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1
Reynolds, Nicholas, and Sunil Thirkannad. "THE RECALL DASH SCORE — A NOVEL RESEARCH TOOL." Hand Surgery 18, no. 01 (2013): 11–14. http://dx.doi.org/10.1142/s0218810413500020.
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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.
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Sumarwoto, Tito, Seti Aji Hadinoto, and Adhitya Indra Pradhana. "FUNCTIONAL OUTCOME BY EVALUATION OF DASH SCORE ON DROP HAND PATIENT TREATED WITH JONES’ TENDON TRANSFER: A RETROSPECTIVE STUDY." (JOINTS) Journal Orthopaedi and Traumatology Surabaya 10, no. 2 (2021): 39. http://dx.doi.org/10.20473/joints.v10i2.2021.39-45.
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Background: Drop hands due to radial nerve injuries cause functional and structural disabilities. Tendon transfer became the last option when nerve repair could not give patients restoration. The most popular method was Jones' Tendon transfer to restore wrist dorsiflexion, extending the thumb and the fingers. The Disabilities of Arm, Shoulder, and Hand (DASH) score measures functional outcomes in patients with upper extremities injuries. This study was to acknowledge the functional outcome and evaluate the DASH score in drop hand patients who undergone surgery by Jones’ Tendon Transfer in Prof. Dr. R. Soeharso Orthopaedic Hospital Surakarta from January 2014 to June 2016.Methods: The collected data from the medical record was evaluated based on functional outcome and DASH score. Eleven patients were included, ten male patients (90.9%) and one female patient (9.1%). The mean age of patients was 27.4 years old, with the most frequently injured arm was the right arm, counted to be eight patients (72.7%), and the left arm was three patients (27.3%).Results: The result from the evaluation of the DASH score indicated ten patients (90.9%) were minimal disability, and one patient (9.1%) was moderate disability. The average score was 12.48, which means that most patients could cope with most daily living activities post-operatively.Conclusions: In conclusion, surgery for drop hand due to radial nerve palsy by Jones’ Tendon Transfer gave a satisfactory functional outcome based on the DASH score.
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HOBBY, J. L., C. WATTS, and D. ELLIOT. "Validity and Responsiveness of the Patient Evaluation Measure as an Outcome Measure for Carpal Tunnel Syndrome." Journal of Hand Surgery 30, no. 4 (2005): 350–54. http://dx.doi.org/10.1016/j.jhsb.2005.03.009.
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The aim of this study was to assess the validity of the Patient Evaluation Measure questionnaire (PEM) as an outcome measure in carpal tunnel syndrome. The PEM was compared to the DASH questionnaire and to objective measurements of hand function. We also compared its responsiveness to changes following carpal tunnel release with that of the DASH score. Twenty-four patients completed the PEM and DASH questionnaires before and 3 months after open carpal tunnel release. Grip strength, static two-point discrimination and the nine-hole peg test were measured. There was a significant correlation between individual items of the PEM and the objective measures. There was also strong correlation between PEM and DASH scores. The PEM showed a greater responsiveness to change (effect size 0.97) than the DASH score (effect size 0.49). The PEM correlates well with objective measures of hand function and the DASH score when used in carpal tunnel syndrome. It is more responsive to change than the DASH score. It is very simple to complete and score and is an appropriate and practical outcome measure in carpal tunnel syndrome.
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Lindqvist, A., M. Hjalmarsson, and O. Nilsson. "DASH and sollerman test scores after hand injury from powered wood splitters." Journal of Hand Surgery (European Volume) 36, no. 1 (2010): 57–61. http://dx.doi.org/10.1177/1753193410381820.
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The purpose of the study was to describe the outcome after hand injury from powered wood splitters, and to investigate the relation between injury severity and outcome. Injury severity was rated according to the Hand Injury Severity Scoring System (HISS system) and the Injury Severity Score method. The patients were evaluated with the Disabilities of the Arm Shoulder and Hand outcome questionnaire (DASH), and 26 of the most severely injured patients were evaluated with the Sollerman test. The mean DASH score was moderately elevated at 15, indicating that many of these patients have sequelae. A statistically significant correlation between HISS and DASH scores was found, implying that initial injury severity is of importance for outcome. The mean Sollerman score in the injured hand was 66, which amounts to a significantly impaired hand function.
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Neubrech, Florian, Christian A. Radu, David Pauli, Berthold Bickert, Ulrich Kneser, and Leila Harhaus. "Funktionelle Ergebnisse nach Hochdruckeinspritzverletzungen der Hand." Handchirurgie · Mikrochirurgie · Plastische Chirurgie 49, no. 03 (2017): 162–68. http://dx.doi.org/10.1055/s-0043-115391.
