Psychometric analysis of measuring functional outcomes in tibial plateau fractures using the Short Form 36 (SF-36), Short Musculoskeletal Function Assessment (SMFA) and the Western Ontario McMaster Osteoarthritis (WOMAC) questionnaires

Background and Aims: Radical surgical intervention is necessary to save patients’ lives in cases of necrotizing fasciitis. This leads to persistent disabilities and most likely to a deteriorated quality of life. The purpose of this study was to evaluate the midterm outcomes after survival of necrotizing fasciitis. Materials and Methods: A retrospective analysis of 69 patients, treated for necrotizing fasciitis between 2003 and 2012. The patients were identified using the International Classification of Diseases (10th Revision) code M 72.6. Of the 50 survivors, 22 patients completed the Short Form 36 and Short Musculoskeletal Function Assessment questionnaires as a postal survey. The follow-up averaged 59 months (range: 6–128 months). Results: The average age at the time of necrotizing fasciitis was 60.0 years. The body mass index average was 29.7. The patients had a significantly decreased physical component summary score of 33.3 compared to a normative group (p < 0.001) (Short Form 36). They further showed a significantly decreased dysfunction and bother indices (Short Musculoskeletal Function Assessment) (p < 0.001). An increased age (⩾70 years) was associated with an inferior role emotional (p = 0.048) and physical functioning (p = 0.011) as well as social functioning (p = 0.038) (Short Form 36). The majority of patients (16, 72.7%) complained of pain at the final follow-up and 50% of patients required an assistive device on a regular basis. Conclusion: Patients who survived necrotizing fasciitis suffer from functional impairment and changed body appearance. Assistive devices or pain medication are often required, and the patients present with significantly decreased physical, social, and emotional functioning at the midterm follow-up. The patient’s age is a critical factor regarding functional or mental outcome parameters. Further research on the post-hospital course and long-term multidisciplinary care is required to improve the outcomes of these patients.

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Use of both short musculoskeletal function assessment questionnaire and short form-36 among tibial-fracture patients was redundant

Journal of Clinical Epidemiology ◽

10.1016/j.jclinepi.2009.01.014 ◽

2009 ◽

Vol 62 (11) ◽

pp. 1210-1217 ◽

Cited By ~ 49

Author(s):

Jason W. Busse ◽

Mohit Bhandari ◽

Gordon H. Guyatt ◽

Diane Heels-Ansdell ◽

Scott Mandel ◽

...

Keyword(s):

Tibial Fracture ◽

Short Form ◽

Short Form 36 ◽

Short Musculoskeletal Function Assessment ◽

Musculoskeletal Function ◽

Assessment Questionnaire ◽

Function Assessment

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Subjective morbidity following radial free flap reconstruction in head and neck tumour patients

The Journal of Laryngology & Otology ◽

10.1017/s0022215119000197 ◽

2019 ◽

Vol 133 (03) ◽

pp. 230-235 ◽

Cited By ~ 1

Author(s):

A Minkara ◽

M R Simmons ◽

A Goodale ◽

Y J Patil

Keyword(s):

Free Flap ◽

Short Form ◽

Donor Site ◽

Radial Forearm Free Flap ◽

Short Musculoskeletal Function Assessment ◽

Neck Tumour ◽

Radial Forearm ◽

Musculoskeletal Function ◽

Assessment Questionnaire ◽

Function Assessment

AbstractObjectiveEvaluation of post-operative donor site disability remains unaddressed in radial forearm free flap cases. This study aimed to assess donor site dysfunction following radial forearm free flap harvest using validated general, disease-specific and site-specific disability questionnaires.MethodsIn this retrospective case series of 24 patients at a tertiary academic medical centre, patients were assessed using the Short Form 36 Health Survey, Short Musculoskeletal Function Assessment questionnaire, and Disabilities of the Arm, Shoulder and Hand questionnaire. One-sample z-tests were performed, comparing means of the cohort to controls.ResultsCompared to population controls, the cohort had higher mean scores for the Disabilities of the Arm, Shoulder and Hand questionnaire (18.22 vs 10.1, p < 0.01), and Short Musculoskeletal Function Assessment questionnaire bothersome index (21.44 vs 13.77, p = 0.04), and a lower mean score for the Short Form 36 Health Survey physical component (38.88 vs 50, p < 0.01), indicating a greater disability for the cohort compared to controls.ConclusionRadial forearm free flap harvest causes significant long-term donor site disability in head and neck tumour patients. The Disabilities of the Arm, Shoulder and Hand questionnaire is a concise tool for measuring this dysfunction.

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Outcomes of Total Ankle Arthroplasty in Moderate and Severe Valgus Deformity

Foot & Ankle Specialist ◽

10.1177/1938640018785953 ◽

2018 ◽

Vol 12 (3) ◽

pp. 238-245 ◽

Cited By ~ 6

Author(s):

Constantine A. Demetracopoulos ◽

Elizabeth A. Cody ◽

Samuel B. Adams ◽

James K. DeOrio ◽

James A. Nunley ◽

...

