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Suzuki N, Yoda T, Nakadai M, Takano T, Oinuma T, Kawashima H. Short-term clinical outcomes of mirogabalin for carpal tunnel syndrome: A single-center retrospective pilot study. J Orthop 2025; 64:102-107. [PMID: 39691639 PMCID: PMC11648625 DOI: 10.1016/j.jor.2024.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2024] [Revised: 11/14/2024] [Accepted: 11/23/2024] [Indexed: 12/19/2024] Open
Abstract
Aims & objectives Carpal tunnel syndrome (CTS) is a common condition caused by compression of the median nerve, leading to neuropathic pain such as numbness and nocturnal discomfort, thus impacting daily life. Mirogabalin besylate (MGB), a novel gabapentinoid, shows promise for neuropathic pain, but its efficacy in CTS remains unclear.Therefore, this pilot study aimed to evaluate the short-term clinical outcomes of MGB for CTS. Materials & methods This retrospective observational study examined 21 patients with CTS who received MGB between April 2022 and March 2023. Evaluations included the Carpal Tunnel Syndrome Instrument (CTSI), Quick Disabilities of the Arm, Shoulder and Hand (Quick DASH), and Visual Analog Scale (VAS) before and 12 weeks after treatment. The primary outcome was the change in CTSI-total. Secondary outcomes included CTSI subparts (symptom severity and functional status), Quick DASH, VAS, and adverse drug reactions (ADRs). Results MGB led to significant improvement in CTSI-total (p=0.022), with medium standardized response mean (SRM) and effect size (ES). CTSI-symptom severity (p<0.01) and VAS (p<0.001) also improved, showing medium SRM and ES for CTSI and large SRM and ES for VAS. No significant changes were observed in CTSI-functional status (p=0.349) or Quick DASH (p=0.102). ADRs occurred in 42.9 % of patients, mostly mild. Conclusions MGB demonstrated significant short-term efficacy in improving CTS symptoms and reducing pain, though mild ADRs were common. Further studies are needed to assess long-term outcomes and compare MGB with other treatments. Levels of evidence Level IV.
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Affiliation(s)
- Nobuaki Suzuki
- Department of Orthopedic Surgery, Niigata University Medical and Dental Hospital, 754 Asahimachi-dori Ichibancho, Chuo-ku, Niigata-shi, Niigata, 951-8520, Japan
| | - Takuya Yoda
- Department of Orthopedic Surgery, Niigata University Medical and Dental Hospital, 754 Asahimachi-dori Ichibancho, Chuo-ku, Niigata-shi, Niigata, 951-8520, Japan
| | - Masato Nakadai
- Department of Orthopedic Surgery, Niigata University Medical and Dental Hospital, 754 Asahimachi-dori Ichibancho, Chuo-ku, Niigata-shi, Niigata, 951-8520, Japan
| | - Takehito Takano
- Department of Orthopedic Surgery, Niigata University Medical and Dental Hospital, 754 Asahimachi-dori Ichibancho, Chuo-ku, Niigata-shi, Niigata, 951-8520, Japan
| | - Takeo Oinuma
- Department of Orthopedic Surgery, Sado General Hospital, 161 Chigusa, Sado City, Niigata, 952-1209, Japan
| | - Hiroyuki Kawashima
- Department of Orthopedic Surgery, Niigata University Medical and Dental Hospital, 754 Asahimachi-dori Ichibancho, Chuo-ku, Niigata-shi, Niigata, 951-8520, Japan
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Naito K, Imazu N, Ishi S, Yamamoto Y, Suzuki T, Kawamura K, Kawakita S, Itoh T, Ishijima M. Central sensitization inventory score after surgical treatment for distal radius fractures. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2025; 35:187. [PMID: 40355797 DOI: 10.1007/s00590-025-04310-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2025] [Accepted: 04/20/2025] [Indexed: 05/15/2025]
Abstract
PURPOSE Volar locking plate (VLP) fixation for distal radius fractures has relatively stable clinical outcomes. However, surgeons who assess postoperative outcomes as good may have difficulty fully understanding the perspectives of patients who express dissatisfaction. Central sensitization inventory (CSI) score is now thought to assess psychogenic pain. Therefore, clinical evaluation related to CSI score following volar locking plate fixation for distal radius fractures in this study. METHODS Twenty-nine distal radius fracture patients (12 males and 17 females; mean age: 55.2 ± 15.9 years) treated with VLP were included. At final follow up before removal of volar locking plate, wrist joint range of motion (flexion, extension, pronation, and supination), grip strength (% of the healthy side), numerical rating scale (NRS), quick disabilities of the arm, shoulder, and hand (Q-DASH) score, and CSI score were investigated. In addition, the association between each evaluation item and Q-DASH and CSI scores was analyzed using univariate analysis. RESULTS Wrist range of motion and grip strength were not associated with CSI score (flexion: P = 0.651, r = - 0.089; extension: P = 0.689, r = 0.079; pronation: P = 0.241, r = 0.229; supination: P = 0.864, r = 0.034; grip strength healthy side ratio: P = 0.582, r = - 0.109). On the other hand, NRS (P = 0.038, r = 0.393) and Q-DASH scores (P = 0.012, r = 0.469) were significantly associated with CSI scores. CONCLUSIONS This study suggested that after volar locking plate fixation (before plate removal), patient-reported outcomes (Q-DASH score and CSI score) were not associated with clinician-reported outcomes and impairment measure.
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Affiliation(s)
- Kiyohito Naito
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan.
- Department of Orthopedics, Juntendo University Faculty of Medicine, Tokyo, Japan.
| | - Norizumi Imazu
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Orthopedics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Shoichiro Ishi
- Department of Orthopedics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yasuhiro Yamamoto
- Department of Orthopedics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Takamaru Suzuki
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Orthopedics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Kenjiro Kawamura
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Orthopedics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - So Kawakita
- Department of Orthopedics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Tatsuki Itoh
- Department of Orthopedics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Muneaki Ishijima
- Department of Medicine for Orthopedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Orthopedics, Juntendo University Faculty of Medicine, Tokyo, Japan
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Kashima S, Irie K, Watanabe D, Kanazawa S, Uemura S, Nagai-Tanima M, Aoyama T. Development of a bottle-type sensor measuring two-hand movement. Med Eng Phys 2025; 138:104315. [PMID: 40180528 DOI: 10.1016/j.medengphy.2025.104315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2024] [Revised: 02/09/2025] [Accepted: 02/24/2025] [Indexed: 04/05/2025]
Abstract
Daily life activities entail the coordinated movement of both hands. Although devices for evaluating the function of one hand are available, in addition, there are currently some limitations in devices for quantitatively evaluating the two-hand movement. This study aimed to develop and examine the validity of a device, called the bottle-type sensor, which can simultaneously measure two-hand movements. A bottle-type sensor was created by wrapping a newly developed high-precision flexible sensor sheet around a three-dimensional-printed cap and body part. The force component of each sensor was calculated from the load data, and the loads for each finger were summed. Thirty healthy adults participated in the study, 21 for validity and 9 for reliability. In the validity studies, the values for the body and cap part of the bottle-type sensor were correlated with the grip and pinch forces. For reliability studies, the intraclass correlation coefficient 2, 3 were calculated comparing the results after a day. Significant positive correlations with the body and cap parts of the bottle-type sensor were found for the grip and pinch forces. Reliability studies revealed that the body part of the bottle-type sensor had an ICC of >0.75. However, the cap part had an ICC of <0.75, which was insufficient. The bottle-type sensor developed in this study showed significant correlations with the grip and pinch forces, but the cap part did not yield satisfactory results in terms of reliability. In the future, the usefulness of the bottle-type sensor needs to be clarified by improving the cap part, as well as by evaluating it during two-hand movements and measuring it in patients with various diseases.
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Affiliation(s)
- Soshiro Kashima
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan
| | - Keisuke Irie
- Department of Occupational Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan
| | - Daiki Watanabe
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan
| | - Shunsuke Kanazawa
- Human Augmentation Research Center, National Institute of Advanced Industrial Science and Technology, Japan
| | - Sei Uemura
- Human Augmentation Research Center, National Institute of Advanced Industrial Science and Technology, Japan
| | - Momoko Nagai-Tanima
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan
| | - Tomoki Aoyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Japan.
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Machida T, Katayama H, Matsukubo Y, Ono-Matsukubo Q, Watanabe A, Hirooka T. Reflection of power DOPPLER activity in the subacromial space on nocturnal pain in patients with rotator cuff tears: a cross-sectional study. J Shoulder Elbow Surg 2025; 34:e152-e157. [PMID: 39147264 DOI: 10.1016/j.jse.2024.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 06/25/2024] [Accepted: 06/27/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Nocturnal shoulder pain is seen in patients with rotator cuff tears (RCTs). The purpose of the present study was to determine whether Doppler ultrasound parameters predict the intensity of nocturnal pain in patients with RCTs. METHODS A total of 60 patients with RCTs were included. Doppler ultrasound parameters (peak systolic velocity in the anterior humeral circumflex artery, Doppler activity in the glenohumeral joint and subacromial space [SAS]) and clinical parameters were examined. For the presence of nocturnal pain, the clinical parameters were compared with and without nocturnal pain. For the intensity of the nocturnal pain, a multivariate analysis of clinical parameters and nocturnal pain intensity was performed. RESULTS In all, 39 patients (65%) reported nocturnal pain, and the mean pain intensity was 47.0 (standard deviation, 26.0) on the visual analog scale. In nocturnal pain presence analysis, Doppler activity in the SAS showed significant associations (P < .001). In nocturnal pain intensity analysis, Doppler activity in the SAS and diabetes showed significant associations (P < .001, P = .01, respectively). CONCLUSION Doppler activity in the SAS emerges as an independent factor associated with the presence and intensity of nocturnal pain in patients with RCTs. Our findings may provide a basis for further exploration and refinement of treatment strategies.
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Affiliation(s)
- Takahiro Machida
- Department of Rehabilitation, Machida Orthopaedics, Kochi, Japan; Department of Orthopaedic Surgery, Machida Orthopaedics, Kochi, Japan
| | - Hinako Katayama
- Department of Rehabilitation, Machida Orthopaedics, Kochi, Japan
| | - Yuki Matsukubo
- Department of Rehabilitation, Machida Orthopaedics, Kochi, Japan
| | | | - Akihisa Watanabe
- Department of Rehabilitation, Machida Orthopaedics, Kochi, Japan.
| | - Takahiko Hirooka
- Department of Orthopaedic Surgery, Onomichi Municipal Hospital, Hiroshima, Japan
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Lue YJ, Cheng KI, Lin CL, Chen CH, Lu YM. Psychometric Properties of the QuickDASH in Patients with Neck Pain. J Clin Med 2025; 14:1266. [PMID: 40004795 PMCID: PMC11856220 DOI: 10.3390/jcm14041266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2025] [Revised: 02/10/2025] [Accepted: 02/12/2025] [Indexed: 02/27/2025] Open
Abstract
Background/Objectives: Many patients with neck pain have upper limb disorders, and prolonged use of computers at work commonly induces neck/shoulder pain. The purpose of this study was to investigate the psychometric properties of the Quick Disability of the Arm, Shoulder, and Hand (QuickDASH) in patients with neck pain. Methods: A total of 189 patients with neck pain were included in acceptability, reliability, validity, and responsiveness studies. The floor and ceiling effects were used for assessing acceptability. The internal reliability and test-retest reliability were used for assessing reliabilities. The construct validities (convergent/divergent validity and exploratory/confirmatory factor analyses) were used for assessing validity. The effect size (ES) and standardized response mean (SRM) were used for assessing responsiveness. Results: The QuickDASH had a slight floor effect (16.4%). For reliability, the internal consistency (Cα= 0.945) and test-retest reliability (ICC = 0.98; SEM = 3.17, and MDC = 8.79) were excellent. For validity, the convergent and divergent validities were satisfactory. Exploratory factor analysis revealed two factors of the QuickDASH (function factor and symptom factor), and confirmatory factor analysis confirmed the two-factor model. Responsiveness was supported by the high ES (0.85) and SRM (0.82). Conclusions: The QuickDASH is a reliable, valid, and responsive instrument for assessing upper limb disorders in patients with neck pain.
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Affiliation(s)
- Yi-Jing Lue
- Department of Physical Therapy, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Kuang-I Cheng
- Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan;
| | - Chih-Lung Lin
- Department of Neurosurgery, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan;
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Chung-Hwan Chen
- Department of Orthopaedics, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
| | - Yen-Mou Lu
- Department of Orthopaedics, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
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Takasaki H. Female teleworkers with pain have the highest presenteeism, where its primary contributing variable was not those of musculoskeletal disability. INDUSTRIAL HEALTH 2025; 63:71-83. [PMID: 39098046 PMCID: PMC11779516 DOI: 10.2486/indhealth.2024-0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/11/2024] [Indexed: 08/06/2024]
Abstract
Presenteeism, among desk workers with pain can be affected by musculoskeletal disabilities (MSDs), working styles, and gender. In this study, teleworkers were defined as those who teleworked >70% of the time at home, while others were defined as non-full teleworkers. This study aimed to (1) compare the magnitude of presenteeism among four groups: male and female teleworkers with pain and male and female non-full teleworkers with pain, and (2) create a regression model of presenteeism with 66 independent biopsychosocial variables for each group. Data were collected through an anonymous online survey. Presenteeism was evaluated using the work functioning impairment scale. The 66 independent biopsychosocial variables included four disability measures, namely, stiff neck/shoulders, low back pain, and upper or lower limb problems, along with other factors relevant to presenteeism in previous studies, such as age, body mass index, comorbidities, work-related variables, pain catastrophizing, and various psychological distress measures. Data from 1,068 male non-full teleworkers, 1,043 female non-full teleworkers, 282 male teleworkers, and 307 female teleworkers were analyzed. Presenteeism was the highest among female teleworkers with pain. Furthermore, in all models, overall psychological distress, rather than the four MSD measures, was the primary contributing factor for presenteeism.
