THE RECALL DASH SCORE — A NOVEL RESEARCH TOOL

Hand Surgery ◽  
2013 ◽  
Vol 18 (01) ◽  
pp. 11-14 ◽  
Author(s):  
Nicholas Reynolds ◽  
Sunil Thirkannad
Keyword(s):  
Statistical Analysis ◽  
Patient Population ◽  
Hand Function ◽  
Hand Surgery ◽  
Clinic Visit ◽  
Research Tool ◽  
Time Interval ◽  
Dash Score ◽  
Pre Treatment

The DASH score is a universally accepted method for assessment of hand function. However, there are occasions when a pre-treatment DASH score is unavailable. This study provides a solution to this situation. An initial DASH score was obtained from all patients at the time of their first clinic visit. A second score was obtained at the time of final follow-up asking the patient to "Recall" their pre-treatment status. The two scores were compared with appropriate statistical analysis. Thirty-eight patients were included in the study and scores were obtained at an average time interval of 32 weeks (6–121 weeks). Excellent agreement was noted for the ability of the patient population to recall their scores with a group correlation of 0.86. This proves that the Recall DASH score is an excellent and useful research tool for use in hand surgery.

Partial trapeziectomy and pyrocarbon interpositional arthroplasty for trapeziometacarpal osteoarthritis: minimum 8-year follow-up

2020 ◽  
Vol 45 (5) ◽  
pp. 472-476 ◽  
Author(s):  
Francesco Smeraglia ◽  
Sergi Barrera-Ochoa ◽  
Gerardo Mendez-Sanchez ◽  
Morena A. Basso ◽  
Giovanni Balato ◽  
...  
Keyword(s):  
Young Patients ◽  
Hand Surgery ◽  
Dash Score ◽  
Level Of Evidence ◽  
Interpositional Arthroplasty ◽  
Trapeziometacarpal Osteoarthritis ◽  
Select Group ◽  
Trapeziometacarpal Joint Osteoarthritis ◽  
Surgical Treatments

We undertook a retrospective study to evaluate minimal 8-year outcomes of 46 trapeziometacarpal joints (46 patients) treated with pyrocarbon implant arthroplasty after partial trapeziectomy for trapeziometacarpal joint osteoarthritis in two different hand surgery units. The mean follow-up interval was 9.5 years (average 113 months with a range 97–144 months). The study showed that pyrocarbon interpositional arthroplasty provided pain relief and high patient satisfaction. All patients experienced a reduction in the DASH score, with an average change of 30 points. The visual analogue scale score, the Kapandji score, and key pinch also showed remarkable improvement. The PyroDisk implant exhibited good longevity, with good implant survival. A review of the literature revealed that the functional outcomes after implant surgery are not superior to more common techniques, such as trapeziectomy with or without ligamentoplasty. Therefore, this is a reliable surgery but may not have added benefits over simpler surgical treatments. This implant could have a role, perhaps in a select group of young patients, as a time-procuring procedure. Level of evidence: IV

scholarly journals Associations Between the Fracture Type and Functional Outcomes After Distal Radial Fractures Treated With a Volar Locking Plate

Medicina ◽  
2013 ◽  
Vol 49 (9) ◽  
pp. 62
Author(s):  
Kęstutis Braziulis ◽  
Rytis Rimdeika ◽  
Rima Kregždytė ◽  
Šarūnas Tarasevičius
Keyword(s):  
Locking Plate ◽  
Hand Function ◽  
Linear Regression Analysis ◽  
Type A ◽  
Dash Score ◽  
Volar Locking Plate ◽  
Fracture Type ◽  
Type C ◽  
And Gender

