scholarly journals Parafuso intramedular de redução fechada em fraturas das falanges proximais dos dedos da mão: Uma série de três casos

2021 ◽  
Author(s):  
Arsanto Triwidodo ◽  
Hendar Nugrahadi Priambodo ◽  
Yogi Ismail Gani
Keyword(s):  
Quick Dash

ResumoAs lesões esqueléticas mais frequentes são as fraturas que ocorrem nas mãos, que representam aproximadamente 20% de todas as fraturas. As mais comuns são as fraturas falangeanas, que abrangem 6% de todas as fraturas. As fraturas da falange proximal aparecem com mais frequência. O principal objetivo do atendimento é corrigir a anatomia, reduzir os danos aos tecidos moles, e mobilizar os dedos atingidos assim que a estabilização da fratura permitir. Este relato tem como objetivo examinar os efeitos clínicos e da radiação nas fraturas da falange proximal, em pacientes infectados com a fixação de parafuso intramedular que foram submetidos a redução fechada. Este é o relato de três casos consecutivos de fratura da falange: duas fraturas da base e uma fratura simples da diáfise. Todos foram submetidos a redução fechada com parafuso intramedular de compressão sem cabeça. A magnitude pré-operatória da angulação da falange proximal foi em média 30,3° (variação de 13° a 42°). Dois pacientes apresentaram deformidade rotacional. Os achados clínicos foram medidos com a versão abreviada do questionário de Disfunções do Braço, Ombro e Mão (Quick Disabilities of the Arm, Shoulder and Hand, QuickDash, em inglês), em que foram avaliados a amplitude de movimento e os resultados funcionais. Complicações foram observadas em um período mínimo de 3 meses. Os pacientes apresentavam flexo-extensão ativa total na articulação interfalangiana proximal e na articulação metacarpofalangiana de flexo-extensão sem deformidade rotacional. A pontuação no Quick-DASH foi satisfatória (média: 2,3; variação: 0 a 4,5). Não houve cirurgias secundárias, e não se observaram complicações. A fixação intramedular das fraturas da falange proximal com o parafuso de tensão canulado tem se mostrado uma cirurgia segura, com excelente desempenho funcional e recuperação precoce. A fratura é minimizada e consolidada adequadamente pelos pacientes.

Cambios en la función y calidad de vida en paciente con ehlers-danlos mediante un programa de ejercicio terapéutico y práctica

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Alberto Pérez-González ◽  
Juan José Fernández-Pérez
Keyword(s):  
Calidad De Vida ◽  
Quick Dash

Introducción: El síndrome de Ehlers Danlos (EDS) es una colagenopatía hereditaria, producida por defectos genéticos de la formación de colágeno. En la literatura, la cirugía ortopédica no reporta ningún beneficio sobre el dolor, siendo siempre la segunda opción de tratamiento, no existiendo evidencia para un tratamiento conservador adecuado. Presentación del caso: paciente MR, mujer de 18 años con sensación de debilidad en miembros inferiores, con dolor articular en miembro inferior (EVA 28). Como antecedentes médicos, el más relevante es síndrome de Ehlers-Danlos (SED) tipo hipermóvil y múltiples cirugías ortopédicas. Hallazgos clínicos: el análisis de la marcha muestra un patrón en Trendelenburg. No presenta una alteración en factores psicosociales, pero sí en función de miembro superior (Quick Dash) 66% e inferior (LEFI) 43/80. Tratamiento conservador: siendo el objetivo principal mejorar la función del miembro inferior, se realizó una intervención de fisioterapia ejercicio terapéutico y trabajo de marcha con imaginería motora y observación de acciones. Resultados y conclusión: mejora de todas las variables al mes de tratamiento, en especial la TSK-11 (11 puntos). La imaginería motora y observación de acciones mejora la ejecución de la marcha post aplicación y de la función de miembro inferior combinado con ejercicio.