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Affiliation(s)
- Hiroshi Takasaki
- Department of Physical Therapy, Saitama Prefectural University, Japan
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Covarrubias O, Agaisse T, Portnoff B, Hoffman R, Molino J, Paxton ES, Green A. Validation of DASH and QuickDASH for Outcome Assessment of Anatomic Total Shoulder Arthroplasty for Treatment of Advanced Glenohumeral Osteoarthritis. J Bone Joint Surg Am 2024; 106:2187-2195. [PMID: 39630137 DOI: 10.2106/jbjs.23.01288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2025]
Abstract
BACKGROUND The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and its abbreviated version, QuickDASH, are commonly used patient-reported outcome measures (PROMs) for the assessment of an upper-extremity disability. Theoretically, they can be used to compare the treatment outcomes of different upper-extremity conditions. Despite increasingly widespread use for some shoulder conditions, these questionnaires have not been rigorously validated for use to assess the outcomes of patients undergoing anatomic total shoulder arthroplasty (aTSA). The objective of this study was to validate the DASH and QuickDASH scores for a longitudinal outcome assessment of patients undergoing aTSA to treat advanced glenohumeral osteoarthritis (GHOA). METHODS In this study, 450 patients with a median age of 70.3 years (interquartile range [IQR] width, 11.7 years) were included; 52.4% of the patients were female. The DASH and QuickDASH questionnaires, the American Shoulder and Elbow Surgeons (ASES) score, the Simple Shoulder Test (SST), and the EuroQol-5 Dimensions (EQ-5D) questionnaire were completed preoperatively and at follow-ups of 3 months, 6 to 12 months, and a minimum of 2 years by patients undergoing aTSA. The criterion validity, construct validity, reliability, and responsiveness of the DASH and QuickDASH were assessed. RESULTS The DASH and QuickDASH scores demonstrated moderate to very strong correlations with the ASES scores (ρ = -0.83 to -0.62), SST scores (ρ = -0.73 to -0.55), and EQ-5D scores (ρ = -0.72 to -0.57); minimal floor or ceiling effects; internal consistency (Cronbach alpha > 0.80); and large Cohen d and standardized response means (<1.6) at all time points. Very strong positive correlations were observed between the DASH and QuickDASH scores at all time points (ρ = 0.96 to 0.97). CONCLUSIONS The DASH and QuickDASH scores, which are region-specific rather than shoulder-specific, are valid, reliable, and responsive PROMs for the evaluation of patients with advanced GHOA treated with aTSA. Therefore, the DASH and QuickDASH scores can be used to compare the outcomes of aTSA for the treatment of advanced GHOA with the outcomes of treatment of other upper-extremity disorders, potentially facilitating comparative cost-effectiveness and value analysis studies. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Oscar Covarrubias
- Division of Shoulder and Elbow Surgery, Department of Orthopaedic Surgery, Alpert Medical School, Brown University. Providence, Rhode Island
| | - Ty Agaisse
- Alpert Medical School, Brown University, Providence, Rhode Island
| | - Brandon Portnoff
- Division of Shoulder and Elbow Surgery, Department of Orthopaedic Surgery, Alpert Medical School, Brown University. Providence, Rhode Island
| | - Ryan Hoffman
- Division of Shoulder and Elbow Surgery, Department of Orthopaedic Surgery, Alpert Medical School, Brown University. Providence, Rhode Island
| | - Janine Molino
- Division of Shoulder and Elbow Surgery, Department of Orthopaedic Surgery, Alpert Medical School, Brown University. Providence, Rhode Island
| | - E Scott Paxton
- Division of Shoulder and Elbow Surgery, Department of Orthopaedic Surgery, Alpert Medical School, Brown University. Providence, Rhode Island
| | - Andrew Green
- Division of Shoulder and Elbow Surgery, Department of Orthopaedic Surgery, Alpert Medical School, Brown University. Providence, Rhode Island
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Kawamura K, Naito K, Suzuki T, Yamamoto Y, Kawakita S, Imazu N, Ishijima M. Factors that interfere with immediate return to activity following volar locking plate fixation for distal radius fractures. MEDICINE INTERNATIONAL 2024; 4:65. [PMID: 39169985 PMCID: PMC11336805 DOI: 10.3892/mi.2024.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 07/30/2024] [Indexed: 08/23/2024]
Abstract
In the present study, the clinical findings that interfere with the immediate return to activity following volar locking plate (VLP) fixation for distal radius fractures were investigated. A total of 95 patients who underwent VLP fixation for distal radius fracture between July, 2014 and January, 2022 were divided into a good group (good score and outcome; n=86; 22 males and 64 females; median age, 61 years) and a poor group (poor score and outcome; n=8; 8 females; median age, 63.6 years) according to the quartiles of the disabilities of the arm, shoulder and hand (Q-DASH) score, at 1 month following VLP fixation. The duration from injury to surgery, the direction of fracture dislocation and radiographic parameters [radial inclination (RI), volar tilt (VT) and ulnar variance (UV)] at the time of injury were examined. Radiographic parameters (RI, VT and UV), the range of motion of the wrist joint, grip strength ratio and visual analog scale (VAS) at 1 month following VLP fixation were also examined. These parameters were compared among both groups. Moreover, logistic regression analysis was performed to determine whether these factors were independently associated with a poor Q-DASH score at 1 month following VLP fixation. At the time of injury, fracture displacement was significantly higher in the poor group (VT, -23.8˚; UV, 4.2 mm) than the good group (VT, -6.5˚; P=0.02; UV, 1.3 mm; P=0.01). No differences in the other parameters were observed between the groups. At 1 month following VLP fixation, the grip strength ratio (17.2%) in the poor group was significantly lower than that in the good group (43.8%, P<0.001), while the VAS score (5.6) in the poor group was significantly higher than that in the good group (2.4, P<0.001). Logistic regression analysis revealed that VT and UV at injury (P<0.05), grip strength ratio (P<0.001) and pain (VAS score) (P<0.001) were all independently associated with a poor Q-DASH score. On the whole, the present study suggests that large amounts of fracture displacement, weakness of grip strength and post-operative pain can be factors interfering with the return to activity immediately following VLP fixation.
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Affiliation(s)
- Kenjiro Kawamura
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
- Department of Orthopaedics, Faculty of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Kiyohito Naito
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
- Department of Orthopaedics, Faculty of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Takamaru Suzuki
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
- Department of Orthopaedics, Faculty of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Yasuhiro Yamamoto
- Department of Orthopaedics, Faculty of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - So Kawakita
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
- Department of Orthopaedics, Faculty of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Norizumi Imazu
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
- Department of Orthopaedics, Faculty of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Muneaki Ishijima
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
- Department of Orthopaedics, Faculty of Medicine, Juntendo University, Tokyo 113-8421, Japan
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Ishigaki T, Yokota H, Akuzawa H, Akiho-Toyoda N, Ushiro K, Ebihara Y, Tanaka S, Wada T, Jigami H, Matsumoto H, Ito Y, Kikumoto T, Matsuura Y, Hirabayashi R, Sekine C, Yamamoto N, Omori G, Edama M. Translation and Cross-cultural Adaptation of the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score Into Japanese and Comparison of Visual Analog Scale and 10-Point Scale Formats. Orthop J Sports Med 2024; 12:23259671241291861. [PMID: 39564395 PMCID: PMC11574881 DOI: 10.1177/23259671241291861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Accepted: 04/29/2024] [Indexed: 11/21/2024] Open
Abstract
Background The Kerlan-Jobe Orthopaedic Clinic shoulder and elbow score (KJOC) is sensitive enough to detect subtle changes in the functional level of the shoulder or elbow in overhead athletes. However, a Japanese version of the KJOC is not yet available. Moreover, the original KJOC uses a visual analog scale (VAS) assessment format that requires a print version so that users can add a check mark along a horizontal line. The KJOC can be completed using online tools such as Google Forms if a 10-point scale format can be used with comparable results. Purposes To (1) translate and cross-culturally adapt the KJOC into Japanese (KJOC-J) and assess its validity and (2) evaluate the correlation between a standard VAS format and a 10-point scale format (KJOC-J10). Study Design Cohort study (Diagnosis); Level of evidence, 3. Methods In total, 318 athletes participated in the validation study, 255 in the test-retest reliability study for the KJOC-J, and 273 in the validation study for the KJOC-J10. Internal consistency was evaluated using the Cronbach alpha. Validity was evaluated by calculating the correlation between the KJOC-J and the Disability of the Arm, Shoulder and Hand (DASH). Test-retest reliability was assessed using the intraclass correlation coefficient (ICC). The validity of the KJOC-J10 was evaluated by calculating the correlation between the KJOC-J10 and KJOC-J. Results The Cronbach alpha was 0.914, indicating good internal consistency. The KJOC-J was moderately correlated with the DASH (r = -0.581; P < .001) and had good test-retest reliability (ICC, 0.874). A strong correlation was found between the KJOC-J and KJOC-J10 (r = 0.846; P < .001). Conclusion The study results demonstrated good internal consistency, validity, and reliability for the KJOC-J, indicating that it is a valid assessment tool for shoulder and elbow functions in Japanese overhead athletes. Moreover, a strong correlation was found between the VAS and 10-point formats of the KJOC-J.
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Affiliation(s)
- Tomonobu Ishigaki
- Athlete Support Research Center, Niigata University of Health and Welfare, Niigata City, Niigata, Japan; Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan; Institute of Life Innovation Research Center, Toyo University, Tokyo, Japan
| | - Hirotake Yokota
- Athlete Support Research Center, Niigata University of Health and Welfare, Niigata, Japan; Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Hiroshi Akuzawa
- Athlete Support Research Center, Niigata University of Health and Welfare, Niigata, Japan; Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Noriko Akiho-Toyoda
- Student Support Organization, Niigata University of Health and Welfare, Niigata, Japan
| | - Keisuke Ushiro
- Faculty of Physical Education, Department of Sports and Physical Education, Kokushikan University, Tama, Tokyo, Japan
| | - Yuki Ebihara
- Faculty of Physical Education, Department of Sports and Physical Education, Kokushikan University, Tama, Tokyo, Japan
| | - Shigeharu Tanaka
- Faculty of Physical Education, Department of Sports and Physical Education, Kokushikan University, Tama, Tokyo, Japan
| | - Tadashi Wada
- School of Science and Engineering, Human Informatics Course, Kokushikan University, Tokyo, Japan
| | - Hirofumi Jigami
- School of Science and Engineering, Human Informatics Course, Kokushikan University, Tokyo, Japan
| | - Hisashi Matsumoto
- Department of Rehabilitation, Orthopaedic Hokushin Hospital, Sapporo, Japan
| | - Yu Ito
- Department of Rehabilitation, Orthopaedic Hokushin Hospital, Sapporo, Japan
| | - Takanori Kikumoto
- Athlete Support Research Center, Niigata University of Health and Welfare, Niigata, Japan; Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Yuiko Matsuura
- Athlete Support Research Center, Niigata University of Health and Welfare, Niigata, Japan; Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Ryo Hirabayashi
- Athlete Support Research Center, Niigata University of Health and Welfare, Niigata, Japan; Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Chie Sekine
- Athlete Support Research Center, Niigata University of Health and Welfare, Niigata, Japan; Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Noriaki Yamamoto
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan; Department of Orthopedic Surgery, Niigata Rehabilitation Hospital, Niigata, Japan
| | - Go Omori
- Athlete Support Research Center, Niigata University of Health and Welfare, Niigata, Japan
| | - Mutsuaki Edama
- Athlete Support Research Center, Niigata University of Health and Welfare, Niigata, Japan; Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
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10
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Güngör S, Emi R Z, Tore NG, Çevi K K. Construct validity of the Hand10 questionnaire in patients with hand osteoarthritis. J Bodyw Mov Ther 2024; 40:1816-1820. [PMID: 39593529 DOI: 10.1016/j.jbmt.2024.10.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 07/26/2024] [Accepted: 10/14/2024] [Indexed: 11/28/2024]
Abstract
BACKGROUND The Hand10 questionnaire is a short, easy-to-understand, visual questionnaire developed for the functional assessment of upper extremity disorders. It consists of visuals of each item as well as facial expressions that reflect the degree of difficulty during the function. It has been stated that the Hand10 questionnaire is suitable for application in the elderly population due to its stated features. OBJECTIVE This study aimed to evaluate the validity of the Hand10 questionnaire in hand osteoarthritis, the prevalence of which increases with age. METHODS Patients filled the Hand10, Disabilities of the Arm, Shoulder, and Hand (DASH), and Australian/Canadian Osteoarthritis Hand Index (AUSCAN) questionnaires, once. Validity of Hand10 was determined with DASH and AUSCAN questionnaires using Pearson Correlation Coefficient analysis. RESULTS Sixty patients were enrolled in the study. The Hand10 score of the patients was 45.15 ± 25.81; DASH score was 76.31 ± 26.37, and AUSCAN score was 32.75 ± 15.58. The analysis revealed that Hand10 scores showed a positive correlation with DASH scores at a "very good" level (r = 0.71; p < 0.001; 95% confidence interval (CI) [0.55, 0.82]) and AUSCAN scores at an "excellent" level (r = 0.76; p < 0.001; 95% CI [0.63, 0.85]). CONCLUSION The Hand10 questionnaire is a valid tool in patients with hand OA. This questionnaire, which consists of ten items and includes pictures that have a positive effect on repeatability, is very practical in evaluating hand function in upper extremity disorders, especially in older age individuals.
