scholarly journals Patient satisfaction after treatment of distal radial fractures in older adults

2019 ◽  
Vol 45 (1) ◽  
pp. 77-84 ◽  
Author(s):  
Kevin C. Chung ◽  
Sarah E. Sasor ◽  
Kelly A. Speth ◽  
Lu Wang ◽  
Melissa J. Shauver ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Grip Strength ◽  
Hand Surgery ◽  
Additional Patient ◽  
Distal Radial Fractures ◽  
Level Of Evidence ◽  
Wrist Motion ◽  
Surgical Trial ◽  
Patient Reported ◽  
Functional Measure

The Wrist and Radius Injury Surgical Trial (WRIST) collaboration is the largest clinical trial ever conducted in hand surgery. We applied data from this study to examine the relationship between functional outcomes and patient satisfaction after treatment of distal radial fractures. Patients aged 60 years and older with isolated distal radial fractures were enrolled at 24 health systems. Grip strength and the arc of wrist motion were measured after treatment. The Michigan Hand Outcomes Questionnaire was used to measure patient satisfaction. Receiver operating characteristic curves were created using patient satisfaction as the reference standard and each functional measure as a predictor. At 12 months after treatment, mean grip strength was 82% of normal and mean arc of motion was 88% of normal. The optimal cut-off points to distinguish satisfaction from dissatisfaction occurred when patients recovered 59% of hand strength and 79% of wrist motion. Continuing therapy to increase functional gains beyond this point unnecessarily utilizes healthcare resources without additional patient-reported gains. Level of evidence: IV

Salter-Harris II distal radial fractures treated with the intrafocal K-wire technique: a retrospective study of 20 cases

2020 ◽  
pp. 175319342095307
Author(s):  
J. Terrence Jose Jerome
Keyword(s):  
Patient Reported Outcomes ◽  
Age Groups ◽  
Treatment Delay ◽  
Distal Radial Fractures ◽  
Level Of Evidence ◽  
Wrist Motion ◽  
Fracture Displacement ◽  
Patient Reported ◽  
Salter Harris

We retrospectively reviewed 20 children with Salter-Harris II fractures of the distal radius treated with intrafocal pinning according to Kapandji. Unlike conventional crossed K-wire pinning, this method avoids crossing the physis with the pins and thus minimizes the risk of physeal damage. None of the children had fracture re-displacement, angulation or growth deformities. The age, sex, side of injury, fracture displacement or angulation, treatment delay or immobilization period had any significant impact on the functional outcome. At a mean follow-up of 49 months (range 47–60), plain radiographs and MRI showed no growth arrests or physeal bars or bridges. Grip strength, wrist motion and patient-reported outcomes were almost normal with no or minimal pain at the injury site. We conclude that intrafocal K-wire pinning is simple, safe and affordable. We cannot provide data on what is acceptable fracture displacement for different age groups to allow for acceptable final remodelling of any malalignment. Level of evidence: IV

scholarly journals Which Are the Most Relevant Questions in the Assessment of Outcome after Distal Radial Fractures?

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Donald Buchanan ◽  
D. Prothero ◽  
J. Field
Keyword(s):  
Patient Satisfaction ◽  
Scoring Systems ◽  
Multivariate Regression Analysis ◽  
Distal Radial Fractures ◽  
Level Of Evidence ◽  
Household Chores ◽  
Wrist Fractures ◽  
Satisfactory Outcome ◽  
Level Of Satisfaction ◽  
Individual Variables

A study was designed to determine which wrist scoring system best correlates with patient satisfaction and which individual variables predict a satisfactory outcome. We looked at forty-five females and 5 males with wrist fractures at 12 weeks after injury and compared their level of satisfaction with various respected outcome measures. The mean age was 66 years. Multivariate regression analysis was carried out using a statistical software package. Patient satisfaction correlated best with the MacDermid, Watts, and DASH scores. The variables in these scoring systems that predicted satisfaction were pain and ability to perform household chores or usual occupation, open packets, and cut meat. The four most important questions to ask in the clinic following wrist fractures are about severity of pain and ability to open packets, cut meat, and perform household chores or usual occupation. This may provide simple and more concise means of assessing outcome after distal radial fractures. Level of evidence is level 4.