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Zusammenfassung Hintergrund Hochdruckeinspritzverletzungen der Hand sind schwere Verletzungen, die häufig zu einem Verlust des primär betroffenen Fingers führen. Bisherige Arbeiten fokussieren sich hauptsächlich auf Amputationsraten, während funktionelle Ergebnisse nach dieser Verletzungsentität bislang wenig untersucht wurden. Patienten und Methoden Zwischen den Jahren 1998 und 2016 sind in unserer Klinik 47 Fälle einer Hochdruckeinspritzverletzung der Hand registriert worden. Hiervon konnten die Daten von 26 Patienten, alles Männer mit einem Altersdurchschnitt von 42 (18–62) Jahren, nach durchschnittlich 4 (1–12) Jahren retrospektiv untersucht werden. Erfasst wurden DASH-Score, das Schmerzniveau auf einer Visuellen Analogskala (VAS, 1–10), die Fingerbeweglichkeit als durchschnittlicher Fingerkuppenhohlhandabstand (FKHA), der Bewegungsumfang der Handgelenke, die Griffkraft und die 2-Punktdiskriminierungsfähigkeit (2PD). Die statistische Auswertung erfolgte deskriptiv und mittels Korrelationsanalyse. Ergebnisse Der DASH-Score betrug bei diesen 26 Patienten durchschnittlich 45 (30–93), das Dauerschmerzniveau 2,5 (0–9) auf der VAS, der FKHA 1 (0–4)cm, die Handgelenksbeweglichkeit 99 (77–122) % der Gegenseite. Die Griffkraft war im Durchschnitt auf 67 (0–164) % der Gegenseite reduziert. Die 2PD betrug im Durchschnitt 9 (2–25) mm. Arbeitsfähigkeit ließ sich bei 19 von 26 Patienten erzielen. Bei 7 von 26 Patienten musste eine Amputation eines Fingers vorgenommen werden. Diese Patienten hatten mehr Schmerzen und weniger Kraft. Eine lange Latenz bis zur operativen Versorgung verschlechterte das funktionelle Ergebnis, für den DASH war dies statistisch signifikant (p < 0,05). Eine distale Verletzungshöhe und eine Injektion toxischer Substanzen verschlechterten das funktionelle Ergebnis tendenziell. Ein hoher Injektionsdruck bei der Verletzung hatte dagegen keine negativen Auswirkungen. Schlussfolgerung Hochdruckeinspritzverletzungen hinterlassen sowohl bei Patienten mit Fingererhalt als auch mit Amputationsnotwendigkeit schwere Funktionsdefizite der Hand und oft chronische Schmerzen. Zur weiteren Untersuchung von Prognosefaktoren werden Metaanalysen auch funktioneller Parameter benötigt. Der DASH-Score scheint ein sinnvolles Evaluationsinstrument für die Verletzungsentität zu sein.
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Izawa, Kazuhiro, Yusuke Kasahara, Koji Hiraki, Yasuyuki Hirano, Koichiro Oka, and Satoshi Watanabe. "Longitudinal Changes of Handgrip, Knee Extensor Muscle Strength, and the Disability of the Arm, Shoulder and Hand Score in Cardiac Patients During Phase II Cardiac Rehabilitation." Diseases 7, no. 1 (2019): 32. http://dx.doi.org/10.3390/diseases7010032.
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Handgrip strength (HS) and knee extensor muscle strength (KEMS) showed a negative correlation with the Disabilities of the Arm, Shoulder, and Hand (DASH) score at one month following cardiac surgery. We performed a longitudinal study to examine changes in HS/KEMS and DASH score during phase II cardiac rehabilitation (CR) in patients after cardiac surgery. We measured and assessed HS, KEMS, and DASH score in 41 consecutive patients at one and three months following cardiac surgery and examined the relation between these factors at three months following cardiac surgery. Wilcoxon signed-rank test and Spearman correlation coefficients were used to analyze the results. Finally, 26 patients (63.2 years, 73.1% male) were analyzed. There were significant differences from one month to three months following cardiac surgery in HS (26.78 ± 8.26 to 31.35 ± 9.41 kgf, p < 0.001), KEMS (1.53 ± 0.42 to 1.72 ± 0.46 Nm/kg, p = 0.001), and DASH score (14.76 ± 12.58 to 7.62 ± 9.29, p < 0.001). DASH score correlated negatively with HS (r = −0.41, p = 0.01) but not with KEMS (r = −0.32, p = 0.09) after three months of phase II CR. Although HS, KEMS, and DASH scores changed significantly from one to three months following cardiac surgery during phase II CR, only HS correlated negatively with DASH score at three months following cardiac surgery.