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Affiliation(s)
- S Güngör
- Department of Physiotherapy and Rehabilitation, Health Science Institute, Gazi University, Ankara, Turkey.
| | - Z Emi R
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - N G Tore
- Department of Physiotherapy and Rehabilitation, Health Science Institute, Gazi University, Ankara, Turkey
| | - K Çevi K
- Department of Orthopedics and Traumatology, Etlik City Hospital, Ankara, Turkey
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11
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Yamamoto K, Motomiya M, Ono K, Matsui Y, Yasui K, Iwasaki N. Initial patient demographics affecting return to original work after traumatic hand injury in a rural area in Japan: A retrospective single-center study. J Orthop Sci 2024; 29:1280-1286. [PMID: 37839976 DOI: 10.1016/j.jos.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/23/2023] [Accepted: 09/05/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Time off work after traumatic hand injury not only affects individuals but also has socioeconomic repercussions, becoming a serious problem from the viewpoint of labor shortages. In depopulated rural areas, the impact of labor shortages due to time off work is more serious than in urban areas; however, few studies have examined return to original work in rural areas. The purpose of this study was to investigate the patient demographics at the time of hand injury that affect return to original work in a rural area of Japan. METHODS We retrospectively examined 246 patients with traumatic hand and/or forearm injuries who were working at the time of injury, and who underwent surgical operations and postoperative rehabilitation in a level II hospital in a rural agricultural area. We examined patients' initial demographic data, including gender, age, occupation (white or blue collar), employment status (self-employed, full-time, or part-time workers), complications other than hand injury, workers' compensation, dominant hand injury, and injury severity as determined using the modified Hand Injury Severity Score. Multivariate logistic regression analysis examined the association between initial patient demographics and return to original work within 150 days after injury. RESULTS In total, 186 patients (76 %) were able to return to original work within 150 days. A multivariate logistic regression analysis showed that three explanatory variables (i.e., severity of injury, complications other than hand injury, and female gender) significantly compromised return to original work. CONCLUSIONS In the treatment of traumatic hand injury, intensive support should be provided for return to original work for patients who are expected to have difficulty returning to work quickly. In addition, labor shortages can be mitigated by sharing information with the workplace about patients' prospects of return to original work.
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Affiliation(s)
- Kazuhiro Yamamoto
- Department of Medical Technology Occupational Therapy, Obihiro Kosei Hospital, Obihiro, Japan
| | - Makoto Motomiya
- Department of Orthopaedic Surgery, Obihiro Kosei Hospital Hand Center, Obihiro, Japan.
| | - Kota Ono
- Ono Biostat Consulting (Kota Ono is also an employee of AbbVie GK.), Japan
| | - Yuichiro Matsui
- Section for Clinical Education, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan; Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Keigo Yasui
- Department of Orthopaedic Surgery, Obihiro Kosei Hospital, Obihiro, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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12
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Matsumoto S, Yamashita Y, Chang X, Hasegawa T, Nishi K, Moriuchi T, Noguchi K, Nakao Y, Furukawa K, Higashi T. Effects of Disturbed Body Perception on Arm Function in Patients With Frozen Shoulder. Cureus 2024; 16:e69031. [PMID: 39391388 PMCID: PMC11464269 DOI: 10.7759/cureus.69031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2024] [Indexed: 10/12/2024] Open
Abstract
Purpose Considering pain-related beliefs, this study aimed to investigate the influence of disturbed body perception on arm function in patients with frozen shoulder (FS). Methods This study included 90 patients with FS who visited the orthopedic outpatient clinic. We recorded measurements including the Visual Analog Scale (VAS) for pain at rest and during movement, the quick disability of the arm, shoulder, and hand (QDASH) questionnaire for perceived arm function, the short version of the Pain Self-Efficacy Questionnaire-2 (PSEQ-2) for self-efficacy in pain, the short version of the Pain Catastrophizing Scale (PCS-6) for catastrophic thoughts about pain, the short version of the Tampa Scale for Kinesiophobia (TSK-11) for fear of movement, and the Fremantle Shoulder Awareness Questionnaire (FreSHAQ) for disturbed perception around the shoulder. For statistical analysis, we constructed three models. Model 1 used the QDASH score as the dependent variable, with gender, age, duration of disease onset, VAS score at rest, and VAS score during movement as control variables. Model 2 included pain-related beliefs (PSEQ-2, PCS-6, and TSK-11) added to the variables in Model 1. Model 3 further included the FreSHAQ to the variables in Model 2. We calculated the difference in the adjusted coefficients of determination (R² adj) from Model 1 to Model 2 and Model 3 to determine the amount of change (ΔR² adj). Additionally, we calculated the standardized regression coefficient (β-value) of the input factors to examine their effects. Result Hierarchical multiple regression analysis showed a ΔR² adj of 0.13 and 0.17 for Models 2 and 3, respectively, indicating an increase in ΔR²adj after adding the FreSHAQ. Furthermore, the FreSHAQ had the largest effect of all factors, with β = 0.27 (p<0.05). Conclusions The influence of disturbed body perception on perceived arm function in patients with FS was demonstrated, suggesting the importance of considering somatosensory factors in clinical practice.
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Affiliation(s)
- Shinichi Matsumoto
- Department of Health Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, JPN
- Department of Rehabilitation, Furukawa Miyata Orthopedic and Internal Medicine Clinic, Nagasaki, JPN
| | - Yuh Yamashita
- Department of Health Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, JPN
- Department of Rehabilitation, Morinaga Orthopedic Clinic, Saga, JPN
| | - Xiaoqian Chang
- Department of Health Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, JPN
| | | | - Keita Nishi
- Department of Physical Therapy, School of Health Science, Toyohashi Sozo University, Toyohashi, JPN
| | - Takefumi Moriuchi
- Department of Occupational Therapy Science, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, JPN
| | - Kaoru Noguchi
- Department of Rehabilitation, Furukawa Miyata Orthopedic and Internal Medicine Clinic, Nagasaki, JPN
| | - Yuichi Nakao
- Department of Rehabilitation, Furukawa Miyata Orthopedic and Internal Medicine Clinic, Nagasaki, JPN
| | - Keizo Furukawa
- Department of Orthopedics, Furukawa Miyata Orthopedic and Internal Medicine Clinic, Nagasaki, JPN
| | - Toshio Higashi
- Department of Health Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, JPN
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13
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Sato K, Ishigaki D, Iwabu S, Okazaki M, Koh S, Soejima O, Funakoshi T, Moriya K, Suzuki T, Ozasa Y, Sugiyama D. Japanese version of the Patient-rated elbow evaluation score correlates with physician-rated Japanese orthopaedic association-Japan elbow society elbow function score. J Orthop Sci 2024; 29:817-822. [PMID: 37173218 DOI: 10.1016/j.jos.2023.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/19/2023] [Accepted: 04/17/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND The association between Patient-Rated Elbow Evaluation: Japanese version (PREE-J) and Japanese Orthopaedic Association-Japan Elbow Society Elbow Function score (JOA-JES score) is unclear. This study evaluated the association between PREE-J and JOA-JES scores. METHODS The patients with elbow disorders were divided into two groups: Group A (conservative treatment, n = 97) and Group B (surgical treatment, n = 156). The patients were also divided into four disease subgroups according to the JOA-JES classification (rheumatoid arthritis, trauma, sports, and epicondylitis groups), and the association between PREE-J and JOA-JES scores in each disease category was examined. In group B, associations between PREE-J and JOA-JES scores were examined pre-and postoperatively. RESULTS In group A, there were significant associations between PREE-J and JOA-JES scores. In group B, a strong association between preoperative PREE-J and JOA-JES scores was observed in all disease categories. There was also a significant association between postoperative PREE-J and JOA-JES scores. Additionally, group B showed significant postoperative improvements in PREE-J and JOA-JES scores. CONCLUSIONS The PREE-J score correlates well with the JOA-JES score and reflects treatment response before and after treatment.
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Affiliation(s)
- Kazuki Sato
- Institute for Integrated Sports Medicine, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Daisuke Ishigaki
- Department of Orthopaedic Surgery, Saiseikai Yamagata Saisei Hospital, Yamagata, Japan
| | - Shohei Iwabu
- Department of Orthopaedic Surgery, Saiseikai Utsunomiya Hospital, Tochigi, Japan
| | - Masato Okazaki
- Department of Orthopaedic Surgery, Ogikubo Hospital, Tokyo, Japan
| | - Shukuki Koh
- Department of Orthopaedic Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan
| | - Osamu Soejima
- Department of Orthopaedic Surgery, Fukuoka Sanno Hospital, Fukuoka, Japan
| | - Tadanao Funakoshi
- Department of Orthopaedic Surgery, Keiyu Orthopaedic Hospital, Gunma, Japan
| | - Koji Moriya
- Department of Orthopaedic Surgery, Niigata Hand Surgery Foundation, Niigata Hand Care Center Niigata, Japan
| | - Taku Suzuki
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yasuhiro Ozasa
- Department of Orthopaedic Surgery, Sapporo Maruyama Orthopaedic Hospital, Hokkaido, Japan
| | - Daisuke Sugiyama
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
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14
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Shibahashi H, Murakawa M, Yuki I, Uno T, Takakubo Y, Takagi M. Patient Sex Is a Significant Factor in Arm Function Recovery After Arthroscopic Rotator Cuff Repair. Arthrosc Sports Med Rehabil 2024; 6:100834. [PMID: 38162587 PMCID: PMC10756958 DOI: 10.1016/j.asmr.2023.100834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 10/31/2023] [Indexed: 01/03/2024] Open
Abstract
Purpose The purpose of this study was to investigate the impact of patient sex on arm functional recovery after arthroscopic rotator cuff repair (ARCR). Methods We retrospectively reviewed the clinical records of patients who underwent rehabilitation after ARCR at two affiliated hospitals between January 2014 and December 2019. Patient characteristics included age, sex, type of muscle tear, tear location, muscle strength, Japanese Orthopedic Association (JOA) score, and patient responses to the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire. We used mixed-effects regression models with random intercepts to evaluate the QuickDASH scores, JOA scores, and muscle strength relative to the nonoperated side. Results Of the 124 patients, 82 (66.1%) were 65-year-old men and 42 (33.9%) were 67-year-old women. The preoperative JOA scores (P = .03) and those at 6 months (P < .001) and 12 months (P = .04) after ARCR were significantly greater for men than for women. QuickDASH scores of men were significantly lower at 24 months (P = .02) and all other time points (P < .001) than those of women. The improvement in QuickDASH scores was significantly higher for women than for men (P < .01). The results of the multiple regression analysis showed that patient sex (95% confidence interval, 0.01-0.45; P < .05) had an impact on QuickDASH scores at 24 months after ARCR. Conclusion In this study, patient sex was a significant factor affecting the recovery and QuickDASH scores of patients who underwent ARCR. Level of Evidence: Level IV, prognostic case series.
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Affiliation(s)
- Hirotomo Shibahashi
- Major of Occupational Therapy, Department of Rehabilitation, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan
| | - Miyuki Murakawa
- Department of Rehabilitation, Yamagata University Hospital, Yamagata, Japan
| | - Issei Yuki
- Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Tomohiro Uno
- Department of Rehabilitation, Yamagata University Hospital, Yamagata, Japan
- Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Yuya Takakubo
- Department of Rehabilitation, Yamagata University Hospital, Yamagata, Japan
- Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Michiaki Takagi
- Department of Rehabilitation, Yamagata University Hospital, Yamagata, Japan
- Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan
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15
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Moriya K, Maki Y, Yoshizu T. Forty-Two-Year Follow-Up After Heterodigital Vascularized Hemijoint Transfer: A Case Report. JOURNAL OF HAND SURGERY GLOBAL ONLINE 2023; 5:856-861. [PMID: 38106943 PMCID: PMC10721550 DOI: 10.1016/j.jhsg.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/22/2023] [Indexed: 12/19/2023] Open
Abstract
Heterodigital vascularized hemijoint transfer can theoretically produce a near normal joint by combining intact joint components from different fingers and maintaining the joint space over the long term. We present herein an extremely rare case of heterodigital vascularized hemijoint transfer with a 42-year follow-up, demonstrating the longevity of this joint reconstruction technique for the restoration of hand function. Our patient's outcome indicates that despite the gradual progression of osteoarthritic changes, good subjective results and maintenance of an active range of motion can be acquired even after a long period. Technical factors such as graft fixation and the congruity of the articular surface may influence the gradual degeneration of joint surfaces.
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Affiliation(s)
- Koji Moriya
- Niigata Hand Surgery Foundation, Seiro-machi, Niigata, Japan
| | - Yutaka Maki
- Niigata Hand Surgery Foundation, Seiro-machi, Niigata, Japan
| | - Takae Yoshizu
- Niigata Hand Surgery Foundation, Seiro-machi, Niigata, Japan
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16
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Stirling PHC, McEachan JE, Rodrigues JN, Harrison CJ. Improving the structural validity of the QuickDASH questionnaire: Exploratory factor analysis and structural equation modelling in 1798 patients with carpal tunnel syndrome. J Hand Ther 2023; 36:523-527. [PMID: 36914493 DOI: 10.1016/j.jht.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 03/16/2023]
Abstract
STUDY DESIGN Retrospective cohort. BACKGROUND The QuickDASH is a commonly used questionnaire for the assessment of carpal tunnel patients, although it is unclear whether the questionnaire has suitable structural validity PURPOSE: This study aimed to evaluate the structural validity of the QuickDASH patient-reported outcome measure (PROM), when used in CTS, through exploratory factor analysis (EFA) and structural equation modelling (SEM). METHODS Between 2013 and 2019, we recorded preoperative QuickDASH scores of 1916 patients undergoing carpal tunnel decompressions at a single unit. One hundred and eighteen patients with incomplete datasets were excluded leaving a final study group of 1798 patients with complete data. EFA was undertaken using the R statistical computing environment. We then conducted SEM in a random sample of 200 patients. Model fit was assessed using the chi-square (χ2) test, comparative fit index (CFI), Tucker-Lewis index (TLI), root mean square error of approximation (RMSEA) and standardized root mean square residuals (SRMR). A second "validation" SEM analysis was undertaken by repeating the analysis with a separate sample of 200 randomly-selected patients. RESULTS EFA revealed a 2-factor model: items 1-6 represented the first factor ("function") and items 9-11 measured a different factor ("symptoms"). SEM demonstrated excellent fit (χ2 p value 0.167, CFI 0.999, TLI 0.999, RMSEA 0.032, SRMR 0.046) and this was supported in our "validation" sample. CONCLUSIONS This study demonstrates that the QuickDASH PROM measures 2 distinct factors in CTS. This is comparable with the findings of a previous EFA that assessed the full-length Disabilities of the Arm, Shoulder and Hand PROM in patients with Dupuytren's disease.
