relationships between stimulus properties and liking (e.

Probabilistic modelling of microtiming perception.

Music performances are rich in systematic temporal irregularities called "microtiming", too fine-grained to be notated in a musical score but important for musical expression and communication. Several studies have examined listeners' preference for rhythms varying in microtiming, but few have addressed precisely how microtiming is perceived, especially in terms of cognitive mechanisms, making the empirical evidence difficult to interpret. Here we provide evidence that microtiming perception can be simulated as a process of probabilistic prediction.

Occult Amyloid Deposition in Older Patients Presenting With Bilateral Carpal Tunnel Syndrome or Multiple Trigger Digits.

Purpose: The diagnosis of amyloidosis is important for early intervention, disease monitoring, and prevention of complications and progression. Carpal tunnel syndrome (CTS) and trigger digit (TD) are two common conditions associated with early disease. The purpose of this study was to define disease prevalence among patients with bilateral CTS and multiple TDs and assess for an increased rate of diagnosis in the presence of both.

Multicenter randomized trial of carpal tunnel release with ultrasound guidance versus mini-open technique.

Background: Comparative studies of carpal tunnel release with ultrasound guidance (CTR-US) vs. mini-open CTR (mOCTR) are limited, prompting development of this randomized trial to compare efficacy and safety of these techniques.

Research Design And Methods: Patients were randomized (2:1) to CTR-US or mOCTR, treated by experienced hand surgeons (median previous cases: 12 CTR-US; 1000 mOCTR), and followed for 3 months.

Trial of ultrasound guided carpal tunnel release versus traditional open release (TUTOR).

Background: Carpal tunnel release (CTR) is a surgical treatment option for patients with carpal tunnel syndrome (CTS) symptoms that are unresponsive to conservative treatment. Most patients experience symptomatic relief after CTR regardless of the surgical technique. However, direct comparisons of the safety and effectiveness between CTR surgical techniques are limited.

Modeling enculturated bias in entrainment to rhythmic patterns.

Long-term and culture-specific experience of music shapes rhythm perception, leading to enculturated expectations that make certain rhythms easier to track and more conducive to synchronized movement. However, the influence of enculturated bias on the moment-to-moment dynamics of rhythm tracking is not well understood. Recent modeling work has formulated entrainment to rhythms as a formal inference problem, where phase is continuously estimated based on precise event times and their correspondence to timing expectations: PIPPET (Phase Inference from Point Process Event Timing).

Does Use of a Night Extension Orthosis Improve Outcomes in Patients With Dupuytren Contracture Treated With Injectable Collagenase?

Purpose: Current prescribing information for the treatment of patients with Dupuytren contracture with injectable collagenase (CCH) recommends use of a night extension orthosis for 4 months after treatment. The present study examines whether this treatment improves the outcomes.

Methods: Adult patients with Dupuytren contracture treated with CCH during the study period were eligible for inclusion.

Efficacy of a single, image-guided corticosteroid injection for glenohumeral arthritis.

Background: Limited data are available on the efficacy of cortisone injections for glenohumeral osteoarthritis (GHOA). The amount and longevity of pain relief provided by a single cortisone injection are unclear. Additionally, it remains uncertain how the severity of radiographic GHOA and patient-reported function and pain levels impact the efficacy of an injection.

Enigmatic and Unusual Cases of Upper Extremity Pain: Mislabeling As Malingerers.

With the intricate anatomy of the hand and upper extremity, there are many possible etiologies of pain. In addition, one must be alert to conditions typically affecting other areas of the body presenting in the hand and upper extremity. To add to the complexity of diagnosis, one must also be aware of potential secondary gains.

Radiation Exposure Safety Patterns with the Use of Intraoperative Fluoroscopy.

Purpose: To examine current practice patterns in occupational radiation safety by members of the American Society for Surgery of the Hand (ASSH) and to assess if these vary by surgeon demographics and experience.

Methods: An online survey was sent to members of the ASSH and included 18 questions on fluoroscopy practice patterns as well as demographic information, including gender, years of experience, specialty, and geographic region. Multivariate logistic and multinomial regressions were used to determine predictors for fluoroscopy practice patterns while adjusting for these demographic factors.

Early Practice Patterns of Hand Surgeons: An American Board of Orthopaedic Surgery Database Study.

Purpose: To investigate the variety of cases that are performed by newly graduated fellowship-trained orthopedic hand surgeons.

Methods: All cases submitted by board-eligible orthopedic surgeons taking part II of their board examination between 2004 and 2013 were obtained from the database of the American Board of Orthopaedic Surgery (ABOS). Each case was then categorized based on the fellowship training of the treating surgeon and whether it was a hand surgery case.