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Uehara, Kosuke, Toshiki Miura, Ohe Takashi, Tokuhide Doi, Sakae Tanaka, and Yutaka Morizaki. "Development of a patient-oriented outcome measure for patients with hand and elbow disorder: HandQ." Journal of Orthopaedic Surgery 28, no. 3 (2020): 230949902095915. http://dx.doi.org/10.1177/2309499020959151.
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Purpose: The Disabilities of the Arm, Shoulder, and Hand (DASH) is the most widely used patient-oriented outcome measure for the upper extremities in the world, and high reliability and validity of it has already been confirmed. However, there are several problems with using the DASH, some of which are culturally related. We aimed to (1) develop a patient-oriented disease-specific outcome measure for patients with disorders of the hand and elbow, which we call the HandQ and (2) examine the practical applicability, reliability, and validity of the HandQ for any patient with disorders of the hand and elbow. Methods: A total of 216 patients were surveyed with the HandQ, as well as the Hand20 and the DASH to assess psychometric characteristics. Results: There were no considerable floor and ceiling effects regarding the total HandQ score. Test–retest reliability and internal consistency determined using the intraclass correlation coefficient (0.942) and Cronbach’s α test (0.961) were excellent. The HandQ was well correlated with the Hand20 and the DASH scores. Scree plot showed unidimensionality of the HandQ, and the graphical model showed the questionnaire items of the HandQ had reasonable correlation among each item. Conclusions: The HandQ has a sufficient reliability and internal consistency, and an excellent validity, and was shown to be able to be practically applicable in all patients with hand and elbow disorders.
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Al-Qattan, M. M. "The exploded hand syndrome: a report of five industrial injury cases." Journal of Hand Surgery (European Volume) 38, no. 8 (2012): 880–87. http://dx.doi.org/10.1177/1753193412468577.
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The term ‘exploded hand syndrome’ refers to a specific type of crush injury to the hand in which a high compressive force excessively flattens the hand leading to thenar muscle extrusion through burst lacerations. Out of 89 crushed hands seen over a period of seven years, only five had exploded hand syndrome. They were all male industrial workers ranging in age between 24 and 55 years. All patients had thenar muscle extrusion. Other concurrent injuries included fractures/dislocations, compartment syndrome, and ischaemia. All patients were treated by excision of the extruded intrinsic muscles, as well as primary management of concurrent injuries. All patients had functional assessment including: motor power and sensory testing, range of motion of hand joints, and the quick DASH score. Objective testing showed reduced sensibility in the thumb, reduced grip strength (mean 52% of contralateral hand), reduced pinch strength (mean of 27% of contralateral hand), reduced thumb opposition (the mean Kapandji Score was 5 out of 10), and deficits in the range of motion of the metacarpophalangeal and interphalangeal joints of the thumb. The quick DASH score ranged from 11 to 49 and only two patients were able to go back to regular manual work.
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Saurborn, Emily, Seth Noorbakhsh, Jenna Enoch, Raul Cortes, and William McClellan. "Prospective Treatment of First Carpometacarpal Osteoarthritis With Autologous Fat Transfer." Plastic and Reconstructive Surgery - Global Open 13, no. 4 (2025): e6713. https://doi.org/10.1097/gox.0000000000006713.
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Background: The purpose of this study was to analyze the effect of autologous fat transfer on outcomes in patients with basilar thumb arthritis. Methods: Twenty-three patients with carpometacarpal (CMC) arthritis underwent autologous fat transfer under fluoroscopic guidance. Autologous fat was harvested from the abdomen and separated with nonadherent gauze (Telfa). After processing, 2 mL of fat was injected into the CMC joint. All patients were placed in a prefabricated thermoplastic splint for 2 weeks postoperatively. Patients completed the Disability of Arm-Shoulder-Hand Questionnaire (DASH) questionnaire both preoperatively and postoperatively at 1, 6, and 12 months. Paired t tests were used to compare pretreatment to posttreatment DASH scores. Significance was set at a P value less than 0.05 (95% confidence interval [CI]). Results: The average preoperative DASH score was 51.81 (95% CI, 45.85–57.76). Average postoperative DASH score at 1-month follow-up was 26.16 (95% CI, 19.76–32.57), followed by a DASH score at 6-month follow-up of 22.49, 95% CI (15.41–29.54), and a DASH score at 12-month follow-up of 26.62 (95% CI, 17.68–35.56). Improvements in DASH score were as follows: 26.49 at 1 month postoperatively (P < 0.01), 30.64 at 6 months postoperatively (P < 0.01), and 26.89 at 12 months postoperatively (P < 0.01). No major adverse events were observed. Conclusions: Autologous fat transfer for the treatment of CMC osteoarthritis significantly improved hand function in our cohort. Additional studies of fat transfer are warranted to better understand the physiologic mechanisms and therapeutic benefits.