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Affiliation(s)
- Paul H C Stirling
- Queen Margaret Hospital, Dunfermline, Fife, UK; Fife Virtual Hand Clinic, Dunfermline, Fife, UK.
| | - Jane E McEachan
- Queen Margaret Hospital, Dunfermline, Fife, UK; Fife Virtual Hand Clinic, Dunfermline, Fife, UK.
| | - Jeremy N Rodrigues
- Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, UK.
| | - Conrad J Harrison
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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17
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Moriya K, Maki Y, Koda H, Tsubokawa N. A Novel Reconstruction Technique for Chronic Distal Biceps Tendon Rupture: A Case Report. JBJS Case Connect 2023; 13:01709767-202309000-00039. [PMID: 37556579 DOI: 10.2106/jbjs.cc.23.00184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
CASE A 71-year-old otherwise healthy man presented with an 8-week history of elbow pain and weakness in both elbow flexion and forearm supination. Magnetic resonance imaging revealed complete rupture of the distal biceps tendon insertion associated with 65 mm of proximal retraction. At 10 weeks after initial injury, the patient underwent a novel reconstruction technique using a periosteal flap from the iliac crest; subsequently, all symptoms resolved. CONCLUSION Chronic distal biceps tendon injuries can be reconstructed safely and effectively using a periosteal flap from the iliac crest that allows not only rigid but also biological graft attachment.
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18
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Ajiki T, Murayama A, Hayashi Y, Takeshita K. Validation of a Handprint for Clinical Evaluation of Dupuytren's Contracture. J Hand Microsurg 2023; 15:181-187. [PMID: 37388561 PMCID: PMC10306974 DOI: 10.1055/s-0041-1735347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Objective We have developed a handprint-based method for visualizing and quantifying the palmar contact of patients with Dupuytren's contracture. The purpose of this study was to examine whether the generated handprint was useful for assessing the severity of flexion contracture of the fingers and for evaluating the therapeutic effects of collagenase clostridium histolyticum (CCH) injection for Dupuytren's contracture. Methods The handprint was created by applying medical-grade ethanol-containing hand sanitizer over the entire palmar surface of the affected hand and then pressing it on thermal paper for word processors. The reliability of the handprint was evaluated through test-retest of 10 healthy volunteers at an interval of 10 days, and the validity of the handprint was assessed using a flexion contracture model in which the little finger was fixed in an Alfence splint. In addition, we obtained handprints of the affected hand in 33 patients with unilateral Dupuytren's contracture both before CCH injection and at the final observation after injection to investigate the contact area of the hand (CAH) and the length of the hand (LH). The relationships between CAH, LH, total extension deficit angle (TEDA), and patient-reported outcome measures (Japanese Society for Surgery of the Hand Version of the Quick Disability of Arm, Shoulder, and Hand Questionnaire [Quick DASH-JSSH] and Hand20) were examined. Results The test-retest correlation coefficient was 0.9187 ( p < 0.001) for CAH and 0.9052 ( p < 0.001) for LH, indicating high reliability of the handprint. The ratios of CAH and LH decreased gradually as the contracture angle of the splinted finger increased. The handprint revealed a marked improvement of palmar contact after CCH injection for Dupuytren's contracture. Furthermore, the ratios of CAH and LH were strongly correlated with TEDA, Quick DASH-JSSH, and Hand20 before treatment. Conclusion Our handprint-based assessment method was extremely useful for clinical evaluation of CCH treatment for Dupuytren's contracture. Type of Study/Level of Evidence Therapeutic.
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Affiliation(s)
- Takashi Ajiki
- Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan
- Department of Orthopedic Surgery, Ishibashi General Hospital, Tochigi, Japan
| | - Akira Murayama
- Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan
| | - Yukinori Hayashi
- Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan
| | - Katsushi Takeshita
- Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan
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19
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Yuine H, Mutsuzaki H, Yoshii Y, Shimizu Y, Ishida N, Yasuda T, Iwai K, Hotta K, Shiraishi H, Tachibana K. Evaluation of hand functions and distal radioulnar joint instability in elite wheelchair basketball athletes: a cross-sectional pilot study. BMC Sports Sci Med Rehabil 2023; 15:58. [PMID: 37061701 PMCID: PMC10105936 DOI: 10.1186/s13102-023-00658-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 03/24/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Wrist injury affects wheelchair basketball players' performance; however, the relationship between distal radioulnar joint (DRUJ) instability and hand functions is unclear. This cross-sectional pilot study investigated DRUJ instability in elite female wheelchair basketball athletes using force-monitor ultrasonography. METHODS Nine elite female wheelchair basketball athletes (18 wrists) were included in the study. A triangular fibrocartilage complex (TFCC) injury was confirmed using magnetic resonance imaging (MRI). Hand functions were evaluated based on the range of motion (ROM) of wrist palmar flexion, dorsiflexion, radial deviation, and ulnar deviation; grip strength; arm circumference; forearm circumference; and DRUJ instability or pain using the ballottement test. The Mann-Whitney U test was used to compare parameters between the TFCC-injured and intact wrists. Radioulnar displacement was measured using force-monitor ultrasonography and pressure data, and the displacement-to-force ratio was used as an indicator of DRUJ instability. The correlation between the DRUJ displacement-to-force ratio and each hand function assessment was evaluated using Pearson correlation coefficient for the TFCC-injured and intact wrists. A generalized linear mixed model (GLMM) was used to estimate the relationship between hand functions and DRUJ instability. RESULTS TFCC injuries in seven wrists were confirmed using MRI findings (38.9%). The ulnar deviation ROM values of the TFCC-injured wrist (n = 7) and intact (n = 11) groups were 38.6 ± 8.0° and 48.6 ± 7.8°, respectively. The ulnar deviation ROM was significantly smaller in the TFCC-injured wrists (p = 0.02, r = - 0.54). In the TFCC-injured wrists, no correlation was observed between the displacement-to-force ratio and the hand function assessment. In contrast, the displacement-to-force ratio negatively correlated with grip strength, arm circumference, and forearm circumference in the intact wrists (Pearson correlation coefficient r = - 0.78, - 0.61, and - 0.74, respectively). The GLMM showed that the displacement-to-force ratio significantly affected grip strength, arm circumference, and forearm circumference in the intact group. CONCLUSIONS In intact wrists, correlations were observed between hand functions such as upper arm/forearm strength and DRUJ stability evaluated using ultrasound. Maintaining and strengthening grip strength, forearm circumference, and arm circumference are associated with DRUJ stability and may be related to TFCC injury prevention in wheelchair basketball athletes. TRIAL REGISTRATION The protocol was registered with the UMIN Clinical Trials Registry (UMIN000043343) [Date of first registration: 16/02/2021].
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Affiliation(s)
- Hiroshi Yuine
- Department of Occupational Therapy, School of Health Sciences, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Ami-Machi, Inashiki-Gun, Ibaraki, 300-0394, Japan.
| | - Hirotaka Mutsuzaki
- Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki, 300-0394, Japan
| | - Yuichi Yoshii
- Department of Orthopaedic Surgery, Tokyo Medical University Ibaraki Medical Center, Ami, Ibaraki, 300-0395, Japan
| | - Yukiyo Shimizu
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Natsuki Ishida
- Geriatric Health Services Facility Nadeshiko, Tsukuba, Ibaraki, 300-4245, Japan
| | - Taku Yasuda
- Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki, 300-0394, Japan
| | - Koichi Iwai
- Center for Humanities and Sciences, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki, 300-0394, Japan
| | - Kazushi Hotta
- Department of Occupational Therapy, School of Health Sciences, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Ami-Machi, Inashiki-Gun, Ibaraki, 300-0394, Japan
| | - Hideki Shiraishi
- Department of Occupational Therapy, School of Health Sciences, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami, Ami-Machi, Inashiki-Gun, Ibaraki, 300-0394, Japan
| | - Kaori Tachibana
- Department of Physical Therapy, School of Health Sciences, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki, 300-0394, Japan
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Hihara M, Kuro A, Mitsui T, Kakudo N. Twenty-minute harvesting of flow-through type vastus lateralis muscle flap significantly reduces the need for a temporary intravascular shunt in the treatment of severe upper extremity trauma in civilian patients. Medicine (Baltimore) 2023; 102:e33311. [PMID: 36930070 PMCID: PMC10019110 DOI: 10.1097/md.0000000000033311] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 02/27/2023] [Indexed: 03/18/2023] Open
Abstract
For the reconstruction of severe upper extremity trauma involving arterial injury in civilian patients, it is generally recommended that the revascularization time be shortened using a temporary intravascular shunt (TIVS). However, if a flow-through type vastus lateralis muscle (VLm) flap can be harvested in 20 minutes and bypassed at the obstructed ischemic zone within 30 minutes, blood flow can be restored as quickly or more quickly than when using a TIVS, eliminating the need for a TIVS. This procedure was applied in the reconstruction of 3 cases of severe extremity trauma with vascular injury. The mean age was 69.7 years. Surgery was started an average of 2.93 hours from the onset. The average flap harvest time was 0.33 hours. The average time to revascularization from flap harvest was 1.33 hours, the average total operation time was 6.43 hours, and all upper extremities were salvaged. No cases showed ischemia-reperfusion injury or severe muscle contracture. The flow-through-type VLm flap can be applicable as a bypass graft for a 20 cm defect at any region distal to the elbow. In addition, harvesting the flap attached to blood-rich muscle not only controls the infection of contaminated wounds through the filling of dead space, but also has the potential to replace damaged muscle or tendon tissue. Even though TIVS placement is currently used extensively in this field of treatment, its role could be significantly reduced if a flow-through-type VLm flap can be harvested within 20 minutes.
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Affiliation(s)
- Masakatsu Hihara
- Department of Plastic and Reconstructive Surgery, Kansai Medical University, Osaka, Japan
| | - Atsuyuki Kuro
- Department of Plastic and Reconstructive Surgery, Kansai Medical University, Osaka, Japan
| | - Toshihito Mitsui
- Department of Plastic and Reconstructive Surgery, Kansai Medical University, Osaka, Japan
| | - Natsuko Kakudo
- Department of Plastic and Reconstructive Surgery, Kansai Medical University, Osaka, Japan
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21
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Isobe F, Hayashi M, Kobayashi R, Nakamura M, Kosho T, Takahashi J. Clinical Presentation and Characteristics of the Upper Extremity in Patients with Musculocontractural Ehlers-Danlos Syndrome. Genes (Basel) 2022; 13:1978. [PMID: 36360214 PMCID: PMC9689626 DOI: 10.3390/genes13111978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 10/25/2022] [Indexed: 09/08/2024] Open
Abstract
Musculocontractural Ehlers-Danlos syndrome (mcEDS) is a subtype of EDS caused by defective dermatan sulfate biosynthesis, characterized by multiple malformations (craniofacial features, ocular and visceral malformations) and progressive cutaneous, skeletal, vascular, and visceral fragility-related manifestations. Repeated dislocations and deformities of the joints due to joint relaxation are observed, causing serious damage to the musculoskeletal system of the whole body; however, the motor function of the upper limbs and the morphology of the bone joints have not been systematically investigated. In this study, we present a detailed and comprehensive report on upper limb lesions of 13 patients with a mean age at the first visit of 21 years. Twelve patients (92.3%) had a history of dislocation. Eleven patients (84.6%) had shoulder dislocations, and two patients (15.4%) had elbow dislocations. Four patients (30.8%) had elbow osteoarthritis, and three patients (23.1%) had distal radioulnar joint (DRUJ) osteoarthritis. The phalanges and metacarpals are thin, and the ratio of medullary cavity of the metacarpal bone decreases with age. As bone and joint deformity progresses, patients with mcEDS should be recommended to receive regular follow-up, including radiology. The present findings suggest an important role for dermatan sulfate in the maintenance of the skeletal system.