Objective. The aim of this study to investigate the associations of fracture type, age, and gender with hand function after distal radius fractures treated with a volar locking plate at a 6-month follow-up. Material and Methods. A total of 120 patients with displaced distal radius fractures were included into the study. They were operated on using a volar locking plate system. All the fractures were classified according to the AO classification, and the patients were divided into 3 groups by the fracture type. The range of motion and grip strength were evaluated at the 6-month follow-up. Multivariate linear regression analysis was used to evaluate the associations of age, gender, and fracture type with the score of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. The DASH questionnaire was completed as an outcome measure. Results. A total of 28 patients experienced type A fractures; 70 patients, type B fractures; and 22 patients, type C fractures. No statistically significant difference regarding age and sex among the groups was observed. At 6 months after the surgery, the mean DASH score for type A, B, and C fractures was 16, 13, and 32, respectively (P=0.01). After the surgery, the radiographic parameters such as the volar tilt and the ulnar variance were significantly worse in the patients with type C fractures. Grip strength and the range of motion of the contralateral healthy hand at the 6-month follow-up were significantly better than those of the operated hand. The linear regression analysis showed that the type C fracture was the only factor significantly associated with lower DASH score. Conclusions. The patients with type C fractures treated with a volar locking plate had a worse wrist function as compared with the patients type A and B fractures at the 6-month follow-up. The postoperative hand function was significantly associated only with the type C fracture, while age and gender had no significant impact.

Metacarpophalangeal Joint Arthroplasty Based on the Osseointegration Concept

1993 ◽  
Vol 18 (6) ◽  
pp. 693-703 ◽  
Author(s):  
G. LUNDBORG ◽  
P.-I. BRÅNEMARK ◽  
I. CARLSSON
Keyword(s):  
Range Of Motion ◽  
Hand Function ◽  
Clinical Signs ◽  
Hand Surgery ◽  
Metacarpophalangeal Joint ◽  
Active Range Of Motion ◽  
Good Cosmetic ◽  
Primary Osteoarthrosis ◽  
Post Traumatic

The osseointegration concept has been used for fixation of 68 MP joint endoprostheses in 31 patients operated on at the Department of Hand Surgery, Malmö General Hospital during the period 1988–1992. The indications were rheumatoid arthritis (50 joints), primary osteoarthrosis (three joints), post-traumatic osteoarthrosis (three joints), post-traumatic osteoarthrosis (five joints), post-infectious osteoarthrosis (seven joints) and joint deformities secondary to spastic conditions (three joints). The average follow-up time was 2.5 years (6–54 months). The surgical procedure included resection of the joint followed by introduction of screw-shaped titanium fixtures into the bone marrow cavities of the metacarpal and the phalangeal base. Rheumatoid cases usually required grafting of cancellous bone and marrow from the iliac crest. At the same time a flexible constrained silicone spacer was connected to the titanium fixtures in such a way as to allow later replacement of the spacer if accessory. The average active range of motion (ROM) was 57° in the rheumatoid cases and 50° in all cases. Radiological and clinical osseointegration occurred in every case, and there were no clinical signs of loosening. In four cases (6%) there was a fracture of the joint mechanism. Patient satisfaction was high, with pain relief, increased range of motion, improved hand function and good cosmetic appearance.

scholarly journals Functional reconstruction of severe hand injuries using allogeneic tendons: a retrospective study

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052095503
Author(s):  
Gu Heng Wang ◽  
Tian Mao ◽  
Shu Guo Xing ◽  
Ya Lan Chen ◽  
Yu Xuan Zhang ◽  
...  
Keyword(s):  
Cell Count ◽  
Grip Strength ◽  
Hand Function ◽  
Hand Injuries ◽  
Pinch Strength ◽  
Dash Score ◽  
Active Motion ◽  
Functional Reconstruction ◽  
Total Active Motion

Objective To evaluate the effectiveness and safety of allogeneic tendons for functional reconstruction of severe hand injuries. Methods From August 2007 to July 2014, we performed functional reconstruction with tendon allografts for severe hand injuries affecting two or more tendons. At the final follow-up, we assessed total active motion (TAM); pincer pinch strength; grip strength; Disabilities of the Arm, Shoulder, and Hand (DASH) score; degree of satisfaction; and adhesion. We measured the white blood cell count, C-reactive protein concentration, erythrocyte sedimentation rate, total T-cell count, and CD4+T/CD8+T ratio to evaluate the immune response and check for infection. Results Ten patients received 26 allogeneic tendons to reconstruct hand function. The average follow-up period was 50.0 months (range, 24–82 months). The TAM was 126.4° (12°–253°), pincer pinch strength was 0.83 kg (0–4.5 kg), and grip strength was 13.69 kg (4–41.5 kg). The DASH score was 14.25 (3.3–30.8), and seven and three patients were satisfied and partially satisfied, respectively. One patient developed tendon adhesion. All immune and infectious parameters were within the reference range. Conclusion Functional reconstruction using allogeneic tendons for severe hand injuries with multiple tendon defects was effective and safe; however, more research is needed.