Patient Reported Outcomes (PROs) – a Tool for Strengthening Patient Involvement and Measuring Outcome in Orthopaedic Outpatient Rehabilitation

2020 ◽  
Author(s):  
Marcus Müller ◽  
Joscha Brunssen ◽  
Martin Messingschlager
Keyword(s):  
Lower Extremity ◽  
Patient Reported Outcomes ◽  
Patient Involvement ◽  
Pain Treatment ◽  
Cervical Disc ◽  
Outpatient Rehabilitation ◽  
Positive Effects ◽  
Disc Surgery ◽  
Patient Reported ◽  
Quick Dash

AbstractThe present study serves to establish Patient Reported Outcomes (PROs) as a tool for strengthening patient involvement and measuring outcomes in orthopaedic outpatient rehabilitation. Assessments by FFbH-R (Hannover Back Function Questionnaire for patients with back problems), Quick-DASH (Disabilities of Arm, Shoulder, and Hand Score for patients with upper extremity lesions), and LEFS (Lower Extremity Function Scale for patients with lower extremity lesions) were employed in 20 outpatient rehabilitation centres over a period of 12 months to evaluate changes in performance and participation from the subjective patient perspective. The following questionnaires were used: FFbH-R status post: lumbar disc surgery; cervical disc surgery; spinal canal decompression; conservative back pain treatment; other; Quick-DASH status post: rotator cuff reconstruction; shoulder arthroplasty; fracture (conservative or osteosynthesis); other; LEFS status post: hip arthroplasty; knee arthroplasty; anterior cruciate ligament repair; osteotomy; fracture (conservative treatment or osteosynthesis); other. Analysis of the 6,751 usable data sets demonstrated significant positive changes in all scores and diagnostic subgroups. The mean difference in score was 14.2 points in the FFbH-R, − 22 points in the Quick-DASH and 18 points in the LEFS. Thus, this study proves the positive effects of orthopaedic rehabilitation in an outpatient setting. PROs were instituted on a permanent basis in seven of the participating institutions.

A proximal interphalangeal joint custom-made orthosis in trigger finger: Functional outcome

Hand Therapy ◽  
2021 ◽  
pp. 175899832110187
Author(s):  
Kawee Pataradool ◽  
Chayanin Lertmahandpueti
Keyword(s):  
Outcome Measures ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Mean Difference ◽  
Trigger Finger ◽  
Symptom Improvement ◽  
Dash Score ◽  
Full Time ◽  
Custom Made ◽  
Quick Dash

Introduction Trigger finger is a common and functionally limiting disorder. Finger immobilization using an orthotic device is one of the conservative treatment options for treating this condition. The most common orthosis previously described for trigger finger is metacarpophalangeal joint immobilization. There are limited studies describing the effectiveness of proximal interphalangeal joint orthosis for treatment of trigger finger. Methods This study was a single group pretest-posttest design. Adult patients with single digit idiopathic trigger finger were recruited and asked to wear a full-time orthoses for 6 weeks. The pre- and post-outcome measures included Quick-DASH score, the Stages of Stenosing Tenosynovitis (SST), the Visual Analogue Scale (VAS) for pain, the number of triggering events in ten active fists, and participant satisfaction with symptom improvement. Orthotic devices were made with thermoplastic material fabricated with adjustable Velcro tape at dorsal side. All participants were given written handouts on this disease, orthotic care and gliding exercises. Paired t-tests were used to determine changes in outcome measures before and after wearing the orthosis. Results There were 30 participants included in this study. Evaluation after the use of PIP joint orthosis at 6 weeks revealed that there were statistically significant improvements in Quick-DASH score from enrolment (mean difference −29.0 (95%CI −34.5 to −23.4); p < 0.001), SST (mean difference −1.4 (95%CI −1.8 to −1.0); p < 0.001) and VAS (mean difference −3.4 (95%CI −4.3 to −2.5); p < 0.001). There were no serious adverse events and patient satisfaction with the treatment was high. Conclusions Despite our small study size, the use of proximal interphalangeal joint orthosis for 6 weeks resulted in statistically significant improvements in function, pain and triggering, and also high rates of acceptance in patients with isolated idiopathic trigger finger.

scholarly journals A study on the outcome of displaced midshaft non-comminuted clavicle fractures treated with anatomical locking plate versus titanium elastic nail