Four-corner arthrodesis with a dorsal locking plate: 4–9-year follow-up

2020 ◽  
Vol 45 (7) ◽  
pp. 673-678
Author(s):  
Lionel Athlani ◽  
Sophie Sabau ◽  
Nicolas Pauchard ◽  
François Dap ◽  
Gilles Dautel
Keyword(s):  
Sick Leave ◽  
Grip Strength ◽  
Locking Plate ◽  
Contralateral Side ◽  
Level Of Evidence ◽  
Wrist Motion ◽  
Flexion Extension ◽  
Preoperative Status ◽  
Wrist Function

We report the outcomes of four-corner arthrodesis for advanced wrist collapse in 50 patients (51 wrists) using a dorsal locking plate. At a mean follow-up of 6 years (range 4–9), pain was significantly reduced and wrist function was significantly improved compared with preoperative status. After four-corner arthrodesis, grip strength was 80% of the contralateral side, and wrist motion averaged 50° flexion–extension and 30° radioulnar deviation. Immobilization time was 5 weeks (4–6) and sick-leave was 3 months (2–5) following surgery. There were seven nonunions (14%) that underwent repeat arthrodesis. Three wrists were later converted to total arthrodesis due to persisting pain. Radiographic dorsal impingement was found in five wrists after four-corner arthrodesis and did not require reoperation. The outcomes appear not remarkably different from those reported using other fixation methods other than an apparent earlier return to activities. Level of evidence: IV

Bilateral total shoulder arthroplasty: A systematic review of clinical outcomes

2020 ◽  
pp. 175857322091682
Author(s):  
John-Rudolph H Smith ◽  
Darby A Houck ◽  
Jessica A Hart ◽  
Jonathan T Bravman ◽  
Rachel M Frank ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Clinical Outcomes ◽  
Shoulder Arthroplasty ◽  
English Language ◽  
External Rotation ◽  
Total Shoulder Arthroplasty ◽  
Cochrane Library ◽  
Level Of Evidence ◽  
Patient Reported

Background The purpose of this study was to describe the clinical outcomes following bilateral total shoulder arthroplasty (TSA). Methods A systematic search of the PubMed, Embase, and Cochrane Library databases following PRISMA guidelines was performed. English-language literature published from 2010 to 2018 analyzing bilateral TSA (anatomic and/or reverse) with a minimum one-year follow-up was reviewed by two independent reviewers. Study quality was evaluated with the Modified Coleman Methodology Score and the methodological index for non-randomized studies score. Results Eleven studies (1 Level II, 3 Level III, 7 Level IV) with 292 patients were included. Two studies reported on bilateral anatomic TSA ( n = 54), six reported on bilateral reverse TSA (RTSA; n = 168), two reported on anatomic TSA with contralateral RTSA (TSA/RTSA; n = 31), and one compared bilateral anatomic TSA ( n = 26) and bilateral RTSA ( n = 13). Among studies, mean revision rate ranged from 0% to 10.53% and mean complication rate ranged from 4.9% to 31.3%. At final follow-up, patients experienced significant overall improvements in range of motion and patient-reported outcome score measurements. However, bilateral anatomic TSA resulted in greater improvements in external rotation compared to bilateral RTSA. Overall patient satisfaction was 91.0%. Conclusion The available data indicate that bilateral TSA allows for functional and pain improvements and result in high patient satisfaction. Level of evidence IV.

scholarly journals Capitolunate Arthrodesis versus Four-corner Arthrodesis in Scaphoin Nonunion Advanced Collapsed Wrist Treatment

2019 ◽  
Vol 47 (01) ◽  
pp. 032-038
Author(s):  
Sara Alicia González Porto ◽  
María Ángeles Cano Leira ◽  
Alba González Rodríguez ◽  
Ángel Álvarez Jorge
Keyword(s):  
Grip Strength ◽  
Radiographic Evaluation ◽  
Dorsal Plate ◽  
Level Of Evidence ◽  
Plate Removal ◽  
Ulnar Deviation ◽  
Patient Reported ◽  
The Mean ◽  
Dash Questionnaire

