Clinical trial NCT06838247: Ultrasonographic Analysis of Post-Traumatic Shoulder Lesions After Hand Trauma
Official title: Detection of Simultaneous Presence of Shoulder Lesions in Patients with Hand Injuries by Diagnostic Ultrasonography
Study type: OBSERVATIONAL
Overall status: ENROLLING_BY_INVITATION
Conditions: Shoulder
Ultrasonographic
Hand Injuries
Keywords: Hand injuries
Shoulder
Diagnostic
Ultrasonography
Lead sponsor: Ankara Training and Research Hospital
Sponsor class: OTHER
First posted: 2025-02-20
Enrollment: 60
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_CONTROL
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Patients who apply to our hand rehabilitation clinic for rehabilitation after hand injury will undergo a routine shoulder examination as well as a hand examination. The group with shoulder symptoms and examination findings will constitute the case group, and the group with a normal shoulder examination will constitute the control group. Age, gender, height, weight, occupation, dominant hand, type of injury, type of injury, duration of injury, operation time, and immobilization time will be recorded for both groups.

Brief summary: 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.

Detailed description: Hand injuries constitute one fifth of the injuries that are brought to the emergency room and one third of the work accidents. They are very costly because they require surgical intervention and a long rehabilitation process and delay the patient's return to work. The general tendency in hand rehabilitation is to focus more on treatments focused on the hand and wrist.

There are studies that draw attention to the relationship between hand grip strength and rotator cuff function and that other upper extremity musculoskeletal injuries are often neglected in patients with hand injuries. This may affect rehabilitation results and prevent the patient from returning to daily activities.

It is reported that in patients with hand and wrist injuries, other upper extremity musculoskeletal problems are seen simultaneously in 40% of cases and most of these are related to the shoulder.

It is reported that rotator cuff problems and lateral epicondylitis are 9 times more common even in carpal tunnel syndrome, which is a relatively simple hand problem that is encountered very frequently in clinical practice.

Traumatic hand injuries can also affect all upper extremity functions. In these patients, it was determined that there was weakness in both the ipsilateral supraspinatus and infraspinatus muscles. The researchers emphasized that the inclusion of shoulder muscle training during the postoperative rehabilitation protocol and selective strengthening of the rotator cuff muscles in distal extremity problems may be clinically important.

In studies conducted to detect shoulder problems in patients with hand injuries, either patient examination or self-reports of the patients have been used so far.

In this study, the investigators aimed to concretely reveal shoulder pathologies by evaluating the results of diagnostic ultrasonography performed on our patients with shoulder symptoms. In this way, the investigators aimed to obtain a clearer result on whether the shoulder should be included in the hand rehabilitation program.

Our study is the first study to evaluate shoulder pathologies in patients with hand injuries with diagnostic ultrasonography.

Eligibility criteria: Inclusion Criteria:

* Having a history of hand injury and applying for hand rehabilitation after surgical and conservative treatment.

Exclusion Criteria:

* Being under 18 and over 65 years of age
* Patients with systemic diseases (Diabetes mellitus, Peripheral vascular diseases)
* Any rheumatic disease involving the hand and upper extremity
* History of neuropathy involving the hand and upper extremity
* Those with any shoulder problems prior to the hand injury
* Those with an open wound on the hand
* Those who cannot cooperate
* Other upper extremity traumatic injuries occurring during the hand injury

Primary outcomes:
measure: Diagnostic shoulder ultrasonography
timeFrame: up to 12 weeks
Secondary outcomes:
measure: Visual analog scale (VAS) scores
timeFrame: up to 12 weeks
measure: Joint range of motion
timeFrame: up to 12 weeks
measure: Handgrip Strength Test
timeFrame: up to 12 weeks
measure: The Shoulder Pain and Disability Index
timeFrame: up to 12 weeks
Other outcomes:
Locations:
city: Ankara
country: Turkey
facility: Department of Physical Therapy and Rehabilitation, University of Health Sciences, Ankara Training and Research Hospital
state: Altindag
Study officials:
References:
citation: Abdallah EA, Eldesoky MT, Saweres JW, Abdelhaleem MD. Effect of Adding Shoulder Stabilization Exercises to the Rehabilitation of Postoperative Hand Injuries in Young Adult Patients. Hand (N Y). 2024 Feb 15:15589447241232017. doi: 10.1177/15589447241232017. Online ahead of print.
citation: Winiarski LM, Livoni JD, Madsen PV, Rathleff MS, Larsen P. Concurrent musculoskeletal complaints in elbows, shoulders, and necks after common hand and forearm injuries or conditions: A cross-sectional study among 600 patients. J Hand Ther. 2021 Oct-Dec;34(4):543-548. doi: 10.1016/j.jht.2020.05.002. Epub 2020 Sep 4.
citation: Horsley I, Herrington L, Hoyle R, Prescott E, Bellamy N. Do changes in hand grip strength correlate with shoulder rotator cuff function? Shoulder Elbow. 2016 Apr;8(2):124-9. doi: 10.1177/1758573215626103. Epub 2016 Jan 25.
citation: Xue R, Wong J, Imere A, King H, Clegg P, Cartmell S. Current clinical opinion on surgical approaches and rehabilitation of hand flexor tendon injury-a questionnaire study. Front Med Technol. 2024 Feb 15;6:1269861. doi: 10.3389/fmedt.2024.1269861. eCollection 2024.
citation: Jha CK, Shukla Y, Mukherjee R, Rathva P, Joshi M, Jain D. A Glove-Based Virtual Hand Rehabilitation System for Patients With Post-Traumatic Hand Injuries. IEEE Trans Biomed Eng. 2024 Jul;71(7):2033-2041. doi: 10.1109/TBME.2024.3360888. Epub 2024 Jun 19.