Analysis of Fracture Midshaft Clavicle Treated by Intramedullary Device Versus Conservative

2021 ◽  
Vol 12 (4) ◽  
pp. 2615-2629
Author(s):  
Swapnil Date ◽  
Kiran Saoji ◽  
Kushal Surana
Keyword(s):  
Clavicle Fracture ◽  
Time Interval ◽  
Dash Score ◽  
Female Ratio ◽  
Conservative Group ◽  
Intramedullary Device ◽  
Male Female Ratio ◽  
Clinical And Radiological Outcome ◽  
The Mean

Clavicle fractures account for about 2.6 to 4 % of all fractures. The best method to treat the displaced midshaft fracture of the clavicle remains a topic of debate. Although there is a large number of studies published about this topic, it is still relatively unknown as to which modality provides better long term functional outcomes and low complications rates. In our study, we have analyzed midshaft clavicle fracture treated with intramedullary device versus conservatively in terms of clinical, functional and radiological outcomes. The mean age of the patients in our study was 35.766 years. Male: Female ratio was 5.0:1.0.  The mean time interval between injury and intervention was 2.1 days. Out of 30 patients, 11 patients (36.666%) had left sided fractures, while 19 patients (63.333%) had right sided fractures. Out of 30 patients, 12 patients (40%) had type 2B1 fracture according to Robinson's classification, followed by type 11 patients (36.666%) type 2B2, 6 patients (20%) type 2A1 and 1 patient (3.333%) type 2A2 fracture. Inoperative group, the mean Constant and Murley score before the intervention, at 1 month follow up, 3 months follow up and at 6 months follow up were 47.46, 76.73, 82.8 and 90.73, while in a conservative group, it was 47.53, 71.66, 79.2 and 89.46 respectively. Inoperative group, the mean Q-DASH score before the intervention, at 1 month follow up, 3 months follow up and at 6 months follow up were 29.33, 19.33, 16.86 and 13.8, while in a conservative group, it was 31.266, 22.533, 18.8 and 15.66 respectively. The final outcome, on the basis of the final Constant and Murley score in 13 patients (43.33%), was excellent, 11 patients (36.66%) was good and 6 patients (20%) was fair. Inoperative group, complications were seen in 6 patients (40%), while in the conservative group, complications were seen in 10 patients (66.66%). Thus, the functional, clinical and radiological outcome of the patients managed surgically with an intramedullary device was significantly better when compared with patients treated conservatively.

scholarly journals Giant Cell Tumor on Tendon Sheath of the Hand: The Incidence of Recurrence, Functional Outcomes and a Literature Review

2020 ◽  
Vol 5 (12) ◽  
pp. 638-644
Author(s):  
Kastanis G ◽  
Bachlitzanaki M ◽  
Kapsetakis P ◽  
Christoforidis C ◽  
Chaniotakis C ◽  
...  
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Functional Outcomes ◽  
Hand Function ◽  
Tendon Sheath ◽  
Cell Tumor ◽  
Dash Score ◽  
A2 Pulley ◽  
Quick Dash