2020 ◽  
pp. 221049172097518
Author(s):  
Vineet Thomas Abraham ◽  
Chandrasekaran Marimuthu
Keyword(s):  
Functional Outcome ◽  
Locking Plate ◽  
Plate Versus ◽  
Dash Score ◽  
Titanium Elastic Nail ◽  
Constant Murley Score ◽  
Elastic Nail ◽  
Clavicle Fractures ◽  
The Mean ◽  
Quick Dash

Purpose: Fixation of displaced midshaft clavicle is well known to decrease nonunion, malunion and shoulder disability as compared to nonoperative treatment. This study was done to compare the clinical and functional outcome of group 1 clavicle fractures treated with anatomic locking plates (ALP) versus Titanium elastic nail (TEN). Methods: We studied patients presenting with displaced midshaft clavicle fractures treated with ALP or TEN. The study period was from Jan 2013 to Dec 2016. Patients were reviewed and at each visit clinical and radiological progress of union was noted, complications if any were noted, functional assessment was done using the quick Dash score and Constant Murley score. Results: A total of 116 patients met our inclusion criteria. 62 patients were treated with TEN and 54 with ALP. Bony union was achieved at an average of 11.8 weeks in the TENS group and 12.8 weeks in the ALP group post operatively and this was found to be significant. The mean postoperative Constant Murley score in the ALP and the TEN groups were 92.8 (range 80–97), and 93.7 (82–97) respectively. The mean postoperative quick dash score in the ALP and TEN groups were 2.48(range from 0 to 6.8) and 2.1 (range 0–9.1) respectively. Conclusion: Both Anatomical locking plate and TEN are good options for the treatment of non-comminuted mid clavicular fractures as they have a similar functional outcome. TEN nail insertion has the advantage of being minimally invasive, having a faster union time and may be recommended in midshaft clavicle fractures without comminution.

Validation of a Handprint for Clinical Evaluation of Dupuytren’s Contracture

2021 ◽  
Author(s):  
Takashi Ajiki ◽  
Akira Murayama ◽  
Yukinori Hayashi ◽  
Katsushi Takeshita
Keyword(s):  
Clinical Evaluation ◽  
High Reliability ◽  
Flexion Contracture ◽  
Dupuytren’S Contracture ◽  
Therapeutic Effects ◽  
Level Of Evidence ◽  
Dupuytren's Contracture ◽  
Palmar Surface ◽  
Patient Reported ◽  
Quick Dash

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.

Distal interphalangeal Joint Arthrodesis using only Kirschner Wires in small distal Phalanges

2021 ◽  
Vol 53 (05) ◽  
pp. 462-466
Author(s):  
Jun-Ku Lee ◽  
Soonchul Lee ◽  
SeongJu Choi ◽  
Dong Hun Han ◽  
Jongbeom Oh ◽  
...  
Keyword(s):  
Distal Phalanx ◽  
Bony Union ◽  
Dash Score ◽  
Medical Database ◽  
X Ray ◽  
Wire Fixation ◽  
Distal Interphalangeal ◽  
K Wires ◽  
Quick Dash

Abstract Purpose To report the clinical and radiographic results of arthrodesis of relatively small-sized distal interphalangeal joints (DIPJs) using only K-wire fixation. Patients and methods Between January 2000 and December 2018 28 arthrodesis in 21 patients (9 males and 12 females with an average age of 52.1 years) with relatively small-sized DIPJs were performed using only K-wires. Data on patient’s characteristics, such as age, sex, affected finger, and the number and size of the used k-wires were collected from the medical database. The narrowest diameter of the cortex and medulla of the distal phalanx was measured on preoperative plain radiographs. The time to union and the arthrodesis angle was determined using serial X-ray radiography follow-up. Preoperatively and at the latest follow-up examination, pain using the visual analogue scale (VAS) and the quick DASH score was registered. In addition, complications were investigated. Results Average follow-up period was 11.4 months. The small finger was mostly affected (n = 12; 42.9 %). The narrowest diameters of the distal phalanx cortex and the medulla measured on preoperative X-ray images were 2.8 mm (SD 0.5) and 1.2 mm (SD 0.4), respectively. Seven fusions were done with use of 1 K-wire, 20 with 2 (71.4 %), and 1 with 3 K-wires. The most common K-wire sizes were 1.1-inch (24 K-wires = 48 %), and 0.9 inch (21 K-wires = 42 %) The preoperative VAS score and quick DASH score improved from 6.1 (range: 0–9) and 25.8 (range: 2–38) to 0.4 (range: 0–2) and 3.4 (range: 0–10.2), respectively. 25 (89.3 %) out of 28 fingers achieved bony union in an average of 96.1 days (range: 58–114) with three non-union. Conclusion Arthrodesis of small DIPJs with K-wire fixation has a high success rate. Therefore, we suggest K-wire fixation as an acceptable alternative for patients with a small phalanx which may be at risk of mismatch with bigger implants. However, concerns remain in terms of fusion delay with K-wire only fixation.