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Affiliation(s)
- Fumihiro Isobe
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto 390-8621, Japan
| | - Masanori Hayashi
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto 390-8621, Japan
| | - Rena Kobayashi
- Shinshu University School of Medicine, Matsumoto 390-8621, Japan
| | - Manami Nakamura
- Shinshu University School of Medicine, Matsumoto 390-8621, Japan
| | - Tomoki Kosho
- Department of Medical Genetics, Shinshu University School of Medicine, Matsumoto 390-8621, Japan
- Center for Medical Genetics, Shinshu University Hospital, Matsumoto 390-8621, Japan
- Division of Clinical Sequencing, Shinshu University School of Medicine, Matsumoto 390-8621, Japan
- Research Center for Supports to Advanced Science, Shinshu University, Matsumoto 390-8621, Japan
| | - Jun Takahashi
- Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto 390-8621, Japan
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22
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Yuine H, Yoshii Y, Miyata K, Shiraishi H. Quantitative assessment of the course of distal radioulnar joint instability. HAND THERAPY 2022; 27:83-90. [PMID: 37905198 PMCID: PMC10588430 DOI: 10.1177/17589983221113872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 06/29/2022] [Indexed: 11/02/2023]
Abstract
Introduction There is a lack of methods to objectively evaluate improvement in distal radioulnar joint (DRUJ) instability through treatment. We used ultrasonography to assess DRUJ instability and calculated the minimal detectable change (MDC) in healthy individuals. MDC was used to evaluate post-treatment changes in a patient with triangular fibrocartilage complex (TFCC) injury. Methods DRUJ instability was evaluated using force-monitor ultrasonography in eight healthy male participants to determine MDC and in a man in his 60s who underwent surgery and rehabilitation for TFCC injury (Palmer classification: type 2C). In the patient, DRUJ instability was measured pre-operatively, 3 months postoperatively, and 1 year post-operatively. Self-reported hand and upper limb functional ability were also recorded. The transducer of the force-monitor ultrasonographic system was used to apply cyclic compressions to the wrists automatically and measure DRUJ displacements. The amount of displacement was calculated using the distance between the radius and ulna before and during cyclic compression to the wrists. The applied pressure was measured as the force to the wrist, and the displacement-to-force ratio was calculated. Results The 95% confidence MDC95 for radioulnar displacement, displacement force, and displacement-to-force ratio were 0.27-0.31 mm, 0.30-0.59 N, and 0.12-0.15 mm/N, respectively. The patient's post-operative decrease in displacement exceeded the MDC95. DRUJ stability, pain, and use of the affected hand in daily life improved. Discussion Force-monitor ultrasonography can quantitatively evaluate post-treatment improvement in DRUJ stability over time. MDC for DRUJ instability can assess recovery after treatment or rehabilitation and determine changes resulting from interventions.
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Affiliation(s)
- Hiroshi Yuine
- Department of Occupational Therapy, School of Health Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
| | - Yuichi Yoshii
- Department of Orthopaedic Surgery, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan
| | - Kazuhiro Miyata
- Department of Physical Therapy, School of Health Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
| | - Hideki Shiraishi
- Department of Occupational Therapy, School of Health Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
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Pitfalls and suggestions for the treatment of open, comminuted fractures of the middle phalanx using custom made dynamic external fixators: a retrospective case series. CURRENT ORTHOPAEDIC PRACTICE 2022. [DOI: 10.1097/bco.0000000000001157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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24
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Tajika T, Kuboi T, Endo F, Chikuda H. Relationship Between Morphological Change of Median Nerve and Clinical Outcome Before and After Open Carpal Tunnel Release: Ultrasonographic 1-Year Follow-up After Operation. Hand (N Y) 2022; 17:534-539. [PMID: 32643958 PMCID: PMC9112745 DOI: 10.1177/1558944720937367] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The aims of this study were 2-fold: (1) to assess the morphological change of the median nerve in patients with carpal tunnel syndrome (CTS) preoperatively and at 6 and 12 months postoperatively; and (2) to analyze correlation between the changes in ultrasonographic findings and the changes in clinical findings after surgical decompression. Methods: Of the 28 patients with CTS, 34 wrists were treated with open carpal tunnel release. We evaluated them using the Boston questionnaire, Japanese Society for Surgery of the Hand Version of the Quick Disability of the Arm, Shoulder, and Hand questionnaire, nerve conduction study (NCS), and ultrasound preoperatively and at 6 and 12 months postoperatively. We measured the cross-sectional area (CSA) of the median nerve at the level of the proximal inlet of the carpal tunnel (CSAc) and more proximally at the level of the distal radioulnar joint (CSAd). Paired t tests and repeated measures analysis of variance of ranks were used to identify changes over time. The Spearman correlation coefficient by rank test was used for the analysis of the relation between the amount of change of CSA and the patient-rated questionnaire score and NCS findings. Results: Findings for CSAc, CSAd, and NCS and patient-rated outcomes at 6 and 12 months postoperatively were significantly lower than their preoperative values. However, no significant correlation was found between the postoperative changes in CSAc, CSAd, and clinical variables obtained preoperatively and postoperatively. Conclusions: Evaluation of sonographic imaging might not be helpful for assessing clinical conditions in patients with CTS after surgical decompression.
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Affiliation(s)
- Tsuyoshi Tajika
- Gunma University, Maebashi, Japan,Tsuyoshi Tajika, Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, 3-39-22 Showa-machi, Maebashi 371-8511, Gunma, Japan.
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25
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Doi K, Sem SH, Hattori Y, Sakamoto S, Hayashi K. Psychometric Evaluation of the Disabilities of the Arm, Shoulder and Hand Outcome Questionnaire for Brachial Plexus Injury Using Rasch Analysis. J Hand Surg Asian Pac Vol 2022; 27:285-293. [PMID: 35404203 DOI: 10.1142/s2424835522500230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is the most widely used patient-reported outcome measure (PROM) for assessment of upper extremity disability assessment. However, DASH is a multidimensional measurement with different difficulty levels and ratio apportionment of the items categorised by ordinal scale. This has caused a misinterpretation of the total disability scores. We created a modified DASH adapted to the Rasch model. The aim of this study is to compare the functional recovery and quality of life (QOL) improvement and to assess the validity of the original DASH and modified DASH between C56/C567, C5-8 and total types of brachial plexus injury (BPI) following surgical reconstruction. Methods: A total of 183 BPI patients who underwent reconstructive surgery were evaluated for functional recovery using the range of motion and power of the affected limb, and improvement in QOL with DASH. The collected data were analysed using Rasch measurement theory to detect the misfit items. The original and modified DASH were compared under the three different types of BPI after item reduction by removing the misfit items. Results: There were significant differences in functional recovery between three types of palsy. However, PROM using DASH score with or without misfit items (12 items) did not show any significant differences. Conclusions: DASH is not suitable for comparison of upper extremity disabilities even after being corrected mathematically due to the inclusion of items from many different domains unequally. Therefore, each item of the function (with or without compensation of the uninjured hand), pain and impact to the patients should be evaluated separately. Level of Evidence: Level IV (Prognostic).
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Affiliation(s)
- Kazuteru Doi
- Department of Orthopaedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi, Japan
| | - Sei Haw Sem
- Department of Orthopaedics, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia
| | - Yasunori Hattori
- Department of Orthopaedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi, Japan
| | - Sotetsu Sakamoto
- Department of Orthopaedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi, Japan
| | - Kota Hayashi
- Department of Orthopaedic Surgery, Ogori Daiichi General Hospital, Ogori, Yamaguchi, Japan
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Fujibuchi T, Imai H, Jono A, Kiyomatsu H, Miura H. Preiser disease in a child before complete ossification of the scaphoid: a case report. BMC Musculoskelet Disord 2022; 23:265. [PMID: 35303840 PMCID: PMC8933920 DOI: 10.1186/s12891-022-05226-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/15/2022] [Indexed: 11/23/2022] Open
Abstract
Background The pathology of Preiser disease remains controversial, and treatment for Preiser disease has not yet been standardised. Preiser disease itself is rare, and although it can be found in children, its presentation is even rarer; therefore, the treatment of paediatric patients with Preiser disease is more unclear than adult cases. Case presentation A 10-year-old boy who complained of left wrist pain was diagnosed with Preiser disease from osteosclerosis and segmentation on plain radiography and computed tomography, and low signal intensity on both T1- and T2-weighted images on magnetic resonance imaging. Because the patient was a child whose scaphoid was immature and pre-ossified, we chose a conservative immobilisation treatment with a thumb spica cast followed by an orthosis. After 3 months of immobilisation, the distal pole of the scaphoid showed remodelling. One year after the initial visit, plain radiography showed remodelling of the whole scaphoid, although magnetic resonance T1-weighted image showed that the recovery of intensity change was only observed in the distal pole. Two years after the initial visit, both plain radiography and magnetic resonance imaging showed a normal appearance and 5 years after the initial visit; the scaphoid bone showed normal development. Conclusions This is the first case report of Preiser disease before complete ossification of the scaphoid; therefore, we cannot say anything definitive about the treatment strategy. However, our experience suggests that conservative treatment may provide a cure for Preiser disease in children with immature ossification of the scaphoid without carpal collapse.
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Affiliation(s)
- Taketsugu Fujibuchi
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
| | - Hiroshi Imai
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Akihiro Jono
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Hiroshi Kiyomatsu
- Department of Bone and Joint Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
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27
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Hihara M, Takeji K, Mitsui T, Fujita M, Satou A, Himejima T, Kakudo N, Kusumoto K. Reconstruction of extra-large severe punching hole injury in the palm: A case report. Trauma Case Rep 2022; 39:100638. [PMID: 35368722 PMCID: PMC8965141 DOI: 10.1016/j.tcr.2022.100638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 11/29/2022] Open
Abstract
A 48-year-old man sustained a severe punching hole injury of 8 cm in diameter on the palm of his left hand using a punching instrument (for making the bottom of drink cans), and his middle and ring fingers were almost amputated. A flow-through type immediate ALT (anterolateral thigh) flap was used to bypass the distal blood flow and a titanium plate for mandibular reconstruction and plantar glabrous skin were used to preserve the floating amputated fingers. As there has been no report of reconstruction of a punching hole in the palmar region that exceeds 8 cm in diameter, this report is novel and educational.
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Affiliation(s)
- Masakatsu Hihara
- Corresponding author at: Department of Plastic and Reconstructive Surgery, Kansai Medical University, 2-5-1, Shin-machi, Hirakata, Osaka 573-1010, Japan.
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“Idiopathic” Shoulder Pain and Dysfunction from Carpal Tunnel Syndrome and Cubital Tunnel Syndrome. Plast Reconstr Surg Glob Open 2022; 10:e4114. [PMID: 35198346 PMCID: PMC8856120 DOI: 10.1097/gox.0000000000004114] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 12/14/2021] [Indexed: 11/26/2022]
Abstract
As a referral center for chronic pain, we see many patients with “idiopathic” shoulder pain and limited range of motion. The combination of mild or subclinical carpal tunnel syndrome and cubital tunnel syndrome may be an underrecognized etiology of symptoms in such patients. Here, we report our treatment algorithm and results for such patients.
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PERÇİN A. COVİD-19 PANDEMİSİ SÜRESİNCE UZAKTAN EĞİTİM GÖREN ÜNİVERSİTE ÖĞRENCİLERİNİN YAŞADIĞI BOYUN VE ÜST EKSTREMİTE AĞRILARI VE DİZABİLİTE. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2022. [DOI: 10.17517/ksutfd.1032043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objective: Musculoskeletal system problems emerged in students who had to attend classes with a computer or smartphone during the weekly course hours, due to the fact that the universities providing face-to-face education switched to the online method of distance education due to the Covid-19 pandemic. Purpose of the study; To determine the severity of the pain experienced by the students, to reveal its relationship with disability, and to find the factors that induce pain and disability in daily life.
Method: 100 students between the ages of 18-25, who attended distance education for at least 2 academic semesters and met the study criteria were included in the study. After the Sociodemographic Data Questionnaire was applied to the students included in the study, the Arm, Shoulder and Hand Problems Quick Questionnaire (Q-DASH), Neck Disability Index and NRS tests were applied.
Results: As a result of the Quick Questionnaire for Arm, Shoulder and Hand Problems (Q-DASH), 43% of the students included in the study had moderate disability, and according to the Neck Disability Index, 37% of the study group had complete disability. According to multivariate regression analysis, gender (p
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Gamo K, Baba N, Kakimoto T, Kuratsu S. Efficacy of Hand Therapy After Volar Locking Plate Fixation of Distal Radius Fracture in Middle-Aged to Elderly Women: A Randomized Controlled Trial. J Hand Surg Am 2022; 47:62.e1-62.e7. [PMID: 34607738 DOI: 10.1016/j.jhsa.2021.08.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 06/05/2021] [Accepted: 08/04/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE This study aimed to evaluate the efficacy of hand therapy after volar locking plate fixation of distal radius fractures in middle-aged to elderly women. METHODS Fifty-seven patients diagnosed with distal radius fractures who had undergone volar plate fixation were enrolled in a prospective, randomized controlled trial. Patients were randomized into the hand therapy and independent exercise (IE) groups, in which they exercised independently under the surgeon's direction with and without hand therapy, respectively. The primary outcome was the functional outcome measured using the Disability of Arm, Shoulder, and Hand questionnaire after 6 weeks. The secondary outcomes were functional outcomes measured using the Patient-Rated Wrist Evaluation questionnaire, active and passive ranges of motion (ROMs), grip strength, key pinch strength, and pain measured on a visual analog scale. Patients were followed up in the outpatient department at 2, 4, 6, and 8 weeks and at 3 and 6 months. RESULTS The Disability of Arm, Shoulder, and Hand scores were significantly lower in the hand therapy group at 6 weeks after surgery (12.5 vs 19.4 in the IE group). The postoperative visual analog scale pain scores were significantly lower in the hand therapy group at 2, 4, and 6 weeks (10.2 vs 17.6 in the IE group). The active ROM of the wrist flexion-extension arc at 2, 4, 6, and 8 weeks; active ROM of the pronation-supination arc at 6 and 8 weeks; and passive ROM of the wrist flexion-extension arc at 2, 4, and 8 weeks were significantly greater in the hand therapy group. CONCLUSIONS Hand therapy improved the outcomes after volar locking plate fixation for distal radius fracture in middle-aged to elderly women at 8 weeks after surgery. No significant between-group differences were observed in any functional outcome measure at 6 months after surgery, as previously reported. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic II.
