Pub Date : 2020-02-01DOI: 10.1177/1753193419877752
E. Selçuk, F. Bayraktar
off value for MCID of PRWE was 18, and the value of MDC of PRWE was 13. The sensitivity of this cut-off value was 61%, and the specificity was 100%. Two approaches are usually used to determine the MCID. One is the anchor-based approach, and the other is the distribution-based approach. However, there are various types of calculation methods in both approaches, which is a limitation of the MCID. We chose the ‘global ratings of change’ method, which is one of the most commonly used anchorbased approaches for establishing the MCID in longitudinal studies. Even though the retrospective ratings are susceptible to recall bias and the anchor-based approach does not consider the measurement precision, it is easy to obtain and provides the single best measure of the significance of change from the individual’s perspective. To compensate for the limitation of the anchor-based approach and define clinically meaningful change, use of multiple methods is strongly advocated. The distributionbased approaches, particularly those based on measurement precision, are best suited for the purpose of establishing that any observed changes are beyond the range of the measurement error of the instrument. It cannot be expected that the anchor-based and distribution-based approaches will be equivalent in all circumstances. Therefore, it is essential that the integrated system provides a means for resolving discrepancies across the method, and we used MDC methods as reference standard to determine the MCIDs of both PRO instruments. As the number of exclusions due to incomplete data and poor reliability was substantial and not every patient did have a minimum of two DASH and two PRWE scores, our results should be accepted with caution. Our study suggests that the MCIDs of DASH and PRWE were 9 and 18, respectively; and when the DASH and PRWE are used to measure subjective outcomes, the MCID of DASH is more sensitive and the MCID of PRWE is more specific in detecting clinical changes after surgical treatment of distal radial fractures.
{"title":"Congenital absence of bilateral ulnar arteries in a symptomatic adult patient","authors":"E. Selçuk, F. Bayraktar","doi":"10.1177/1753193419877752","DOIUrl":"https://doi.org/10.1177/1753193419877752","url":null,"abstract":"off value for MCID of PRWE was 18, and the value of MDC of PRWE was 13. The sensitivity of this cut-off value was 61%, and the specificity was 100%. Two approaches are usually used to determine the MCID. One is the anchor-based approach, and the other is the distribution-based approach. However, there are various types of calculation methods in both approaches, which is a limitation of the MCID. We chose the ‘global ratings of change’ method, which is one of the most commonly used anchorbased approaches for establishing the MCID in longitudinal studies. Even though the retrospective ratings are susceptible to recall bias and the anchor-based approach does not consider the measurement precision, it is easy to obtain and provides the single best measure of the significance of change from the individual’s perspective. To compensate for the limitation of the anchor-based approach and define clinically meaningful change, use of multiple methods is strongly advocated. The distributionbased approaches, particularly those based on measurement precision, are best suited for the purpose of establishing that any observed changes are beyond the range of the measurement error of the instrument. It cannot be expected that the anchor-based and distribution-based approaches will be equivalent in all circumstances. Therefore, it is essential that the integrated system provides a means for resolving discrepancies across the method, and we used MDC methods as reference standard to determine the MCIDs of both PRO instruments. As the number of exclusions due to incomplete data and poor reliability was substantial and not every patient did have a minimum of two DASH and two PRWE scores, our results should be accepted with caution. Our study suggests that the MCIDs of DASH and PRWE were 9 and 18, respectively; and when the DASH and PRWE are used to measure subjective outcomes, the MCID of DASH is more sensitive and the MCID of PRWE is more specific in detecting clinical changes after surgical treatment of distal radial fractures.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419877752","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47953833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-01DOI: 10.1177/1753193419880792
M. Birks, Kavita Sharma, K. Steele, Georgina L Jones, J. Miller
The aim of this descriptive epidemiological study of patients, referred to and selected for surgery at a UK tertiary hand centre, was to investigate patterns of common hand disorders and their impact on those individuals. A prospective collection of patient-reported outcome scores was carried out in patients before operation using the Patient Outcomes of Surgery Hand/Arm and the Euro-Qol 5 dimension three-level measures. Patient participation was voluntary and data collected over a 4-year period are discussed. Patient-reported outcome scores were calculated using appropriate algorithms. The results show correlation between the number of comorbidities and both symptoms and activity domains of the Patient Outcomes of Surgery Hand/Arm; higher symptom scores were seen in women. There was no increase in scores for older patients or those from more deprived areas. Population-based research using recognized patient-reported outcome measurement tools could aid future health service planning. Level of evidence: IV