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Aldaihan, Mishal M., and Ali H. Alnahdi. "Responsiveness of the Arabic Quick Disabilities of the Arm, Shoulder and Hand in Patients with Upper Extremity Musculoskeletal Disorders." Healthcare 11, no. 18 (2023): 2507. http://dx.doi.org/10.3390/healthcare11182507.
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This study aimed to examine the responsiveness of the Arabic Disabilities of the Arm, Shoulder and Hand short version (Quick-DASH) in patients with upper extremity musculoskeletal disorders. Participants with upper extremity musculoskeletal disorders (N = 88) under physical therapy care were assessed at initial visit and later at a follow-up visit, and they completed the Arabic Quick-DASH, DASH, Numeric Pain Rating Scale (NPRS), Global Assessment of Function (GAF), and the Global Rating of Change Scale (GRC). Responsiveness of the Arabic Quick-DASH was assessed by examining six pre-defined hypotheses. Consistent with the pre-defined hypotheses, the Arabic Quick-DASH changes scores exhibited significant positive correlation with the change in DASH (r = 0.98), GAF (r = 0.67), NPRS (r = 0.72), and the GRC (r = 0.78). As hypothesized, the Arabic Quick-DASH showed a large effect size above the pre-determined level (ES = 1.61, SRM = 1.49) in patients who reported improved upper extremity function. The Arabic Quick-DASH change score discriminated between patients who reported improvement versus no improvement in upper extremity function (area under the receiver operating characteristic curve = 0.90). The results supported 100% (six out of six) of the pre-defined hypotheses. The Arabic Quick-DASH demonstrated sufficient responsiveness where all the pre-defined hypotheses were supported, leading to the established validity of the Arabic Quick-DASH change score as a measure of change in upper extremity function and symptoms. The minimal importance change in the Arabic Quick-DASH needs to be determined in future studies.
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GHIORGHIU, Ioana, Delia ALEXE, Lili MEIU, Daniela AVRAMESCU, Roxana NARTEA, and Gavril GHEORGHIEVICI. "RECOVERY OF A PATIENT WITH COMPLEX HAND TRAUMA." Romanian Journal of Medical Rehabilitation Physical Medicine and Balneoclimatology 2, no. 1 (2025): 41–47. https://doi.org/10.59277/rjmrpmb.2025.1.08.
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Objective: This case study examines the impact of a rehabilitation program on a complex trauma patient after 9 weeks of therapy. Material and methods: According to the case report, a 24-year-old patient underwent surgery after suffering a crush injury of his left hand (dominant hand) that caused transmetacarpal quasi-amputation, a dorsal integumentary bridge of about two centimeters, and acute ischemia of fingers II–V. After extracting the wires and pins from the II–V metacarpals, he comes to the recovery service right away complaining of pain and swelling in his fingers and fist, as well as left shoulder ache and vegetative symptoms. He need assistance with ADLs; his DASH symptom score is 63 and his DASH manner of working is 100. It is assessed both clinically and functionally, and he follows a specific rehabilitation program that include physical therapy and electrotherapy. Results: After 9 weeks of rehabilitation, scars heal and conform to the underlying planes, reducing discomfort, edema, and vegetative problems while increasing range of motion in the fist and fingers. He can complete ADLs without assistance. The DASH method has a score of 75 points, while the symptom score is 45. Conclusion: Rehabilitation has enhanced mobility, reduced pain and edema, and addressed vegetative disorders; however, the patient's dysfunctional condition persists as a long-term care concern.
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Belangero, William Dias, Carlos Miguel Zublin, Renny Augusto Cardenas Quintero, et al. "Quick-DASH as a main early outcome of humeral shaft fractures: A Latin American multicenter prospective study." Journal of Orthopaedic Surgery 28, no. 2 (2020): 230949902092943. http://dx.doi.org/10.1177/2309499020929436.