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Affiliation(s)
- Kazushige Gamo
- Department of Orthopaedic Surgery, Bellland General Hospital, Osaka, Japan.
| | - Nanako Baba
- Department of Rehabilitation, Bellland General Hospital, Osaka, Japan
| | - Tomohiro Kakimoto
- Department of Rehabilitation, Bellland General Hospital, Osaka, Japan
| | - Shigeyuki Kuratsu
- Department of Orthopaedic Surgery, Bellland General Hospital, Osaka, Japan
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Measurement properties of the Nepali version of the Quick-DASH in patients with shoulder pain. Musculoskelet Sci Pract 2021; 56:102437. [PMID: 34416559 DOI: 10.1016/j.msksp.2021.102437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 07/07/2021] [Accepted: 07/31/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE To examine the measurement properties of the Nepali version of the Quick-Disabilities of the Arm, Shoulder and Hand (QuickDASH-NP). MATERIALS AND METHODS The Nepali DASH and Shoulder Pain and Disability Index (SPADI) were completed at baseline assessment, and again at follow-up with the Nepali Global Rating of Change (GROC-NP) score. The 11 items of the QuickDASH-NP were extracted from the DASH and tested for confirmatory factory analysis (CFA), exploratory factor analysis (EFA), internal consistency (α), item-total correlation (ITC), test-retest reliability (ICC), measurement errors, hypothesis testing (correlation with DASH and SPADI) and responsiveness (effect size-ES, standardised response mean-SRM). RESULTS A total of 156 participants completed questionnaires at baseline and 121 at follow-up with all questionnaires valid (no participant leaving more than one question blank). CFA suggested a poor fit for the single-factor model. The EFA demonstrated two factors with acceptable internal consistency (α = 0.79 and 0.75) for each factor. The test-retest reliability was excellent (ICC = 0.94; 95%CI:0.92-0.98), correlation was positive and very strong with the DASH-NP (r = 0.96) and strong with the SPADI-NP (r = 0.81). The Standard Error of Measurement was 2.83 and Smallest Detectable Change 7.84/100. The ES and SRM were moderate to high. CONCLUSIONS The QuickDASH-NP is reliable, valid, and able to detect change in shoulder symptoms among Nepali participants. It offers a short, easy to complete self-reporting tool for clinical use and research.
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Tajika T, Kuboi T, Endo F, Hatori Y, Chikuda H. Reverse wedge osteotomy for Madelung's deformity in a high school student: A case report. SAGE Open Med Case Rep 2021; 9:2050313X211049898. [PMID: 34616556 PMCID: PMC8488512 DOI: 10.1177/2050313x211049898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 09/13/2021] [Indexed: 11/17/2022] Open
Abstract
Madelung deformity is a congenital disorder with the malformation of anterior ulnar bowing of radius and a dorsally protruding ulnar head caused by premature growth disturbance at the medial volar aspect of the distal radius. This report describes a bilateral idiopathic Madelung deformity in a 17-year-old woman treated successfully using reverse wedge osteotomy of the distal radius in a symptomatic left wrist. Reverse wedge osteotomy can orient the radial joint surface while correcting the whole radius length by reversely putting the wedge bone removed from the distal metaphysis of radius, the base of which is cut from the surplus of the radial and dorsal cortical bone in the hypotrophic portion. We corrected the palmar subluxation of the carpus, restored her good function, and relieved her wrist pain.
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Affiliation(s)
- Tsuyoshi Tajika
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| | - Takuro Kuboi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Fumitaka Endo
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Yuhei Hatori
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Hirotaka Chikuda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
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33
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Accuracy of Quick-DASH tool versus CTS-6 tool in evaluating the outcome of carpal tunnel release. EUROPEAN JOURNAL OF PLASTIC SURGERY 2021. [DOI: 10.1007/s00238-021-01880-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hama S, Okada M, Yokoi T, Uemura T, Nakamura H. Pain and numbness one month after carpal tunnel release predict patient-reported outcome measures at sixth months. J Plast Surg Hand Surg 2021; 56:167-171. [PMID: 34324405 DOI: 10.1080/2000656x.2021.1953041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A number of outcome predictors for carpal tunnel release (CTR) for carpal tunnel syndrome (CTS) have been reported. However, some predictors are controversial, and few studies have referred to the early postoperative outcome prognostic factors after CTR. The aim of this study was to investigate whether pain and numbness at 1 month post-CTR were early postoperative predictors of clinical outcomes 6 months after surgery. Pain and numbness were evaluated using the visual analog scale (VAS) preoperatively and at 1 month post-surgery. Patient-reported outcome measures (PROMs), including the Quick Disabilities of the Arm, Shoulder and Hand (QDASH) measure, the Hand20 questionnaire and the Boston Carpal Tunnel Questionnaire (BCTQ), were recorded for each patient 6 months after surgery. The BCTQ consisted of the Symptom Severity Scale (SSS) and Functional Status Scale (FSS). Multivariable linear regression analysis was performed to investigate the association between the VAS scores and PROMs. We retrospectively identified 93 patients who underwent open carpal tunnel release (OCTR) or endoscopic carpal tunnel release. The mean age of the patients was 67.5 years, and 67 patients (72.0%) were female. Sixty patients were treated by OCTR (65.0%). With multivariable linear regression analysis, we found that pain and numbness, evaluated with VAS 1 month post-surgery had significant correlations with QDASH, Hand20, SSS and FSS 6 months after surgery. In conclusion, pain and numbness 1 month after CTR predict PROMs at 6 months.
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Affiliation(s)
- Shunpei Hama
- Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Mitsuhiro Okada
- Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Takuya Yokoi
- Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Takuya Uemura
- Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.,Department of Orthopedic Surgery, Osaka General Hospital of West Japan Railway Company, Osaka, Japan
| | - Hiroaki Nakamura
- Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
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Hosokawa T, Tajika T, Suto M, Chikuda H. The Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores in 961 Japanese volunteers. J Orthop Surg (Hong Kong) 2021; 28:2309499020970656. [PMID: 33169638 DOI: 10.1177/2309499020970656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Patient-reported outcomes recently have been used to assess treatment outcomes. The Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) is a particularly convenient and useful tools. However, data on the normative values of Japanese population are lacking, so the present study was conducted to gather this information. METHODS We assessed 1098 volunteers over 18 years of age (363 men and 735 women, average 50 years old) who had not received upper limb treatment in a medical facility. These participants included our institution's staff, their family members, and the participants in the group meetings held by institution's staff. Their occupations were also examined. We divided occupations into nonmanual and manual labor. These factors of the participants were then analyzed to clarify which (if any) influenced the QuickDASH. RESULTS Valid answers were obtained from 961 subjects (87.5%). The median score was 2 (mean: 4.8) in the overall population, 0 (mean: 2.6) in men, and 2.5 (mean: 6.0) in women. The scores increased with age and were higher in women than in men. There were no significant differences by manual labor. Female sex and older age were identified as factors that influenced the QuickDASH score in the multiple regression analysis. There were high correlations among QuickDASH, work and sports/music scores. CONCLUSIONS The present study provided QuickDASH scores for Japanese volunteers who had not received upper limb treatment in a medical facility. The scores were associated with older age and female sex. This study helps us to know the degree of potential upper limb impairment in the general population, and will help in populational strategies as primary and secondary preventive medicine for upper limb-related diseases.
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Affiliation(s)
- Takafumi Hosokawa
- Department of Orthopaedic Surgery, Tone Chuo Hospital, Numata, Gunma, Japan.,Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Tsuyoshi Tajika
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Morimichi Suto
- Department of Orthopaedic Surgery, Tone Chuo Hospital, Numata, Gunma, Japan
| | - Hirotaka Chikuda
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
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Alnahdi AH. Validity and reliability of the Arabic quick disabilities of the arm, Shoulder and Hand (QuickDASH-Arabic). Musculoskelet Sci Pract 2021; 53:102372. [PMID: 33780697 DOI: 10.1016/j.msksp.2021.102372] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 03/03/2021] [Accepted: 03/15/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The QuickDASH is a commonly used upper extremity region-specific outcome measure assessing activity limitation and symptoms. The Arabic version of QuickDASH is available in the official outcome measure website, but no prior studies have examined its psychometric properties. OBJECTIVE To examine the psychometric properties of the Arabic QuickDASH in patients with upper extremity musculoskeletal disorders. METHODS Participants with upper extremity musculoskeletal disorders were recruited (N = 109) using convenience sampling and completed the Arabic QuickDASH, Numeric Pain Rating Scale, Global Assessment of Function, and RAND 36-item Health Survey in two testing sessions (2-7 days apart). The Arabic QuickDASH structural validity, internal consistency, floor and ceiling effect, test-retest reliability, measurement error, and construct validity were examined. RESULTS Exploratory factor analysis indicated a one factor underlying the Arabic QuickDASH. The Arabic QuickDASH had Cronbach's alpha of 0.90 and ICC2.1 of 0.91 indicating excellent internal consistency and test-retest reliability. None of the participant reached the minimum or the maximum score. The scale's standard error of measurement and minimal detectable change were 7.0 and 16.3. Five out of the six construct validity predefined hypotheses were supported by the results. CONCLUSION The Arabic QuickDASH is a unidimensional scale with excellent internal consistency, test-retest reliability and acceptable measurement error. The Arabic Quick DASH is a valid and reliable outcome measure that can be used in Arabic speaking countries with Arabic patients suffering from various upper extremity activity limitations and symptoms.
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Affiliation(s)
- Ali H Alnahdi
- Rehabilitation Sciences Department, College of Applied Medical, Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia.
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Uehara K, Miura T, Takashi O, Doi T, Tanaka S, Morizaki Y. Development of a patient-oriented outcome measure for patients with hand and elbow disorder: HandQ. J Orthop Surg (Hong Kong) 2021; 28:2309499020959151. [PMID: 32996436 DOI: 10.1177/2309499020959151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE The Disabilities of the Arm, Shoulder, and Hand (DASH) is the most widely used patient-oriented outcome measure for the upper extremities in the world, and high reliability and validity of it has already been confirmed. However, there are several problems with using the DASH, some of which are culturally related. We aimed to (1) develop a patient-oriented disease-specific outcome measure for patients with disorders of the hand and elbow, which we call the HandQ and (2) examine the practical applicability, reliability, and validity of the HandQ for any patient with disorders of the hand and elbow. METHODS A total of 216 patients were surveyed with the HandQ, as well as the Hand20 and the DASH to assess psychometric characteristics. RESULTS There were no considerable floor and ceiling effects regarding the total HandQ score. Test-retest reliability and internal consistency determined using the intraclass correlation coefficient (0.942) and Cronbach's α test (0.961) were excellent. The HandQ was well correlated with the Hand20 and the DASH scores. Scree plot showed unidimensionality of the HandQ, and the graphical model showed the questionnaire items of the HandQ had reasonable correlation among each item. CONCLUSIONS The HandQ has a sufficient reliability and internal consistency, and an excellent validity, and was shown to be able to be practically applicable in all patients with hand and elbow disorders.
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Affiliation(s)
- Kosuke Uehara
- Department of Orthopaedic Surgery, 26782The University of Tokyo Hospital, Tokyo, Japan
| | - Toshiki Miura
- Department of Orthopaedic Surgery, 13622JR General Hospital, Tokyo, Japan
| | - Ohe Takashi
- Department of Orthopaedic Surgery, NTT Medical Center Tokyo, Tokyo, Japan
| | - Tokuhide Doi
- Geriatric Care Facility Narita-tomisato Tokushuen, Tomisato, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, 26782The University of Tokyo Hospital, Tokyo, Japan
| | - Yutaka Morizaki
- Department of Orthopaedic Surgery, 26782The University of Tokyo Hospital, Tokyo, Japan
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Nishigami T, Watanabe A, Maitani T, Shigetoh H, Mibu A, Wand BM, Catley MJ, Stanton TR, Moseley GL. Development and validation of a shoulder-specific body-perception questionnaire in people with persistent shoulder pain. BMC Musculoskelet Disord 2021; 22:98. [PMID: 33478446 PMCID: PMC7819341 DOI: 10.1186/s12891-021-03944-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 01/02/2021] [Indexed: 12/17/2022] Open
Abstract
Background There is evidence that people with persistent shoulder pain exhibit findings consistent with the presence of sensorimotor dysfunction. Sensorimotor impairments can manifest in a variety of ways, and further developing our understanding of sensorimotor dysfunction in shoulder pain may improve current models of care. The Fremantle Back Awareness Questionnaire (FreBAQ) has been developed to assess disturbed body perception specific to the back. The purpose of the present study was to develop a shoulder-specific self-perception questionnaire and evaluate the questionnaire in people with persistent shoulder pain. Methods The Fremantle Shoulder Awareness Questionnaire (FreSHAQ-J) was developed by modifying the FreBAQ. One hundred and twelve consecutive people with persistent shoulder pain completed the FreSHAQ-J. Thirty participants completed the FreSHAQ-J again two-weeks later to assess test-retest reliability. Rasch analysis was used to assess the psychometric properties of the FreSHAQ-J. Associations between FreSHAQ-J total score and clinical status was explored using correlational analysis. Results The FreSHAQ-J has acceptable category order, unidimensionality, no misfitting items, and excellent test-retest reliability. The FreSHAQ-J was moderately correlated with disability and pain catastrophization. Conclusions The FreSHAQ-J fits the Rasch measurement model well and is suitable for use with people with shoulder pain. Given the relationship between the FreSHAQ-J score and clinical status, change in body perception may be worth assessing when managing patients with shoulder pain.
