Functional outcome with special attention to the DASH questionnaire following callus distraction and phalangization of the thumb after traumatic amputation in the middle one-third

Twelve metacarpals and two phalanges in 14 patients (nine males and five females) were lengthened between August 1992 and March 1999 by the callus distraction technique using a small external fixator (Orthofix®). The indications were traumatic amputation (10 cases), aplasia (three cases) and hypoplasia owing to premature epiphyseal closure of the metacarpal (one case). All patients were reviewed with a median follow-up time of 39 (range, 9–88) months. The median age of the patients was 15 (range, 4–39) years. The median lengthening was 21 (range, 13–34) mm which was a median of 82% (range, 38–162) of the original bone length. The median times for callus distraction and consolidation were 4.5 and 7.5 weeks respectively. All except one patient tolerated the procedure well and were satisfied with the results. Functional improvement was seen in 13 out of 14 patients, but non-union was observed in one patient.

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Lengthening of a One-Bone Forearm

Journal of Hand Surgery (European Volume) ◽

10.1016/s0266-7681(98)80121-6 ◽

1998 ◽

Vol 23 (4) ◽

pp. 453-456 ◽

Cited By ~ 3

Author(s):

C. W. C. TONG ◽

L. K. HUNG ◽

J. C. Y. CHENG

Keyword(s):

Activities Of Daily Living ◽

Functional Outcome ◽

Upper Limb ◽

Daily Living ◽

Callus Distraction ◽

The One ◽

The Right

An 8-year-old girl presented with marked shortening of the right forearm due to destruction of both the radius and ulna secondary to neonatal osteomyelitis. A one-bone forearm operation was performed to achieve a stable forearm. Two years later, the one-bone forearm was lengthened for 6 months by callus distraction (callotasis) achieving 12 cm of extra length. The patient was last followed up at the age of 16. The appearance and functional outcome of the right upper limb had been improved and she was independent in all activities of daily living.

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Outcome of Thumb Replantation following Traumatic Amputation: A Review of Three Cases

The British Journal of Hand Therapy ◽

10.1177/175899830200700403 ◽

2002 ◽

Vol 7 (4) ◽

pp. 124-128

Author(s):

N Burr ◽

Al Pratt ◽

N Bulstrode ◽

R Sanders

Keyword(s):

Functional Outcome ◽

Metacarpophalangeal Joint ◽

Interphalangeal Joint ◽

Hand Dominance ◽

Traumatic Amputation ◽

Sensory Assessment ◽

Pinch Grip ◽

Post Operation ◽

Joint Flexion ◽

Protective Sensation

This paper presents the functional outcome in three patients who sustained a traumatic level-three thumb amputation and replantation during a six-week period and evaluates their functional outcome. It also discusses the current literature on this subject and suitable methods for assessing and reporting the outcomes of these injuries. Assessment was carried out at a mean of 40 weeks post operation (range 36-47) by the same independent therapist. Mean active interphalangeal joint flexion was 47° (range 30-75°) and metacarpophalangeal joint 42° (range 35-50°). Grip strength was a mean of 89 lbs (range 79-101 lbs) and pinch grip was a mean of 12.5 lbs (range 9-18 lbs). On sensory assessment two of the participants had a good return of sensibility with 5-7mm of two-point discrimination and at least diminished protective sensation. Overall satisfaction, sensibility and functional use of the thumb did not appear to be related to age but rather due to the demands placed on their replanted thumb for occupation and hand dominance.

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COMPARATIVE STUDY BETWEEN THE DYNAMIC COMPRESSION PLATING (DCP) AND THE INTRAMEDULLARY INTERLOCKING NAILING IN DIAPHYSEAL FRACTURES OF THE HUMERUS IN ADULTS

10.36106/ijsr/8035898 ◽

2021 ◽

pp. 43-45

Author(s):

Nilabh Kumar ◽

Laljee Chaudhary ◽

Debarshi Jana

Keyword(s):