Intrarater and Interrater Reliability of the Soong Classification for Distal Radius Volar Locking Plate Placement.

The purpose of this study was to analyze the intrarater and interrater reliability of the Soong classification for volar locking plate placement on a randomly selected, consecutive series of radiographs. Our hypothesis was that the classification would be reliable. Six physicians of differing levels of training (orthopedic surgery intern to fellowship-trained upper extremity staff) were asked to review 40 radiographs in a random order on 2 separate occasions, 4 weeks apart.

Treatment of Recurrent Dupuytren Contracture in Joints Previously Effectively Treated With Collagenase Clostridium histolyticum.

Purpose: Collagenase Clostridium histolyticum (CCH) is approved for the treatment of adults with Dupuytren contracture with a palpable cord. This open-label, phase 4 study evaluated the safety and efficacy of CCH for the retreatment of recurrent contractures in joints that were previously effectively treated with CCH.

Methods: Patients participating in a long-term follow-up study who had contracture recurrence (increased ≥ 20° with a palpable cord) after successful treatment in the previous study were eligible.

Embedded Librarian as Research Team Member.

Adding a librarian to an upper extremity surgical and therapy practice has many advantages (educational, research, remaining on the cutting edge of technology). As an embedded team member, the librarian at the Indiana Hand to Shoulder Center prepares literature reviews, creates Google Scholar Alerts for individual clinicians, and introduces developing technologies such as 3-dimensional printers, Smartphone Apps, and online access to nontraditional resources. With the librarian relieving clinicians of these responsibilities, surgeons can devote more time to clinical and research activities.

Leveraging FPGAs for Accelerating Short Read Alignment.

One of the key challenges facing genomics today is how to efficiently analyze the massive amounts of data produced by next-generation sequencing platforms. With general-purpose computing systems struggling to address this challenge, specialized processors such as the Field-Programmable Gate Array (FPGA) are receiving growing interest. The means by which to leverage this technology for accelerating genomic data analysis is however largely unexplored.

Delayed manipulation after collagenase clostridium histolyticum injection for Dupuytren contracture.

Background: Collagenase clostridium histolyticum (CCH) injection for Dupuytren contracture was approved in the USA in 2010. Current FDA guidelines stipulate that finger manipulation occurs the day following injection. To investigate the safety and efficacy of delaying manipulation to 2 or 4 days following CCH injection, we conducted a prospective, randomized trial at two sites.

Dupuytren Contracture Recurrence Following Treatment With Collagenase Clostridium histolyticum (CORDLESS [Collagenase Option for Reduction of Dupuytren Long-Term Evaluation of Safety Study]): 5-Year Data.

Purpose: Collagenase Option for Reduction of Dupuytren Long-Term Evaluation of Safety Study was a 5-year noninterventional follow-up study to determine long-term efficacy and safety of collagenase clostridium histolyticum (CCH) treatment for Dupuytren contracture.

Methods: Patients from previous CCH clinical studies were eligible. Enrolled patients were evaluated annually for contracture and safety at 2, 3, 4, and 5 years after their first injection (0.

Agricultural injuries to the hand and upper extremity.

Agricultural injuries involving the hand and upper extremity are common, debilitating injuries that reflect the significant occupational hazards associated with the agricultural industry. Farm injuries occur in all age groups and are associated with significant resource utilization and treatment costs. Most of these injuries are associated with machinery, including tractors, power take-off devices, grain augers, hay balers, and combine harvesters.

Efficacy and safety of concurrent collagenase clostridium histolyticum injections for multiple Dupuytren contractures.

Purpose: To assess the safety and efficacy of 2 concurrent injections of collagenase clostridium histolyticum (CCH) in the same hand to treat multiple Dupuytren flexion contractures.

Methods: In a multicenter, open-label phase IIIb study, 60 patients received two 0.58-mg CCH doses injected into cords affecting 2 joints in the same hand during 1 visit, followed by finger extension approximately 24 hours later.

Scapula fractures: interobserver reliability of classification and treatment.

Objectives: There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment.

Dupuytren contracture recurrence following treatment with collagenase clostridium histolyticum (CORDLESS study): 3-year data.

Purpose: To evaluate long-term efficacy and safety of collagenase clostridium histolyticum (CCH) after the third year of a 5-year nontreatment follow-up study, Collagenase Option for Reduction of Dupuytren Long-Term Evaluation of Safety Study.

Methods: This study enrolled Dupuytren contracture patients from 5 previous clinical studies. Beginning 2 years after their first CCH injection, we re-evaluated patients annually for joint contracture and safety.