{"title":"Understanding the patient profile and health-related quality of life in patients presenting for hand surgery","authors":"M. Birks, Kavita Sharma, K. Steele, Georgina L Jones, J. Miller","doi":"10.1177/1753193419880792","DOIUrl":"https://doi.org/10.1177/1753193419880792","url":null,"abstract":"The aim of this descriptive epidemiological study of patients, referred to and selected for surgery at a UK tertiary hand centre, was to investigate patterns of common hand disorders and their impact on those individuals. A prospective collection of patient-reported outcome scores was carried out in patients before operation using the Patient Outcomes of Surgery Hand/Arm and the Euro-Qol 5 dimension three-level measures. Patient participation was voluntary and data collected over a 4-year period are discussed. Patient-reported outcome scores were calculated using appropriate algorithms. The results show correlation between the number of comorbidities and both symptoms and activity domains of the Patient Outcomes of Surgery Hand/Arm; higher symptom scores were seen in women. There was no increase in scores for older patients or those from more deprived areas. Population-based research using recognized patient-reported outcome measurement tools could aid future health service planning. Level of evidence: IV","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419880792","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41502318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-01DOI: 10.1177/1753193419866400
J. Maempel, P. Jenkins, J. McEachan
We studied whether mental health status is significantly correlated to patient reported functional outcomes and satisfaction after carpal tunnel release. Over a 7-year period, 809 patients completed Short Form-12 (SF-12) questionnaires which allowed calculation of the SF-12 mental component summary 1 year postoperatively, 780 (96%) completed a satisfaction questionnaire and 777 (96%) completed a QuickDisabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Median QuickDASH score was 55 preoperatively (interquartile range [IQR] 28) and 14 postoperatively (IQR 32). A total of 674 patients were satisfied. Patients with mental disability had worse QuickDASH scores (median 34, IQR 41) and a higher incidence of dissatisfaction (52/245, 21%) than those without mental disability (n = 9, IQR 20, 10%, both p < 0.001). Regression analyses indicated scores in the SF-12 mental component summary were significantly related to postoperative QuickDASH score (p < 0.001) and satisfaction (p = 0.02). We concluded that patients with mental disability report poorer outcomes and lower satisfaction rates; however, the majority still exhibit significant improvements and are satisfied. Level of evidence: II
{"title":"The relationship of mental health status to functional outcome and satisfaction after carpal tunnel release","authors":"J. Maempel, P. Jenkins, J. McEachan","doi":"10.1177/1753193419866400","DOIUrl":"https://doi.org/10.1177/1753193419866400","url":null,"abstract":"We studied whether mental health status is significantly correlated to patient reported functional outcomes and satisfaction after carpal tunnel release. Over a 7-year period, 809 patients completed Short Form-12 (SF-12) questionnaires which allowed calculation of the SF-12 mental component summary 1 year postoperatively, 780 (96%) completed a satisfaction questionnaire and 777 (96%) completed a QuickDisabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Median QuickDASH score was 55 preoperatively (interquartile range [IQR] 28) and 14 postoperatively (IQR 32). A total of 674 patients were satisfied. Patients with mental disability had worse QuickDASH scores (median 34, IQR 41) and a higher incidence of dissatisfaction (52/245, 21%) than those without mental disability (n = 9, IQR 20, 10%, both p < 0.001). Regression analyses indicated scores in the SF-12 mental component summary were significantly related to postoperative QuickDASH score (p < 0.001) and satisfaction (p = 0.02). We concluded that patients with mental disability report poorer outcomes and lower satisfaction rates; however, the majority still exhibit significant improvements and are satisfied. Level of evidence: II","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419866400","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65456517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-01DOI: 10.1177/1753193419883637
N. Goyal, Faisal Akram, R. Wysocki
digitorum superficialis muscle. J Hand Surg Eur. 1999, 24: 570–4. Javed S, Woodruff M. Carpal tunnel syndrome secondary to an accessory flexor digitorum superficialis muscle belly: case report and review of the literature. Hand. 2014, 9: 554–5. Kostkoglu N, Borman H, Kecik A. Anomalous flexor digitorum superficialis muscle belly: an unusual case of mass in the palm. Br J Plast Surg. 1997, 50: 654–6.