Objective To evaluate the outcomes of scaphoidectomy and capitolunate arthrodesis versus four-corner arthrodesis in patients with stage III scaphoid nonunion advanced collapse (SNAC) wrists. Methods We reviewed retrospectively all of the consecutive patients surgically treated in our center between 2007 and 2015, including 20 patients in the four-corner arthrodesis group and 11 patients in the capitolunate group. The mean follow-up time was of 47 months. The follow-up evaluation included wrist range of motion (ROM), grip strength, visual analogue scale (VAS), the disabilities of the arm, shoulder, and hand (DASH) questionnaire, and the Mayo wrist scale (MWS). Postoperative complications and the radiographic evaluation were also assessed. Results There was no statistical difference in flexion, radial deviation, ulnar deviation, grip strength, VAS, DASH or MWS scores. There was a statistically significant increase (6°) in extension in capitolunate arthrodesis versus four-corner arthrodesis, possibly without clinical relevance. There were two nonunions in the four-corner group, and none in the capitolunate group. None of the patients in the capitolunate group required screw removal. One patient in the four-corner group required dorsal plate removal. One patient in each group required conversion to total arthrodesis. Conclusions Capitolunate arthrodesis shows similar results in wrist ROM, grip strength and patient-reported outcomes when compared with four-corner arthrodesis at an average follow-up period of 4 years. We did not have any pisotriquetral arthritis in the capitolunate arthrodesis group, despite not removing the triquetrum in any of patients of this group. Type of study/level of evidence Therapeutic III.

The Net Promoter Scores with Friends and Family Test after four hand surgery procedures

2018 ◽  
Vol 44 (3) ◽  
pp. 290-295 ◽  
Author(s):  
Paul Stirling ◽  
Paul J. Jenkins ◽  
Nicholas D. Clement ◽  
Andrew D. Duckworth ◽  
Jane E. McEachan
Keyword(s):  
Patient Satisfaction ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Carpal Tunnel ◽  
Hand Surgery ◽  
Functional Improvement ◽  
Level Of Evidence ◽  
Net Promoter Score ◽  
Net Promoter

The Friends and Family Test, a variant of the Net Promoter Score, was adapted for the National Health Service to evaluate overall patient satisfaction and how likely patients are to recommend an intervention. It ranges from −100 to 100. Positive scores indicate good performance. This study quantifies the scores in 810 patients at a mean of 14 months following four common procedures. The score was 83 for trigger finger release ( n = 103), 68 for carpal tunnel decompression ( n = 467), 62 for surgery for Dupuytren’s disease ( n = 224) and 44 for ganglia excision ( n = 16). Our study indicates that these procedures are highly valued and are recommended by patients according to the Friends and Family Test. The results of the Friends and Family Test correlated well with postoperative functional improvement and satisfaction. We conclude from this study that a compound score based on the Friends and Family Test is a useful addition to traditional measures of patient satisfaction. Level of evidence: II

Primary Total Knee Arthroplasty: Correlation between Preoperative Radiographic Severity of Arthritis and Postoperative Patient Satisfaction

2020 ◽  
Author(s):  
Katie Rooks ◽  
Devon Houdek ◽  
Haron Obaid ◽  
William Dust
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Retrospective Chart Review ◽  
Level Of Evidence ◽  
Radiographic Severity ◽  
Patient Reported ◽  
Degree Of Satisfaction ◽  
Total Knee

AbstractPredicting postoperative outcomes following total knee arthroplasty (TKA) is important for patient selection. This study focuses on patient-reported outcomes and satisfaction in relation to preoperative radiographic arthritis severity. A retrospective chart review of 420 TKAs was performed. Patient satisfaction was determined using a structured telephone survey with questions focused on degree of satisfaction whether they would have surgery again and their ability to kneel. The radiographic severity of the arthritis of the tibiofemoral joint was graded by a musculoskeletal radiologist using the Kellgren–Lawrence grading scale. The patellofemoral compartment was graded using the scale described by Jones et al. Those grouped as severe arthritis had an overall satisfaction rate of 96% (76% fully satisfied and 20% partially satisfied) compared with 82% of the time (64% fully satisfied and 18% partially satisfied) if their arthritis was mild. Postoperatively 51% of TKA patients were able to kneel. Univariate logistic regression showed an association between higher rates of satisfaction and male gender (p = 0.053), severity of preoperative radiographic arthritis (p = 0.034) those who would have surgery again (p ≤ 0.0001) and those able to kneel (p = 0.005). Patients should be informed preoperatively that if their arthritis is only mild radiographically, their outcomes are less predictable. There should also be a discussion surrounding kneeling and activities patients do, which may require kneeling, as many are unable to kneel postoperatively. The Level of Evidence for the study is III.

