This K24 renewal application will continue to derive evidence in the field of hand surgery by focusing on the treatment of distal radius fractures (DRF) to teach trainees evidence-based practice and principles. The principal investigator (PI) is a health services researcher whose interests include evidence-based medicine, epidemiology and outcomes research. The PI's previous research has concentrated on musculoskeletal diseases such as rheumatoid arthritis and distal radius fractures (DRF), particularly among the elderly. In addition to continuing research on DRF outcomes, this grant will incorporate a mentoring program to teach evidence-based medicine and research methodology to a growing number of junior faculty, surgery residents, international fellows and medical students. The goal of this project is to initiate a randomized-controlled clinical trial to compare outcomes of two hand therapy programs for elderly patients with DRF, which is the most common injury affecting this growing population. Patients treated with open reduction and internal fixation of DRFs using the volar locking plating system (VLPS) will receive fully-supervised hand therapy (FHT) or minimally supervised self-directed hand therapy (MHT).
The specific aims of the study are (1) To conduct a randomized controlled trial comparing MHT versus traditional FHT for DRFs in the elderly treated with VLPS, and 2) To develop a predictor model to identify patients who will benefit from FHT. The data derived from this study will provide vital information about the postoperative management of this injury and define predictors of functional outcomes after open reduction and internal fixation of DRFs. Furthermore, this study will yield evidence to assist healthcare providers in giving the best care to DRF patients and generate economic data to potentially reduce costs nationally. The principal focus of this K24 award is to apply this project to educate trainees about evidence-based medicine, epidemiology, statistics and study methodology. entire application (candidate, environment, and research). Include the candidate's immediate and long-term career goals, key elements of the research career development plan, and a description of the research project, as indicated in Part I.4.4.6. Provide an abstract of th entire application (candidate, environment, and research). Include the candidate's immediate and long-term career goals, key elements of the research career development plan, and a description of the research project, as indicated in Part I.4.4.6. CC

Public Health Relevance

This K24 renewal application will continue to provide evidence-based research on hand surgery. This grant will investigate the treatment of distal radius fractures and educate trainees in research methodology.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
5K24AR053120-08
Application #
9129598
Study Section
Arthritis and Musculoskeletal and Skin Diseases Special Grants Review Committee (AMS)
Program Officer
Washabaugh, Charles H
Project Start
2005-12-01
Project End
2019-05-31
Budget Start
2016-06-01
Budget End
2017-05-31
Support Year
8
Fiscal Year
2016
Total Cost
$182,732
Indirect Cost
$13,536
Name
University of Michigan Ann Arbor
Department
Surgery
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Yamamoto, Michiro; Chung, Kevin C (2018) Implant Arthroplasty: Selection of Exposure and Implant. Hand Clin 34:195-205
Cho, Hoyune E; Zhong, Lin; Kotsis, Sandra V et al. (2018) Finger Replantation Optimization Study (FRONT): Update on National Trends. J Hand Surg Am 43:903-912.e1
Fujihara, Yuki; Huetteman, Helen E; Chung, Ting-Ting et al. (2018) The Effect of Impactful Articles on Clinical Practice in the United States: Corticosteroid Injection for Patients with Lateral Epicondylitis. Plast Reconstr Surg 141:1183-1191
Matros, Evan; Disa, Joseph J (2018) Discussion: The Cost of Contralateral Prophylactic Mastectomy in Women with Unilateral Breast Cancer. Plast Reconstr Surg 141:1103-1104
Fujihara, Yuki; Saito, Taichi; Huetteman, Helen E et al. (2018) Learning from an Unsuccessful Study Idea: Reflection and Application of Innovative Techniques to Prevent Future Failures. Plast Reconstr Surg 141:1056-1062
Kamnerdnakta, Sirichai; Huetteman, Helen E; Chung, Kevin C (2018) Complications of Proximal Interphalangeal Joint Injuries: Prevention and Treatment. Hand Clin 34:267-288
Zhu, Andy F; Rahgozar, Paymon; Chung, Kevin C (2018) Advances in Proximal Interphalangeal Joint Arthroplasty: Biomechanics and Biomaterials. Hand Clin 34:185-194
Huetteman, Helen E; Shauver, Melissa J; Nasser, Jacob S et al. (2018) The Desired Role of Health Care Providers in Guiding Older Patients With Distal Radius Fractures: A Qualitative Analysis. J Hand Surg Am 43:312-320.e4
Nasser, Jacob S; Huetteman, Helen E; Shauver, Melissa J et al. (2018) Older Patient Preferences for Internal Fixation after a Distal Radius Fracture: A Qualitative Study from the Wrist and Radius Injury Surgical Trial. Plast Reconstr Surg 142:34e-41e
Fujihara, Nasa; Fujihara, Yuki; Sterbenz, Jennifer M et al. (2018) Impact of Economic Downturn on the Surgical Volumes of Common Hand Procedures. Plast Reconstr Surg :

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