{"title":"Return to golf after proximal row carpectomy and four-corner arthrodesis for scapholunate and scaphoid nonunion advanced collapse","authors":"N. Goyal, Faisal Akram, R. Wysocki","doi":"10.1177/1753193419883637","DOIUrl":"https://doi.org/10.1177/1753193419883637","url":null,"abstract":"digitorum superficialis muscle. J Hand Surg Eur. 1999, 24: 570–4. Javed S, Woodruff M. Carpal tunnel syndrome secondary to an accessory flexor digitorum superficialis muscle belly: case report and review of the literature. Hand. 2014, 9: 554–5. Kostkoglu N, Borman H, Kecik A. Anomalous flexor digitorum superficialis muscle belly: an unusual case of mass in the palm. Br J Plast Surg. 1997, 50: 654–6.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419883637","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43497161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-01DOI: 10.1177/1753193419877607
Cheng-yu Yin, Hui-Kuang Huang, Jung-pan Wang
Various treatments have been proposed for fracturedislocations of the proximal interphalangeal (PIP) joint. Among them, dynamic distraction external fixation (DDEF) has become an attractive and favourable surgical intervention for hand surgeons because it allows early active motion and is less invasive to the surrounding soft tissues (Abou Elatta et al., 2017). However, it would appear to be impractical to use DDEF alone if the fracture-dislocation of the PIP joint has progressed to a delayed stage with partial healing and malunion at the fracture site. Therefore, we present a method of DDEF with preliminary percutaneous callus release to manage delayed presentation fracture-dislocations of the PIP joint. Between January 2017 and February 2019, three patients with fracture-dislocations of the PIP joint were treated in this manner at the senior author’s hospital. The delay in treatment was longer than 4 weeks from injury, when we considered that early union was underway with unsatisfactory restoration of the articular surface. All fractures involved less than 50% of the base of the middle phalanx. We excluded patients with a fracture pattern hindering the application of DDEF, stiff fingers without any passive range of motion, infection, and severe medical conditions hindering the patient’s survival. All the surgeries were performed by the senior corresponding author (experience Level III – experienced
{"title":"Callus release and dynamic external fixation for delayed presentation of proximal interphalangeal joint fracture-dislocations","authors":"Cheng-yu Yin, Hui-Kuang Huang, Jung-pan Wang","doi":"10.1177/1753193419877607","DOIUrl":"https://doi.org/10.1177/1753193419877607","url":null,"abstract":"Various treatments have been proposed for fracturedislocations of the proximal interphalangeal (PIP) joint. Among them, dynamic distraction external fixation (DDEF) has become an attractive and favourable surgical intervention for hand surgeons because it allows early active motion and is less invasive to the surrounding soft tissues (Abou Elatta et al., 2017). However, it would appear to be impractical to use DDEF alone if the fracture-dislocation of the PIP joint has progressed to a delayed stage with partial healing and malunion at the fracture site. Therefore, we present a method of DDEF with preliminary percutaneous callus release to manage delayed presentation fracture-dislocations of the PIP joint. Between January 2017 and February 2019, three patients with fracture-dislocations of the PIP joint were treated in this manner at the senior author’s hospital. The delay in treatment was longer than 4 weeks from injury, when we considered that early union was underway with unsatisfactory restoration of the articular surface. All fractures involved less than 50% of the base of the middle phalanx. We excluded patients with a fracture pattern hindering the application of DDEF, stiff fingers without any passive range of motion, infection, and severe medical conditions hindering the patient’s survival. All the surgeries were performed by the senior corresponding author (experience Level III – experienced","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419877607","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48448346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1177/1753193419870403
F. Soldado, Ramiro Ledesma-Negreiros, S. Barrera-Ochoa
arthritis and include arthrodesis or excision of the fifth CMC joint. Our patient had no arthritis, and thus the fifth CMC joint could be preserved in order to maintain the transverse carpal arch and preserve some movement for cupping of the hand. Fusing the fifth to fourth metacarpal eliminated the hypermobility of the fifth CMC joint by limiting it to the normal movement of the fourth. This also eliminated intraoperative difficulties with ensuring satisfactory rotation, alignment, and length of the fifth metacarpal, which has been reported with the other procedures. General anaesthesia was chosen as a preference by the patient. The use of local or regional anaesthesia may have provided additional information. This case demonstrates the importance of examining adjacent joints when dealing with cases of instability.