Influence of Complications and Revision Surgery on Fulfillment of Expectations in Foot and Ankle Surgery

2021 ◽  
pp. 107110072098523
Author(s):  
Bopha Chrea ◽  
Jonathan Day ◽  
Jensen Henry ◽  
Elizabeth Cody ◽  
Scott Ellis ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Pain Management ◽  
Postoperative Complications ◽  
Postoperative Complication ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Initial Surgery ◽  
Ankle Surgery ◽  
Patient Reported ◽  
The Impact

Background: Fulfillment of patients’ expectations following foot and ankle surgery has been previously studied, and shown to be an effective modality in assessing patient-reported outcomes (PROs). Although this assessment has been shown to correlate well with patient satisfaction and other validated PROs, the impact of postoperative complications on fulfillment of expectations is unknown. The aim of this study is to therefore investigate the impact of postoperative complications on fulfillment of patients’ expectations. Methods: Preoperatively, patients completed a validated Foot and Ankle Expectations Survey consisting of 23 questions encompassing domains including pain, ambulation, daily function, exercise, and shoe wear. At 2 years postoperatively, patients answered how much improvement they received for each item cited preoperatively. A fulfillment proportion (FP) was calculated as the amount of improvement received versus the amount of improvement expected. Chart review was performed to identify patient demographics, comorbidities, pain management, and postoperative complications, which were classified as minor (infection requiring antibiotics) or major (return to operating room for revision, deep infection). FP in patients with a complication was compared to patients who did not experience a complication. In addition, the Foot and Ankle Outcomes Score (FAOS), satisfaction, and Delighted-Terrible scale (how they would feel if asked to spend the rest of their life with their current foot/ankle symptom) were collected at final follow-up. Of the 271 patients (mean age 55.4 years, 65% female), 31 (11.4%, mean age 53.6, 58% female) had a postoperative complication: 25 major (19 revisions, 6 deep infections requiring irrigation and debridement), 4 minor (4 superficial infections requiring antibiotics), and 2 major and minor (revision and superficial infection). Average time from complication to completion of fulfillment survey was 15 (±3.6) months. The groups were similar in diagnoses. Results: Complications were associated with significantly worse FP (0.69 ± 0.45 vs 0.86 ± 0.40, P = .02). Having a complication significantly correlated with worse satisfaction, Delighted-Terrible scale, and FP ( P < .001). FAOS domains were similar between groups preoperatively; postoperatively, patients without complications had significantly higher Activities of Daily Living and Quality of Life scores ( P < .05). Demographically, there was no difference in age, sex, body mass index, Charlson Comorbidity Index, depression/anxiety, or pain management between the 2 groups. Conclusion: Our data suggests that postoperative complications following foot and ankle surgery were associated with worse patient-reported fulfillment of their operative expectations even after recovery from the initial surgery and complication. This finding is independent of preoperative expectations, and correlates with patient satisfaction with their procedure. Therefore, while patient-perceived fulfillment following foot and ankle surgery is multifactorial, the incidence of a postoperative complication negatively impacts fulfillment as well as satisfaction following surgery. Level of Evidence: Level II, prospective comparative series.

scholarly journals Validation of a one-stop carpal tunnel clinic including nerve conduction studies and hand therapy