Giant Cell Tumor on Tendon Sheath (GCTTS) of the hand is a benign nodular tumor originated from tendon sheath of the tendons and the joints and is the second most common soft tissue tumor of the hand after ganglion cyst. The aim of this study is to evaluate 79 cases of giant cell tumor of tendon sheath of the hand and to analyze the postoperative functional outcomes and recurrence rate of the tumor in a mean period of five years follow up. Material and Methods: Fifty five subjects were females and twenty four males with an average age of 38,8 years-old (range23-65 years old) were included in this study. The most frequent location of tumor was the index finger (32/79 patients, 40,5%). The majority of patients was presented in outpatient’s clinic for a painless swelling on volar side of the digit, while only 13(16,45%) patients presented for painful mass and numbness of the digit in 7(8,9%) cases. All cases were categorized by Al-Qattan classification system with type I lesion in 51(64,5 %) cases and type II in 28(35,5 %) cases. Dimension of tumors macroscopically varied from 0,4cm to 5 cm. In 12 cases we reconstructed the A2 pulley to avoid bowstring deformity and eventual postoperative loss of hand function. In 12 cases we reconstructed the A2 pulley to avoid bowstring deformity and eventual postoperative loss of hand function. 8 patents with bone erosion underwent postoperatively complementary local radiotherapy. A standard protocol of rehabilitation was performed in all patients. Results: Results were evaluated according to complications, range of motion, Quick Dash Score and functional satisfaction of patients in a mean follow-up of 49 months. Two major complications presented in this study: 5 cases with transitional neuroapraxia and 6 cases with recurrence of the tumor with a mean of postsurgical period 14,8 months. Finally at last assessment the mean Quick Dash Score was 4,5 (range from 0-11,4) the range of motion was fully recovered in 73 patients while patient’s satisfaction rated from “very satisfied” in 58(73,4%) cases, “satisfied” in 17(21,5) and “dissatisfied” in 4(5,1%) patients. Conclusions: Giant cell tumor of tendon sheath of the hand is a common tumor which presents a high incidence of recurrence in different populations of patients. The goal of treatment is to reduce the recurrence rate and restore a functional hand. The operation procedure should be well planned preoperatively, the tumor must excised en block, dissection must be under surgical loop and must be emphasized to remove satellite lesion while when patients present increased risk factors or inadequate excision of the mass, postoperative radiotherapy is performed.

Clinical Evaluation of the Variables associated with Treatment Acceptability and Their Relation to Compliance

1992 ◽  
Vol 18 (1) ◽  
pp. 67-76 ◽  
Author(s):  
Thomas M. Reimers ◽  
David P. Wacker ◽  
Linda J. Cooper ◽  
Agnes O. Deraad
Keyword(s):  
Behavior Problem ◽  
Behavior Management ◽  
Positive Reinforcement ◽  
Treatment Acceptability ◽  
Clinic Visit ◽  
Future Research ◽  
Parental Ratings ◽  
Problem Severity ◽  
The Relationship

The authors examined the acceptability ratings of positive reinforcement procedures recommended to parents seen in a pediatric behavior management outpatient clinic. Parental ratings of acceptability were obtained in the clinic and 1, 3, and 6 months following their initial clinic visit. Acceptability variables were examined by group (parents who rated the acceptability of treatments as high vs. low) and by severity (parents who rated their children's behavior problem as severe vs. mild). The relationship between these variables and reported compliance was also examined. Results show that the acceptability variables were useful in differentiating between parents who rated treatments to be more acceptable and parents who rated treatments to be less acceptable. Differences were also observed as a function of behavior problem severity. Significant correlations occurred between acceptability variables and compliance at each of the follow-up points. Results are discussed in relation to the clinical significance of these findings and the impetus they might serve for future research.

scholarly journals Time-to-Treatment in Oral Cancer: Causes and Implications for Survival

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1321
Author(s):  
Constanza Saka-Herrán ◽  
Enric Jané-Salas ◽  
Antoni Mari-Roig ◽  
Albert Estrugo-Devesa ◽  
José López-López
Keyword(s):  
Oral Cancer ◽  
Previous Treatment ◽  
Diagnostic Procedures ◽  
Original Data ◽  
Primary Treatment ◽  
Medical Attention ◽  
Time Interval ◽  
Pre Treatment ◽  
The Impact ◽  
Lack Of Knowledge

The purpose of this review was to identify and describe the causes that influence the time-intervals in the pathway of diagnosis and treatment of oral cancer and to assess its impact on prognosis and survival. The review was structured according to the recommendations of the Aarhus statement, considering original data from individual studies and systematic reviews that reported outcomes related to the patient, diagnostic and pre-treatment intervals. The patient interval is the major contributor to the total time-interval. Unawareness of signs and/or symptoms, denial and lack of knowledge about oral cancer are the major contributors to the process of seeking medical attention. The diagnostic interval is influenced by tumor factors, delays in referral due to higher number of consultations and previous treatment with different medicines or dental procedures and by professional factors such as experience and lack of knowledge related to the disease and diagnostic procedures. Patients with advanced stage disease, primary treatment with radiotherapy, treatment at an academic facility and transitions in care are associated with prolonged pre-treatment intervals. An emerging body of evidence supports the impact of prolonged pre-treatment and treatment intervals with poorer survival from oral cancer.

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