{"title":"Vascularized volar cutaneous flap from the ablated digit to simultaneously address first web contracture in radial polydactyly","authors":"F. Soldado, Ramiro Ledesma-Negreiros, S. Barrera-Ochoa","doi":"10.1177/1753193419870403","DOIUrl":"https://doi.org/10.1177/1753193419870403","url":null,"abstract":"arthritis and include arthrodesis or excision of the fifth CMC joint. Our patient had no arthritis, and thus the fifth CMC joint could be preserved in order to maintain the transverse carpal arch and preserve some movement for cupping of the hand. Fusing the fifth to fourth metacarpal eliminated the hypermobility of the fifth CMC joint by limiting it to the normal movement of the fourth. This also eliminated intraoperative difficulties with ensuring satisfactory rotation, alignment, and length of the fifth metacarpal, which has been reported with the other procedures. General anaesthesia was chosen as a preference by the patient. The use of local or regional anaesthesia may have provided additional information. This case demonstrates the importance of examining adjacent joints when dealing with cases of instability.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419870403","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48216428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1177/1753193419879645
T. Quick, H. Brown
Major nerve injuries such as those of the brachial plexus present a significant challenge for both rehabilitation and evaluation of outcome. With these often complex and multi-faceted injuries, correct selection of outcome measures is important. Healthy nerve function in humans heightens our interactions with the world, creating quality and enjoyment through our experiences of movement and touch. Therefore, assessments should be holistic and representative of all of these features. This article considers the assessment and evaluation of all of the features of nerve injury: sensorimotor, sensation (including that of pain), function and the psychosocial aspects. Current practice is described and combined with clinical experience and research findings to provide suggestions and recommendations for the selection of the most appropriate tools for use with this patient group.
{"title":"Evaluation of functional outcomes after brachial plexus injury","authors":"T. Quick, H. Brown","doi":"10.1177/1753193419879645","DOIUrl":"https://doi.org/10.1177/1753193419879645","url":null,"abstract":"Major nerve injuries such as those of the brachial plexus present a significant challenge for both rehabilitation and evaluation of outcome. With these often complex and multi-faceted injuries, correct selection of outcome measures is important. Healthy nerve function in humans heightens our interactions with the world, creating quality and enjoyment through our experiences of movement and touch. Therefore, assessments should be holistic and representative of all of these features. This article considers the assessment and evaluation of all of the features of nerve injury: sensorimotor, sensation (including that of pain), function and the psychosocial aspects. Current practice is described and combined with clinical experience and research findings to provide suggestions and recommendations for the selection of the most appropriate tools for use with this patient group.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419879645","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44167109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1177/1753193419876063
M. Boeckstyns
The most widely used procedures for salvaging a destroyed wrist are four-corner arthrodesis, radiocarpal arthrodesis, proximal row carpectomy, total wrist arthrodesis, and total wrist replacement or resurfacing. The purpose of this article is to give an overview of the functional results obtained with the various salvage procedures and of the common methods for assessing the surgical outcomes. The outcomes are assessed by clinical measurements and scoring methods, but the actual functional status and well-being of the patients should be presented together with patient-reported outcomes. No salvage procedure can restore entirely full wrist function. Understanding indications, risks, and the outcomes of these procedures would favour a better decision for surgery and help choose the proper treatment from among the surgical options discussed with patients.