Functional Outcome ◽

Dynamic Compression ◽

Interlocking Nailing ◽

Diaphyseal Fractures ◽

The Difference ◽

And Function ◽

Dash Questionnaire ◽

Radiological Union ◽

Compression Plating ◽

Dynamic Compression Plating

AIMS: The aim of our study was to nd the difference between the mean duration of union and functional outcome between the dynamic compression plating (DCP) and the intramedullary interlocking nailing in diaphyseal fractures of the humerus in adults. MATERIALS AND METHODS: From May 2019 to October 2019, 34 patients with diaphyseal fractures of the humerus were treated with compression plating using dynamic compression plate or with intramedullary interlocking nail. The time taken for radiological union in the two groups was compared. After satisfactory radiological union, the functional outcome was assessed by the “Disabilities of Hand, Shoulder and Elbow (DASH) Questionnaire”. RESULTS: All fractures united and a marginal difference was noted in the time taken for union. The functional outcome was better in DCP group compared to interlocking nailing group which was statistically signicant (P= 0.010). The complication associated with interlocking group was more than the DCP group. We are of the opinion that when surgery is opted as a choic CONCLUSION: e of treatment, both the modalities of treatment i.e. dynamic compression plating and interlocking nailing are good as far as union of the fracture is concerned, but considering the number of complications and functional outcome, we opine that dynamic compression plating offers better result than antegrade interlocking nailing with respect to pain and function of the shoulder joint.

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Outcomes following total elbow arthroplasty for rheumatoid arthritis versus post-traumatic conditions

The Bone & Joint Journal ◽

10.1302/0301-620x.101b12.bjj-2019-0799.r1 ◽

2019 ◽

Vol 101-B (12) ◽

pp. 1489-1497 ◽

Cited By ~ 3

Author(s):

Jou-Hua Wang ◽

Hsuan-Hsiao Ma ◽

Te-Feng A. Chou ◽

Shang-Wen Tsai ◽

Cheng-Fong Chen ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Functional Outcome ◽

Aseptic Loosening ◽

Perioperative Complications ◽

Meta Analysis ◽

Deep Infection ◽

Range Of Movement ◽

Septic Loosening ◽

Post Traumatic ◽

Dash Questionnaire

Aims The aim of this meta-analysis was to compare the outcome of total elbow arthroplasty (TEA) undertaken for rheumatoid arthritis (RA) with TEA performed for post-traumatic conditions with regard to implant failure, functional outcome, and perioperative complications. Materials and Methods We completed a comprehensive literature search on PubMed, Web of Science, Embase, and the Cochrane Library and conducted a systematic review and meta-analysis. Nine cohort studies investigated the outcome of TEA between RA and post-traumatic conditions. The preferred reporting items for systematic reviews and meta-analysis (Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)) guidelines and Newcastle-Ottawa scale were applied to assess the quality of the included studies. We assessed three major outcome domains: implant failures (including aseptic loosening, septic loosening, bushing wear, axle failure, component disassembly, or component fracture); functional outcomes (including arc of range of movement, Mayo Elbow Performance Score (MEPS), and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire), and perioperative complications (including deep infection, intraoperative fracture, postoperative fracture, and ulnar neuropathy). Results This study included a total of 679 TEAs for RA (n = 482) or post-traumatic conditions (n = 197). After exclusion, all of the TEAs included in this meta-analysis were cemented with linked components. Our analysis demonstrated that the RA group was associated with a higher risk of septic loosening after TEA (odds ratio (OR) 3.96, 95% confidence interval (CI) 1.11 to 14.12), while there was an increased risk of bushing wear, axle failure, component disassembly, or component fracture in the post-traumatic group (OR 4.72, 95% CI 2.37 to 9.35). A higher MEPS (standardized mean difference 0.634, 95% CI 0.379 to 0.890) was found in the RA group. There were no significant differences in arc of range of movement, DASH questionnaire, and risk of aseptic loosening, deep infection, perioperative fracture, or ulnar neuropathy. Conclusion The aetiology of TEA surgery appears to have an impact on the outcome in terms of specific modes of implant failures. RA patients might have a better functional outcome after TEA surgery. Cite this article: Bone Joint J 2019;101-B:1489–1497

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