scholarly journals Η απόδοση στην ελληνική γλώσσα και ακολούθως η αξιολόγηση και η στατιστική τεκμηρίωση της εγκυρότητας του κλινικού ερωτηματολογίου DASH, της αμερικανικής ορθοπαιδικής εταιρείας AAOS, στην ελληνική του μορφή, σε δείγμα εκατό Ελλήνων ασθενών με παθήσεις στο άνω άκρο

2007 ◽  
Author(s):  
Γεώργιος Γκουδέλης
Keyword(s):  
Construct Validity ◽  
Internal Consistency ◽  
Treatment Effect ◽  
T Test ◽  
Group Validity ◽  
Sf 36 ◽  
Quick Dash

O σκοπός της διατριβής αυτής είναι η μετάφραση από την Αγγλική στην Ελληνική γλώσσα και η προσαρμογή του στην κουλτούρα και τον τρόπο ζωής των Ελλήνων του ερωτηματολογίου DASH (The Disabilities of the Arm Shoulder and Hand) της Αμερικανικής Ορθοπεδικής Εταιρείας που αφορά στην αξιολόγηση της λειτουργικής ικανότητας του άνω άκρου. Ακολούθως διενεργείται η στατιστική τεκμηρίωσης αυτού όσον αφορά στο κύρος (validity) και την αξιοπιστία (reliability) σε 100 Έλληνες ασθενείς και η σύγκρισή του με το ήδη τεκμηριωμένο διεθνώς ερωτηματολόγιο SF-36 το οποίο αξιολογεί την σε σχέση με την υγεία ποιότητα ζωής των ασθενών με προβλήματα του μυοσκελετικού συστήματος. Ο παράγοντας αξιοπιστίας internal consistency των 30 ερωτήσεων του DASH εκτιμώμενος από τον δείκτη Cronbach ήταν 0,96 η οποία φανερώνει την μεγάλη αξιοπιστία και τα αμελητέα λάθη μέτρησης των μεταφρασμένων DASH. Η αξιοπιστία καθορίστηκε υπολογίζοντας 4 παράγοντες: 1) τον συντελεστή συσχέτισης του Pearson, 2) t-test κατά ζεύγη, 3) συντελεστή συσχέτισης του Kental tau-b και 4) δείκτη Cohen Kappa. Η μελέτη αξιολόγησης της εγκυρότητας έγινε με τρείς παραμέτρους: 1) Construct validity, 2) treatment effect validity, 3) known group validity. Η Ελληνική έκδοση του DASH και το Quick DASH είναι διαθέσιμες στο διαδίκτυο και μπορούν να χρησιμοποιηθούν στην κλινική πρακτική ή την έρευνα.

scholarly journals The Impact of Sensory, Motor and Pain Impairments on Patient- Reported and Performance Based Function in Carpal Tunnel Syndrome

2017 ◽  
Vol 11 (1) ◽  
pp. 1258-1267 ◽  
Author(s):  
Goris Nazari ◽  
Niyati Shah ◽  
Joy C MacDermid ◽  
Linda Woodhouse
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Hand Function ◽  
Pinch Strength ◽  
Sensory Motor ◽  
Tunnel Syndrome ◽  
And Performance ◽  
Quick Dash ◽  
The Impact ◽  
Vibration Threshold