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Affiliation(s)
- Tomohiko Nishigami
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1, Gakuen-chou, Mihara, Hiroshima, 723-0053, Japan.
| | - Akihisa Watanabe
- Department of Rehabilitation, Machida Orthopaedics, Kochi, Japan
| | - Toshiki Maitani
- Department of Rehabilitation, Utsumi Orthopaedics Clinic, Kagawa, Japan
| | - Hayato Shigetoh
- Department of Rehabilitation, Miura internal Medicine Michiko Pediatrics Clinic, Kagawa, Japan
| | - Akira Mibu
- Department of Nursing and Physical Therapy, Konan Woman's University, Kobe, Hyogo, Japan
| | - Benedict Martin Wand
- The School of Physiotherapy, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Mark J Catley
- Innovation, Implementation and Clinical Translation in Health (IIMPACT in Health), University of South Australia, Adelaide, SA, Australia
| | - Tasha R Stanton
- Innovation, Implementation and Clinical Translation in Health (IIMPACT in Health), University of South Australia, Adelaide, SA, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia
| | - G Lorimer Moseley
- Innovation, Implementation and Clinical Translation in Health (IIMPACT in Health), University of South Australia, Adelaide, SA, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia
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Tajika T, Kuboi T, Oya N, Endo F, Shitara H, Ichinose T, Sasaki T, Hamano N, Chikuda H. Association Between Upper-Extremity Health Condition and Depressive Status in an Elderly General Population. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2021; 58:469580211059952. [PMID: 34933574 PMCID: PMC8724993 DOI: 10.1177/00469580211059952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: This study was designed to investigate whether psychological status is associated with upper-extremity health status in an elderly general population. Methods: Using Quick Disabilities of the Arm, Shoulder, and Hand of the Japanese Society for Surgery of the Hand (QuickDASH-JSSH), we evaluated 200 Japanese elderly people (76 men, 124 women; mean age, 71.6 years, 60-98 years) to assess their upper-extremity-specific health status. Each had completed a self-administered questionnaire including gender and dominant hand items. As an indicator of hand muscle function, we measured their bilateral hand grip. Study participants were assessed for depressive symptoms using the Geriatric Depression Scale Short-Japanese Version (GDS-S-J). Statistical analyses were applied to clarify associations between self-assessed upper-extremity dysfunction and screening results for depressive symptoms in an elderly general population. Results: Those reporting no complaint of an upper extremity were 72 (36 men and 36 women) (36.0%). The GDS-J score was found to have significant positive correlation with age (r = 0.20, P= 0.0045) and the QuickDASH score (r = 0.25, P = 0.0004). The GDS-J score was found to have significant negative correlation with dominant grip (r = −0.15, P = 0.04) and non-dominant grip strength (r = −0.21, P = 0.004). For all participants, multiple regression analysis revealed the QuickDASH score as associated with the GDS-J score. Conclusion: Self-administered upper-extremity health condition as assessed using QuickDASH is correlated with depressive symptoms in elderly people. Objective pathophysiology and subjective illness behavior must be identified in daily clinical practice. A biopsychosocial approach must be used when advising and treating patients.
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Affiliation(s)
- Tsuyoshi Tajika
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan
| | - Takuro Kuboi
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Noboru Oya
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Fumitaka Endo
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hitoshi Shitara
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Tsuyoshi Ichinose
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Tsuyoshi Sasaki
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Noritaka Hamano
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hirotaka Chikuda
- Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
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da Silva NC, Chaves TC, Dos Santos JB, Sugano RMM, Barbosa RI, Marcolino AM, Mazzer N, Fonseca MCR. Reliability, validity and responsiveness of Brazilian version of QuickDASH. Musculoskelet Sci Pract 2020; 48:102163. [PMID: 32560867 DOI: 10.1016/j.msksp.2020.102163] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 03/23/2020] [Accepted: 03/26/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To analyse the construct validity, test-retest reliability and responsiveness of the Brazilian version of Quick-DASH (QD-Br) in patients with upper limb disorders. METHOD Participants completed the full Brazilian DASH, the QD-Br and the SF-12 Brazil questionnaires at the beginning of treatment, after 48-72h and the after 2-12 months. Construct validity was analysed by Pearson's correlation coefficient (r). To evaluate the test-retest reliability we used the Intraclass Correlation Coefficient (ICC) and the Cronbach's alpha coefficient to test the internal consistency. Responsiveness was analysed by Standardized Response Mean (SRM) and Effect Size (ES). The Minimal detectable change (MDC) score was based upon calculations of the standard error of measurement (SEM), confidence interval of 95%. RESULTS The construct validity presented strong direct correlation with the total QD-Br score and the Brazilian DASH (r = 0.91), a moderate inverse correlation between the total QD-Br score and the physical component of the SF- 12 Brazil (r = -0.55) and weak inverse correlation between the QD-Br and the mental component of SF-12 Brazil (r = -0.49). The ICC test-retest showed good reliability of 0.81 (0.72-0.87). QD-BR presented high responsiveness, with ES of 1.06 and SRM of 0.94. The MDC was 17.27 points. CONCLUSION These results provide evidence that the QD-Br was a valid, reliable and responsive instrument when utilized in patients with upper limb traumatic and no-traumatic disorders in the Brazilian population.
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Affiliation(s)
| | - Thais Cristina Chaves
- Department of Health Sciences - Post Graduation Program in Rehabilitation and Functional Performance, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil.
| | | | - Raquel Metzker Mendes Sugano
- Rehabilitation Centre, Ribeirao Preto Clinical Hospital, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil.
| | | | | | - Nilton Mazzer
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil.
| | - Marisa C Registro Fonseca
- Department of Health Sciences - Post Graduation Program in Rehabilitation and Functional Performance, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil.
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Tsumura T, Matsumoto T, Matsushita M, Ono K, Kishimoto K, Shiode H. How Long Should We Immobilize the Wrist after Vascularized Bone Grafting for the Treatment of Scaphoid Nonunion? J Hand Surg Asian Pac Vol 2020; 25:353-358. [PMID: 32723054 DOI: 10.1142/s242483552050040x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Although vascularized bone grafting can effectively treat scaphoid nonunion, the optimal duration of the immobilization period after bone grafting is unclear. Therefore, we aimed to examine the difference in the union rate and range of motion between short and long immobilization periods and infer the optimal post-immobilization period after pedicled vascularized bone grafting for scaphoid nonunion treatment. Methods: A total of 23 wrists (21 men and 1 woman) with scaphoid nonunion treated using an intercompartmental supraretinacular artery pedicled vascularized bone graft were analyzed. We examined the difference in the union rate and range of motion between patients immobilized for less than 49 days (short immobilization group) and those immobilized for more than 49 days (long immobilization group). The range of motion of the wrist joint was measured before and after surgery. Patient outcomes were also assessed. Results: The overall union rate was 95.6%. A significant difference was found in postoperative extension and flexion between the two groups, but not in terms of the functional outcome. If the intraoperative fixation is solid, intraoperative proximal pole bleeding is confirmed, and the follow-up radiograph shows a normal healing process, we propose immobilization of the wrist for ≤ 7 weeks. Conclusions: The immobilization duration should depend on the solidity of intraoperative fixation and a satisfactory appearance on follow-up radiography: absence of a gap at the graft interface, surrounding lucency, or movement of the implant and displacement of the graft. If there are no signs of graft failure and fixation is solid, immobilization of the wrist for 7 weeks or less is recommended.
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Affiliation(s)
- Takuya Tsumura
- Department of Orthopedic Surgery, Kurashiki Central Hospital, Kurashiki, Japan
| | - Taiichi Matsumoto
- Department of Orthopedic Surgery, Kurashiki Central Hospital, Kurashiki, Japan
| | - Mutsumi Matsushita
- Department of Orthopedic Surgery, Kurashiki Central Hospital, Kurashiki, Japan
| | - Kousei Ono
- Department of Orthopedic Surgery, Kurashiki Central Hospital, Kurashiki, Japan
| | - Katsuma Kishimoto
- Department of Orthopedic Surgery, Kurashiki Central Hospital, Kurashiki, Japan
| | - Hayao Shiode
- Department of Orthopedic Surgery, Kurashiki Central Hospital, Kurashiki, Japan
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Nagura N, Naito K, Sugiyama Y, Obata H, Goto K, Kaneko A, Kawakita S, Kaneko K. Evaluation of Patient-Reported and Clinician-Reported Outcomes of Volar Locking Plate Fixation for Distal Radius Fractures. J Hand Surg Asian Pac Vol 2020; 25:359-363. [PMID: 32723039 DOI: 10.1142/s2424835520500411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Postoperative evaluation of wrist joint trauma is divided into patient-reported outcomes (PROs) and clinician-reported outcomes (CROs). We investigated the association of the Q-DASH score as the postoperative PROs and the Mayo wrist score as the postoperative CROs with clinical evaluation in patients with distal radius fractures surgically treated using a volar locking plate (VLP). Moreover, whether PROs and CROs are correlated to the clinical evaluation was investigated. Methods: The subjects were 109 patients surgically treated for distal radius fractures at our hospital between June 2013 and May 2017. Forty-one patients were male, 68 patients were female, and the mean age was 61.4 (19-86) years old. The fracture type was AO classification A type in 30 patients (A2: 25, A3: 5), B type in 5 (B2: 1, B3: 4), and C type in 74 (C1: 50, C2: 11, C3: 13). All patients were surgically treated using VLP. The range of motion of the wrist, grip strength the Visual Analog Scale (VAS), the Q-DASH score (PROs), and the Mayo wrist score (CROs) were investigated. Each evaluation was compared as the clinical outcome between at 3 months after surgery and the final follow-up. In addition, the correlations of the postoperative PROs and CROs with the clinical evaluation were analyzed. Results: Each evaluation was significantly improved compared with that at 3 months after surgery. There was a significant correlation between PROs and CROs at 3 months after surgery and the final follow-up. However, the range of motion of the wrists was not significantly correlated with PROs or CROs at 3 months after surgery or at the final follow-up. Conclusions: On evaluation after surgery for distal radius fractures, PROs and CROs improved early after surgery (3 months after surgery) before the final follow-up, and an inverse correlation was present between these scores.
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Affiliation(s)
- Nana Nagura
- Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan
| | - Kiyohito Naito
- Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan
| | - Yoichi Sugiyama
- Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan
| | - Hiroyuki Obata
- Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan
| | - Kenji Goto
- Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan
| | - Ayaka Kaneko
- Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan
| | - So Kawakita
- Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan
| | - Kazuo Kaneko
- Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan
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Saito K, Kihara H. A Trial of the Effect of 2-Step Orthosis Treatment for Mallet Finger Fractures. J Sport Rehabil 2020; 30:315-319. [PMID: 32357315 DOI: 10.1123/jsr.2019-0249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 01/23/2020] [Accepted: 02/17/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT Many patients report poor therapeutic outcomes following mallet finger fracture surgery. A more reliable technique is urgently needed. OBJECTIVE To present a novel treatment for mallet finger fractures using a 2-step orthosis method. DESIGN Prospective, observational study. SETTING Hospital. PARTICIPANTS Patients with mallet finger fractures. INTERVENTIONS The finger is fixed with splints for 6 weeks, including 3 weeks for the proximal interphalangeal joint in the flexion position and the distal interphalangeal joint in the hyperextension position (first splint) and 3 weeks for the distal interphalangeal joint in the hyperextension position (second splint). Up to week 8, the second splint was attached at night and during physical exertion. MAIN OUTCOME MEASURES Crawford criteria, Abouna-Brown criteria, bone fusion, grip strength, Doyle classification, Ishiguro classification. RESULTS Sufficient bone fusion was achieved 12 weeks after fixation; at which time, the range of motion with the distal interphalangeal joint flexed, and extended in the 3 patients was 50° and 0°, 70° and -3°, and 60° and 0°, respectively. The right and left hand grip strengths in the 3 patients were 58 and 55 kg, 62 and 58 kg, and 31 and 29 kg, respectively; there were no problems with respect to function or work. The first 2 patients could start sports again with partial return after 1 week and complete return after 12 weeks and 8 weeks, respectively. For the third patient, rehabilitation was complete after 16 weeks. Evaluation of the fracture sites based on the Crawford criteria showed the condition to be perfect, and evaluation based on the Abouna-Brown criteria showed success. CONCLUSIONS This method provides satisfactory fixation and can prevent proximal interphalangeal joint contracture. Favorable long-term outcomes were confirmed in all patients, suggesting that this method may be effective for previously untreated mallet finger fractures with little displacement.
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Nanno M, Kodera N, Tomori Y, Takai S. Pins and rubbers traction system for fractures of the proximal interphalangeal joint. J Orthop Surg (Hong Kong) 2020; 27:2309499019840771. [PMID: 30987517 DOI: 10.1177/2309499019840771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE We aimed to evaluate the clinical results using the pins and rubbers traction system (PRTS) as described by Suzuki et al. for unstable intra-articular fractures of the proximal interphalangeal (PIP) joint and to assess the efficacy and the indication of the technique of the PRTS. METHODS Thirty-nine fingers in 39 patients (mean age 46.0 years) with unstable fractures of the PIP joint were treated by the PRTS. The mean interval between injury and surgery was 30.8 days. Active and passive exercise of range of motion of all fingers was started immediately after surgery. Radiographic and clinical results were evaluated at the final examination. RESULTS The mean period the PRTS was applied was 6.4 weeks. The mean follow-up period was 8.9 months. Anatomical union was obtained in all patients. No joint instability, no malunion, nor osteomyelitis was observed. At the final examination, the average active range of motion of the PIP joint was 74.6°. The average Visual Analogue Scale for pain and Quick Disability of Arm, Shoulder, and Hand score were 1.2 and 3.2, respectively. CONCLUSIONS The current study demonstrated good results of the PRTS for unstable intra-articular fractures of the PIP joint. Furthermore, satisfactory results were obtained in cases of an incomplete amputation at the PIP joint, a pathological fracture due to bone tumor, and an osteochondral defect due to comminuted fracture of the proximal phalangeal head, where costal osteochondral bone was transplanted. From this study, the PRTS is recommended as a useful treatment because it is widely effective for various unstable fractures of the PIP joint.