{"title":"Functional outcomes after salvage procedures for the destroyed wrist: an overview","authors":"M. Boeckstyns","doi":"10.1177/1753193419876063","DOIUrl":"https://doi.org/10.1177/1753193419876063","url":null,"abstract":"The most widely used procedures for salvaging a destroyed wrist are four-corner arthrodesis, radiocarpal arthrodesis, proximal row carpectomy, total wrist arthrodesis, and total wrist replacement or resurfacing. The purpose of this article is to give an overview of the functional results obtained with the various salvage procedures and of the common methods for assessing the surgical outcomes. The outcomes are assessed by clinical measurements and scoring methods, but the actual functional status and well-being of the patients should be presented together with patient-reported outcomes. No salvage procedure can restore entirely full wrist function. Understanding indications, risks, and the outcomes of these procedures would favour a better decision for surgery and help choose the proper treatment from among the surgical options discussed with patients.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419876063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49609528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1177/1753193419871631
Verena J M M Schrier, R. Gelfman, P. Amadio
and none required physical therapy. One patient reported mild pain at the base of the ipsilateral 5th metacarpal up to 9 months postoperatively. The others reported prompt and complete resolution of preoperative pain, noted no functional deficits or wrist weakness, were satisfied with the procedure, and to our knowledge, have not had any late complications. We believe that lengthening the ECU decreases tension in the tendon, which relieves painful stenosis or subluxation. Painless postoperative subluxation may occur. Subluxation or stenosis might be eliminated altogether by performing an ECU tenotomy (Figure 1(d)). However, the senior author favours lengthening over tenotomy to preserve some ECU function, in case the ECU should be called on as a donor tendon in the future, and because patients may be averse to a procedure that definitively eliminates the function of a body part. We recognize that neither of these potential benefits have been subjected to objective assessment. A prospective study including outcome measures is in order to determine the precise indications and efficacy of ECU lengthening.
{"title":"Minimal clinically important difference is lower for carpal tunnel syndrome patients undergoing injection versus surgery","authors":"Verena J M M Schrier, R. Gelfman, P. Amadio","doi":"10.1177/1753193419871631","DOIUrl":"https://doi.org/10.1177/1753193419871631","url":null,"abstract":"and none required physical therapy. One patient reported mild pain at the base of the ipsilateral 5th metacarpal up to 9 months postoperatively. The others reported prompt and complete resolution of preoperative pain, noted no functional deficits or wrist weakness, were satisfied with the procedure, and to our knowledge, have not had any late complications. We believe that lengthening the ECU decreases tension in the tendon, which relieves painful stenosis or subluxation. Painless postoperative subluxation may occur. Subluxation or stenosis might be eliminated altogether by performing an ECU tenotomy (Figure 1(d)). However, the senior author favours lengthening over tenotomy to preserve some ECU function, in case the ECU should be called on as a donor tendon in the future, and because patients may be averse to a procedure that definitively eliminates the function of a body part. We recognize that neither of these potential benefits have been subjected to objective assessment. A prospective study including outcome measures is in order to determine the precise indications and efficacy of ECU lengthening.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419871631","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48475434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.1177/1753193419883968
G. Giddins
There are a number of possible assessments of functional outcomes for thumb carpometacarpal joint arthritis. The most important and easiest to measure is pain, but it is not the only material outcome. Functional scores for measuring the outcome of the treatment of thumb carpometacarpal joint arthritis have been recommended for some time, but are still not widely used even in published studies. It is also unclear which functional scores are the most valuable. Easily used scores, such as the Disabilities of the Arm Shoulder and Hand questionnaire, are freely available, but may not be sensitive enough to assess outcomes especially of thumb carpometacarpal joint arthroplasty. The optimal functional outcome measurement would be weighted for the individual patient. A minimum dataset needs to be defined in order to compare studies and derive meaningful data.
{"title":"Functional outcomes after surgery for thumb carpometacarpal joint arthritis","authors":"G. Giddins","doi":"10.1177/1753193419883968","DOIUrl":"https://doi.org/10.1177/1753193419883968","url":null,"abstract":"There are a number of possible assessments of functional outcomes for thumb carpometacarpal joint arthritis. The most important and easiest to measure is pain, but it is not the only material outcome. Functional scores for measuring the outcome of the treatment of thumb carpometacarpal joint arthritis have been recommended for some time, but are still not widely used even in published studies. It is also unclear which functional scores are the most valuable. Easily used scores, such as the Disabilities of the Arm Shoulder and Hand questionnaire, are freely available, but may not be sensitive enough to assess outcomes especially of thumb carpometacarpal joint arthroplasty. The optimal functional outcome measurement would be weighted for the individual patient. A minimum dataset needs to be defined in order to compare studies and derive meaningful data.","PeriodicalId":73762,"journal":{"name":"Journal of hand surgery (Edinburgh, Scotland)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1753193419883968","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45957932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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