Background: Research has suggested that persistent sensory and motor impairments predominate the symptoms experienced by patients with carpal tunnel syndrome (CTS); with intermittent pain symptoms, being less predominant. Objective: The study aims to determine the relative contribution of sensory, motor and pain impairments as contributors to patient-report or performance-based hand function. Methods: Fifty participants with a diagnosis of CTS confirmed by a hand surgeon and electrodiagnosis were evaluated on a single occasion. Impairments were measured for sensibility, pain and motor performance. A staged regression analysis was performed. In the first step, variables with each of the 3 impairment categories were regressed on the Symptom Severity Scale (SSS) to identify the key variables from this domain. Models were created for both self report (Quick Disabilities of arm, shoulder and hand- Quick DASH) and performance based (Dexterity) functional outcomes. Backward regression modelling was performed for SSS and then, to allow comparability of the importance of different impairments across models, the 7 significant variables from the SSS model were forced into the models. Results: Variables: age, touch threshold and vibration threshold of the little finger of unaffected hand, median-ulnar vibration threshold ratio of affected hand, mean pain tolerance of unaffected hand, grip strength and pinch strength of affected hand, explained 31%, 36% and 63% of the variance in SSS, Quick DASH and dexterity scores, respectively. Conclusion: Hand function in patients with CTS is described by variables that reflect sensory status of the median and ulnar nerves, the persons pain threshold, grip and pinch strength impairments and age.

scholarly journals Giant Cells Tumors of Synovial Sheaths of the Hand are Benign Tumors with a Good Prognosis

2017 ◽  
Vol 1 (3) ◽  
pp. 01-03
Author(s):  
Cesar Edgar ◽  
Trey Rafael ◽  
Robert Mason ◽  
Diego Luis
Keyword(s):  
Retrospective Study ◽  
Tumor Resection ◽  
Tumor Development ◽  
Epidemiological Data ◽  
Recurrence Risk ◽  
Giant Cells ◽  
Good Prognosis ◽  
Benign Tumors ◽  
Macroscopic Appearance ◽  
Quick Dash

Introduction: The giant cells tumors (GCT) of the hand are common benign tumors that pose a recurrence problem. The aim of our study is to analyze epidemiological and clinical data, evaluate results and determine the recurrence risk factors. Materials and Methods: This is a retrospective study of 50 patients operated between 2003 and 2015 for a (GCT) of the hand, we observed epidemiological data, clinical outcome (quotation TAM score Kapandji and quick DASH), the appearance of recurrence, the histological appearance, localization, excision margins and invasion of adjacent anatomical structures were analyzed. Results: We report a retrospective study over thirteen years of 50 cases of GCT of the hand, with a mean age of 42 years and a sex ratio of 1/3. The motive for consulting was the presence of a digital mass, followed by discomfort bending in 20%. Palmar localization was found in 54%, especially at the second ray (30%) and facing the distal phalanx (38%). The radiograph showed soft tissue opacity in 60% of cases. All patients underwent surgery, the macroscopic appearance showed an encapsulated, lobed and yellow chamois tumor in 80% of cases. The mean follow up was 30 months with extremes of 2 months to 10 years. We noted 5 recurrences one of which recurred twice; the average time to recurrence was 22 months and ranged from 6 months to 36 years. In each subsequent offense we noted an intra-articular tumor development in 4 cases and tendon erosion in one case. Functional complications type of stiffness in flexion in 2 cases and hypoesthesia of a finger in 2 cases. The quick way DASH was 2.2 on 100. Conclusion: The GCT of synovial sheaths of the hand are a benign tumors with a good prognosis, the main problem is the risk of recurrence that depends on the type of tumor, intra articular tumor development and quality of tumor resection.

scholarly journals STUDY OF UPPER LIMB PERIPHERAL NERVE PATHOLOGIES WITH SPECIAL EMPHASIS ON QUICK DASH SCORE AND SELECTED ELECTROMYOGRAPHIC PARAMETERS

2018 ◽  
Vol 7 (04) ◽  
pp. 499-503
Author(s):  
Archana Verma ◽  
Sachin Verma ◽  
Sonia Moses ◽  
Rajkumar Mathur ◽  
Lukesh Patil ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Upper Limb ◽  
Dash Score ◽  
Quick Dash
Sign in / Sign up

Export Citation Format

Share Document