2011 ◽  
Vol 93 (8) ◽  
pp. 634-638 ◽  
Author(s):  
C Ball ◽  
M Pearse ◽  
D Kennedy ◽  
A Hall ◽  
J Nanchahal
Keyword(s):  
Patient Satisfaction ◽  
Carpal Tunnel Syndrome ◽  
Grip Strength ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Operating Time ◽  
Nerve Conduction Studies ◽  
Patient Reported ◽  
One Stop ◽  
Tunnel Syndrome

INTRODUCTION Carpal tunnel syndrome is the most common hand disorder. We describe a pathway that includes clinical assessment, neurophysiological testing, surgery and physical therapy all at the same visit. METHODS All referrals for carpal tunnel syndrome were screened for inclusion in a ‘one-stop’ surgeon-led clinic. Prospective clinical data collected included patient reported outcome measures and satisfaction scores, touch threshold, pinch and grip strength. Patients were assessed clinically, underwent nerve conduction studies and surgery as indicated, all on the same day. Baseline and one-year follow-up data were analysed for 57 patients (62 hands). RESULTS There was significant improvement in all domains of the Boston Carpal Tunnel and Michigan Hand Outcomes questionnaires, grip strength and touch threshold. There were no adverse events. The total mean operating time was 12.8 minutes (range: 5–15 minutes) and the mean tourniquet time was 2.5 minutes (range: 1–11 minutes). Using a dual theatre model produced a short mean turnaround time of 14.8 minutes (range: 2–37 minutes). Patient satisfaction as judged using a Picker questionnaire was very high. CONCLUSIONS A highly efficient clinical service involving both diagnostics and treatment can be delivered at a single hospital visit while maintaining optimal outcomes and high patient satisfaction.

scholarly journals Significantly Increased Patient Satisfaction Following Liquid Formulation AbobotulinumtoxinA Treatment in Glabellar Lines: FACE-Q Outcomes From a Phase 3 Clinical Trial

2019 ◽  
Vol 40 (9) ◽  
pp. 1000-1008 ◽  
Author(s):  
Benjamin Ascher ◽  
Berthold Rzany ◽  
Philippe Kestemont ◽  
Said Hilton ◽  
Marc Heckmann ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Least Squares ◽  
Controlled Trial ◽  
Well Being ◽  
Facial Appearance ◽  
Liquid Formulation ◽  
Phase 3 ◽  
Level Of Evidence ◽  
Psychological Well Being ◽  
Patient Reported

Abstract Background The FACE-Q patient-reported outcome assesses patient experiences/outcomes with aesthetic facial procedure. A recent trial of abobotulinumtoxinA (ASI, liquid formulation) was the first to our knowledge to assess satisfaction with FACE-Q after glabellar line (GL) injection. Objectives The authors sought to evaluate patient satisfaction with ASI for GL treatment employing 3 FACE-Q scales: facial appearance, psychological well-being, and aging appearance. Methods This was a Phase 3, randomized, double-blind, placebo-controlled trial (NCT02353871) of ASI 50 units in adults with moderate-to-severe GL with 6-month follow-up. Results Significantly greater least squares mean changes from baseline were associated with ASI treatment (N = 125) vs placebo (N = 59) for satisfaction with facial appearance at all visits until day 148 (5 months; P &lt; 0.0001-0.0037), psychological well-being at all visits (P &lt; 0.0001-0.0279), and aging appearance at all visits except day 148 (P &lt; 0.0001-0.0409). Significant differences (ASI vs placebo) were observed at all visits for individual items: “how rested your face looks” (P &lt; 0.0001-0.0415), “I feel okay about myself” (P = 0.0011-0.0399), and “I feel attractive” (P &lt; 0.0001-0.0102). Maximal least squares mean (standard error) changes in aging appearance score were −1.4 (0.3; ASI) and −0.3 (0.4; placebo). Investigators’ live assessment of GL at maximum frown significantly correlated with improvements in FACE-Q facial appearance and psychological scales (all patients: r = −0.41 and r = −0.36 [both P &lt; 0.0001], respectively). Conclusions Significant improvements in patient satisfaction with aging, facial appearance, and, importantly, psychological well-being were demonstrated with ASI employing FACE-Q scales up to 5 to 6 months post-injection. Results support a long duration of efficacy with ASI and use of FACE-Q in future trials and clinical practice. Level of Evidence: 1

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