Keyword(s):

Short Form ◽

Valgus Deformity ◽

Total Ankle Arthroplasty ◽

Ankle Arthroplasty ◽

Short Musculoskeletal Function Assessment ◽

Sf 36 ◽

Patient Reported ◽

Musculoskeletal Function ◽

American Orthopaedic

Introduction. Failure to correct coronal deformity at the time of total ankle arthroplasty (TAA) can lead to early implant failure. We aimed to determine clinical, radiographic, and patient-reported outcomes of patients with moderate to severe valgus deformity who underwent TAA for end-stage ankle arthritis. Methods. Patients with a valgus deformity of at least 10° who underwent TAA were retrospectively reviewed. The coronal tibiotalar angle was assessed on radiographs preoperatively, at 1 year, and at final follow-up. The visual analog scale (VAS) for pain, Short Form-36 (SF-36), American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot-ankle scale, and Short Musculoskeletal Function Assessment (SMFA) scores were assessed preoperatively and at final follow-up. Results. Mean preoperative valgus deformity was 15.5 ± 5.0°, and was corrected to a mean of 1.2 ± 2.6° of valgus postoperatively. VAS, SF-36, AOFAS, and SMFA scores improved significantly ( P < .001 for all). There was no significant change in tibiotalar angle between 1 year and final follow-up in either group. Reoperation and revision rates did not differ between groups. Conclusion. Correction of coronal alignment was achieved and maintained in patients with both moderate and severe preoperative valgus malalignment. Outcome scores significantly improved for all patients. Levels of Evidence: Therapeutic, Level IV

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Mapping recovery in simple and complex tibial plateau fracture fixation

The Bone & Joint Journal ◽

10.1302/0301-620x.101b8.bjj-2018-1288.r1 ◽

2019 ◽

Vol 101-B (8) ◽

pp. 1009-1014 ◽

Cited By ~ 2

Author(s):

D. N. Ramoutar ◽

K. Lefaivre ◽

H. Broekhuyse ◽

P. Guy ◽

P. O’Brien

Keyword(s):

Functional Outcome ◽

Tibial Plateau ◽

Tibial Plateau Fracture ◽

Short Form ◽

Tibial Plateau Fractures ◽

Functional Score ◽

Complex Group ◽

Sf 36 ◽

Functional Scores ◽

Plateau Fracture

Aims The aim of this study was to determine the trajectory of recovery following fixation of tibial plateau fractures up to five-year follow-up, including simple (Schatzker I-IV) versus complex (Schatzker V-VI) fractures. Patients and Methods Patients undergoing open reduction and internal fixation (ORIF) for tibial plateau fractures were enrolled into a prospective database. Functional outcome, using the 36-Item Short Form Health Survey Physical Component Summary (SF-36 PCS), was collected at baseline, six months, one year, and five years. The trajectory of recovery for complex fractures (Schatzker V and VI) was compared with simple fractures (Schatzker I to IV). Minimal clinically important difference (MCID) was calculated between timepoints. In all, 182 patients were enrolled: 136 (74.7%) in simple and 46 (25.3%) in complex. There were 103 female patients and 79 male patients with a mean age of 45.8 years (15 to 86). Results Mean SF-36 PCS improved significantly in both groups from six to 12 months (p < 0.001) and one to five years (simple, p = 0.008; complex, p = 0.007). In both groups, the baseline scores were not reached at five years. The SF-36 PCS was significantly higher in the simple group compared with the complex group at both six months (p = 0.007) and 12 months (p = 0.01), but not at five years (p = 0.17). Between each timepoint, approximately 50% or more of the patients in each group achieved an MCID in their score change, indicating a significant clinical change in condition. The complex group had a much larger drop off in the first six months, with comparable proportions achieving MCID at the subsequent time intervals. Conclusion Tibial plateau fracture recovery was characterized overall by an initial decline in functional outcome from baseline, followed by a steep improvement from six to 12 months, and ongoing recovery up to five years. In simple patterns, patients tended to achieve a higher functional score by six months compared with the complex patterns. However, comparable functional scores between the groups achieved only at the five-year point suggest later recovery in the complex group. Function does not improve to baseline by five years in either group. This information is useful in counselling patients about the course of prospective recovery. Cite this article: Bone Joint J 2019;101-B:1009–1014.

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Subjective morbidity following fibular free flap reconstruction in head and neck cancer patients

The Journal of Laryngology & Otology ◽

10.1017/s0022215118001068 ◽

2018 ◽

Vol 132 (8) ◽

pp. 729-733

Author(s):

D M Sparkman ◽

M R Simmons ◽

Y J Patil

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Lower Limb ◽

Short Form ◽

Flap Reconstruction ◽

Free Flap Reconstruction ◽

Short Musculoskeletal Function Assessment ◽

Musculoskeletal Function ◽

Function Assessment

AbstractObjectiveThis study aimed to evaluate the presence of subjective post-operative donor site morbidity after fibula free flap reconstruction in head and neck cancer patients, utilising three validated instruments: the 36-item Short Form Health Survey, the Short Musculoskeletal Function Assessment questionnaire and the Lower Limb Core Scale.MethodsIn this retrospective study, all head and neck cancer patients who underwent fibula free flap reconstruction between January 2009 and July 2014 were identified. All questionnaires and their respective subcomponents were scored.ResultsTwenty-one cases were included. Patients were found to have a higher Short Musculoskeletal Function Assessment bothersome index (22.42 vs 13.77, p = 0.03), a lower Short Form 36 Health Survey Physical Component Summary score (42.44 vs 50, p < 0.01) and a decreased Lower Limb Core Scale score (47.08 vs 90.52, p < 0.01), compared to US population norms. The Short Form 36 Health Survey Mental Component Summary scores and Short Musculoskeletal Function Assessment function index failed to demonstrate significant differences. Gender affected overall disability.ConclusionIn this study, significant long-term disability was demonstrated after fibular flap reconstruction, as measured by the Lower Limb Core Scale.

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