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Affiliation(s)
- Mitsuhiko Nanno
- Department of Orthopaedic Surgery, Nippon Medical School, Tokyo, Japan
| | - Norie Kodera
- Department of Orthopaedic Surgery, Nippon Medical School, Tokyo, Japan
| | - Yuji Tomori
- Department of Orthopaedic Surgery, Nippon Medical School, Tokyo, Japan
| | - Shinro Takai
- Department of Orthopaedic Surgery, Nippon Medical School, Tokyo, Japan
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Nanno M, Kodera N, Tomori Y, Takai S. Volar Locking Plate Fixation for Intra-Articular Distal Radius Fractures with Volar Lunate Facet Fragments Distal to the Watershed Line. J NIPPON MED SCH 2020; 87:24-31. [PMID: 31611505 DOI: 10.1272/jnms.jnms.2020_87-106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Standard volar plating of distal radius fractures may not adequately fix the volar lunate facet (VLF) fragment, which can result in volar carpal subluxation. We hypothesized that the size of VLF fragments distal to the watershed line might affect reduction loss after distally placed volar locking plate fixation for intra-articular distal radius fracture and examined if the presence of small displaced VLF fragments was a risk factor for reduction loss. METHODS Twenty-seven hands of 27 patients with intra-articular distal radius fractures with VLF fragments distal to the watershed line were treated by using Acu-Loc 2 volar distal radius locking plate fixation. RESULTS At final follow-up, the mean Mayo Performance Score was 90.9, and the mean Quick Disabilities of Arm, Shoulder, and Hand score was 13.6. On radiography, 5 patients had a reduction loss of >2 mm in ulnar variance from immediately postoperatively to final follow-up (group 1), while 27 had no reduction loss (group 2). The mean longitudinal, transverse, and anteroposterior lengths and joint surface area of the VLF fragment were significantly smaller in group 1 than in group 2. Three-dimensional computed tomography revealed that the fracture patterns of the radiocarpal and distal radioulnar joints in group 1 were mainly volar-displaced VLF fragments. CONCLUSIONS By stabilizing fragments, distally placed volar locking plate fixation effectively treated intra-articular distal radius fractures with VLF fragments distal to the watershed line. However, the presence of small displaced VLF fragments may increase the risk of reduction loss in ulnar variance.
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Affiliation(s)
| | - Norie Kodera
- Department of Orthopedic Surgery, Nippon Medical School
| | - Yuji Tomori
- Department of Orthopedic Surgery, Nippon Medical School
| | - Shinro Takai
- Department of Orthopedic Surgery, Nippon Medical School
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Tajika T, Kuboi T, Endo F, Shinagawa S, Kobayashi H, Hashimoto S, Sakane H, Hamano N, Sasaki T, Ichinose T, Shitara H, Chikuda H. Association between upper extremity dysfunction and sleep disturbance in an elderly general population. SAGE Open Med 2020; 8:2050312120901584. [PMID: 32030126 PMCID: PMC6977088 DOI: 10.1177/2050312120901584] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 12/26/2019] [Indexed: 11/16/2022] Open
Abstract
Objective Several upper extremity disorders are associated with sleep disturbance in patient populations. This study evaluated the relation between self-assessment of upper extremity function and sleep disturbance in an elderly general population. Methods A total of 159 participants (56 men, 103 women, 38-88 years old, mean age of 66.4 years) completed a self-administered questionnaire including items for sex, weight, height, and dominant hand. Upper extremity dysfunction was investigated using Quick Disabilities of the Arm, Shoulder, and Hand of the Japanese Society for Surgery of the Hand. The sleep disturbance severity was evaluated using a Japanese version of the Athens Insomnia Scale. Quality of life was assessed using the EuroQol-5-dimension-3-level, Japanese version. We measured the bilateral hand grip as an indicator of hand muscle function. Statistical tests were applied to clarify the association between upper extremity dysfunction and screening results for sleep disturbance. Results Of 159 participants, 45 (28.3%) had sleep disturbance as assessed using Japanese version of the Athens Insomnia Scale (11 men and 34 women; mean age of 68.1 years). Japanese version of the Athens Insomnia Scale scores correlated with the EuroQol index; EuroQol visual analog scale; and Quick Disabilities of the Arm, Shoulder, and Hand scores. The Quick Disabilities of the Arm, Shoulder, and Hand score and dominant grip strength of the participants with sleep disturbance were significantly higher than those of the no sleep disturbance group. The EuroQol index score and visual analog scale of those reporting a sleep disturbance were significantly lower than those of the no sleep disturbance group. Conclusion Self-administered upper extremity health condition as assessed using Quick Disabilities of the Arm, Shoulder, and Hand correlated with sleep disturbance. Our results suggest a link between upper extremity conditions and sleep disturbance.
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Affiliation(s)
- Tsuyoshi Tajika
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Takuro Kuboi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Fumitaka Endo
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Satoshi Shinagawa
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Hiroki Kobayashi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Shogo Hashimoto
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Hideo Sakane
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Noritaka Hamano
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Tsuyoshi Sasaki
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Tsuyoshi Ichinose
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Hitoshi Shitara
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Hirotaka Chikuda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Gunma University, Maebashi, Japan
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Nanno M, Kodera N, Tomori Y, Takai S. Novel Modification of Abductor Pollicis Longus Suspension Arthroplasty with Trapeziectomy for Thumb Carpometacarpal Osteoarthritis. J NIPPON MED SCH 2019; 86:269-278. [PMID: 31308312 DOI: 10.1272/jnms.jnms.2019_86-507] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND We compared the clinical results of a newly modified abductor pollicis longus (APL) suspension arthroplasty with trapeziectomy procedure (modified Thompson procedure) with those of the original APL suspension arthroplasty with trapeziectomy procedure (original Thompson procedure) for treatment of advanced osteoarthritis of the thumb carpometacarpal (CMC) joint and assessed the effectiveness of the modified Thompson procedure for thumb CMC osteoarthritis. METHODS Ten hands of 10 patients (Group 1) were treated with the original Thompson procedure. Twenty hands of 16 patients (Group 2) were treated with the modified Thompson procedure, in which the bone tunnel positions were rearranged for a more dorsoradial passage of the transferred APL. RESULTS Significant differences between values before and after surgery were noted in thumb palmar and radial abduction angles, pinch power, grip strength, Quick Disability of Arm, Shoulder, and Hand questionnaire (Quick DASH) score, and visual analog scale (VAS) score. There was no statistically significant difference in thumb palmar abduction angle, pinch power, grip strength, Quick DASH score, or VAS score between Groups 1 and 2. However, range of motion of radial abduction in the thumb was significantly better for patients in Group 2 than for those in Group 1. CONCLUSIONS The modified Thompson procedure is a simple, effective technique that results in greater improvement in thumb radial abduction angle, as compared with the original technique, in patients with advanced thumb CMC osteoarthritis. Additionally, the modified technique is as useful as the original procedure for early restoration of thumb function and pain relief.
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Affiliation(s)
| | - Norie Kodera
- Department of Orthopaedic Surgery, Nippon Medical School
| | - Yuji Tomori
- Department of Orthopaedic Surgery, Nippon Medical School
| | - Shinro Takai
- Department of Orthopaedic Surgery, Nippon Medical School
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Uemura T, Takamatsu K, Okada M, Yokoi T, Onode E, Miyashima Y, Konishi S, Nakamura H. A case series of seven patients with recurrent median nerve neuropathy treated by the revision surgery of median nerve neurolysis and wrapping with radial artery perforator adipose flap. J Plast Reconstr Aesthet Surg 2019; 73:453-459. [PMID: 31757685 DOI: 10.1016/j.bjps.2019.09.051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 08/09/2019] [Accepted: 09/28/2019] [Indexed: 11/19/2022]
Abstract
Adhesion neuropathy of the median nerve with persistent pain can be a challenging problem. Currently, coverage of the median nerve with a well-vascularized soft tissue is deemed necessary after secondary neurolysis. Herein, we reviewed the outcomes of seven patients with a persistent median nerve neuropathy after a primary open carpal tunnel release or a median nerve repair, treated with neurolysis and median nerve wrapping with radial artery perforator adipose flaps. During the revision surgery, after a careful and complete neurolysis of the scarred median nerve, the distally based radial artery perforator adipose flap without its fascia was raised and rotated to wrap the median nerve. The mean size of the perforator flap was 1146 mm2, which was enough to wrap the median nerve in all patients. At 26 months postsurgery, both the visual analog scale score for pain with tingling, and the patient-reported outcome measures improved. There was no recurrence of the median nerve adhesion neuropathy and no major complications were noted. Tinel's sign at the palmar wrist completely disappeared in four patients and was relieved in three patients. The median distal motor latency becomes recordable, and closer to a normal compound motor action potential postoperatively in all patients. Secondary neurolysis and median nerve wrapping with a radial artery perforator adipose flap, which was modified to be softer and thinner than the radial artery perforator adipofascial flap, was a successful treatment for the recurrent median nerve neuropathy in terms of both pain relief and restoration of the hand function.
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Affiliation(s)
- Takuya Uemura
- Department of Orthopaedic Surgery, Osaka General Hospital of West Japan Railway Company, 1-2-22 Matsuzakicho, Abeno-ku, Osaka 545-0053, Japan; Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan.
| | - Kiyohito Takamatsu
- Department of Orthopaedic Surgery, Yodogawa Christian Hospital, 1-7-50 Kunijima, Higashiyodogawa-ku, Osaka 533-0024, Japan
| | - Mitsuhiro Okada
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
| | - Takuya Yokoi
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
| | - Ema Onode
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
| | - Yusuke Miyashima
- Department of Orthopaedic Surgery, Osaka General Hospital of West Japan Railway Company, 1-2-22 Matsuzakicho, Abeno-ku, Osaka 545-0053, Japan
| | - Sadahiko Konishi
- Department of Orthopaedic Surgery, Osaka General Hospital of West Japan Railway Company, 1-2-22 Matsuzakicho, Abeno-ku, Osaka 545-0053, Japan
| | - Hiroaki Nakamura
- Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan
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Takagi T, Kobayashi Y, Watanabe M. Thumb Carpometacarpal Arthroplasty with Dynamic Suspension Sling Using Extensor Carpi Radialis Tendon. J Hand Surg Asian Pac Vol 2019; 24:353-358. [PMID: 31438793 DOI: 10.1142/s2424835519500450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Despite various treatment methods, complications are reported with ligament reconstruction for thumb carpometacarpal (CMC) arthropathy, such as proximal migration, dorsal subluxation of the first metacarpal base, and hyperextension of the first CMC joint. The flexor carpi radialis (FCR) tendon is, in some cases, too thin to maintain suspension on the first metacarpophalangeal (MCP) joint. We used one-half of the extensor carpi radialis longus (ECRL) tendon instead of the FCR tendon, and compared this method with conventional reconstruction using the FCR tendon. Methods: The procedures were performed during 12 thumb CMC arthropathies. One-half of the ECRL tendon was passed and then wrapped around the intact FCR tendon several times for 6 cases (ECRL group). One-half of the FCR tendon was passed for 6 cases (FCR group). On radiography, we compared the thumb to index finger metacarpal angle (M1M2) and the first MCP angle (P1M1) between groups. Grip strength, pinch strength, and DASH score were also evaluated up to 2 years post-surgery. Results: In the ECRL group, M1M2 and P1M1 1 year post-surgery showed significant improvements compared to those before surgery; they showed no significant difference in the FCR group, although they achieved a peak at 3 months post-surgery in both groups. Both groups showed improvements in other parameters from 3 months to 1 year post-surgery. Conclusions: Postoperative progression of hyperextension of the first CMC joint was significantly reduced in the ECRL group. The ECRL tendon is thicker than the FCR tendon. In addition, the insertion site of the ECRL tendon is at the dorsal side of the second metacarpal, and the tendon can extend from the dorsal side to the volar side to stabilize the first metacarpal. Thumb CMC arthroplasty using one-half of the ECRL tendon is a useful reconstruction method.
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Affiliation(s)
- Takehiko Takagi
- Division of Orthopaedic Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Yuka Kobayashi
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, Kanagawa, Japan
| | - Masahiko Watanabe
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, Kanagawa, Japan
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Nagano Y, Kawamura D, Terkawi A, Urita A, Matsui Y, Iwasaki N. Minimum Ten-Year Outcomes of Partial Ulnar Nerve Transfer for Restoration of Elbow Flexion in Patients with Upper Brachial Plexus Injury. J Hand Surg Asian Pac Vol 2019; 24:283-288. [PMID: 31438804 DOI: 10.1142/s2424835519500358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Partial ulnar nerve transfer to the biceps motor branch of the musculocutaneous nerve (Oberlin's transfer) is a successful approach to restore elbow flexion in patients with upper brachial plexus injury (BPI). However, there is no report on more than 10 years subjective and objective outcomes. The purpose of this study was to clarify the long-term outcomes of Oberlin's transfer based on the objective evaluation of elbow flexion strength and subjective functional evaluation of patients. Methods: Six patients with BPI who underwent Oberlin's transfer were reviewed retrospectively by their medical records. The mean age at surgery was 29.5 years, and the mean follow-up duration was 13 years. The objective functional outcomes were evaluated by biceps muscle strength using the Medical Research Council (MRC) grade at preoperative, postoperative, and final follow-up. The patient-derived subjective functional outcomes were evaluated using the Quick Disability of the Arm, Shoulder, and Hand (QuickDASH) questionnaire at final follow-up. Results: All patients had MRC grade 0 (M0) or 1 (M1) elbow flexion strength before operation. Four patients gained M4 postoperatively and maintained or increased muscle strength at the final follow-up. One patient gained M3 postoperatively and at the final follow-up. Although one patient achieved M4 postoperatively, the strength was reduced to M2 due to additional disorder. The mean score of QuickDASH was 36.5 (range, 7-71). Patients were divided into two groups; three patients had lower scores and the other three patients had higher scores of QuickDASH. Conclusions: Oberlin's transfer is effective in the restoration of elbow flexion and can maintain the strength for more than 10 years. Patients with upper BPI with restored elbow flexion strength and no complicated nerve disorders have over ten-year subjective satisfaction.
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Affiliation(s)
- Yusuke Nagano
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Daisuke Kawamura
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Alaa Terkawi
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Atsushi Urita
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yuichiro Matsui
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Norimasa Iwasaki
- Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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