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Purpose: The main objective of this study was to evaluate the Quick-Disabilities of the Arm, Shoulder and Hand Score (DASH) score as the main early (90 days) outcome in a prospective multicenter observational Latin American study on isolated humeral shaft fractures. Methods: From December 2015 to April 2017, in six Latin American countries, patients 18 years or older with a closed, isolated nonpathological 12A, 12B, or 12C AO/OTA (Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association) fractures were included. The 90 (±10)-day Quick-DASH score was used to compare the results of the different treatments. The secondary outcomes were patient treatment satisfaction, shoulder and elbow range of motion, and radiographic evaluation. Results: A total of 92 patients successfully completed the Quick-DASH questionnaire. Surgical treatments resulted in better outcomes than nonsurgical treatment, but only minimally invasive plate osteosynthesis produced significantly lower Quick-DASH scores than nonsurgical treatment ( p < 0.05). There were strong correlations between patient self-evaluation and the Quick-DASH score ( p < 0.0005) but not between the Quick-DASH score and radiographic fracture healing. No significant difference was found between the treatments regarding the rate of return to work, but the medical center had a significant influence on treatment choice ( p < 0.0005). Conclusion: The high correlation between Quick-DASH score and patient satisfaction and functional outcome indicates that the Quick-DASH questionnaire is a suitable tool for evaluating adult humeral shaft fracture outcomes. Patients with a Quick-DASH score below 15 could be considered recovered, and patients with a Quick-DASH score above 40 could be considered not yet recovered. Quick-DASH scores were not significantly associated with radiographic fracture healing.
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Hardy, Richard E., Engin Sungur, Christopher Butler, and Jefferson C. Brand. "The Influence of Health Perception on Shoulder Outcome Measure Scores." Clinics in Shoulder and Elbow 22, no. 4 (2019): 173–82. http://dx.doi.org/10.5397/cise.2019.22.4.173.
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Background: Patient reported outcome measures assess clinical progress from the patient’s perspective. This study explored the relationship between shoulder outcome measures (The Disability of the Arm, Shoulder and Hand [DASH], American Shoulder and Elbow Surgeons Standard Shoulder Assessment score [ASES], and Constant score) by comparing the best possible scores obtained in an asymptomatic population compared to overall perception of health, as measured by the SF-36 outcome measure.Methods: Volunteers (age range, 20?69 years) with asymptomatic shoulders and no history of shoulder pain, injury, surgery, imaging, or pathology (bilaterally) were included. The DASH and ASES measures were completed by 111 volunteers (72 female, 39 male), of which 92 completed the Constant score (56 female, 36 male). The SF-36 was completed by all volunteers (level of evidence: IV case series).Results: The mean (x) score for ASES measure on the right shoulder was higher for the left-hand dominant side (x=100.00 vs. 95.02, <i>p</i>-value<0.001); no other significant differences. Better SF-36 scores were associated with better DASH scores. Our prediction models suggest that perception of overall health affects the DASH scores. Sex affected all three shoulder measures scores.Conclusions: Comparing scores of shoulder outcome measures to the highest possible score is not the most informative way to interpret patient progress. Variables such as health status, sex, and hand dominance need to be considered. Furthermore, it is possible to use these variables to predict scores of outcome measures, which facilitates the healthcare provider to deliver individualized care to their patients.
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LEE, E. W. C., M. M. H. CHUNG, A. P. S. LI, and S. K. LO. "Construct Validity of the Chinese Version of the Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH-HKPWH)." Journal of Hand Surgery 30, no. 1 (2005): 29–34. http://dx.doi.org/10.1016/j.jhsb.2004.09.010.
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The study evaluated the construct validity of the Chinese Hong Kong version of the disabilities of the arm, shoulder and hand questionnaire (DASH-HKPWH). Three hundred and thirty four patients with a broad range of upper extremity disorders were recruited into the study. Each completed DASH-HKPWH and SF-36 forms and their pain intensity (numeric pain rating scale) and grip strength were also measured. The mean DASH-HKPWH score was 40 (SD = 20). Principal component factor analysis identified a single factor, which accounted for 47% of the total variance. Pearson correlation was applied to assess convergent and divergent validity of the DASH-HKPWH by comparison with the above-mentioned subjective and objective measurements. Our findings were comparable to the DASH of other languages.
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Akatay, E. A., D. Bayraktar, İ. Kurut Aysin, et al. "POS1479-HPR INVESTIGATING THE RELIABILITY OF THE SOLLERMAN HAND FUNCTION TEST AND THE ASSOCIATIONS WITH DISEASE- AND HAND-RELATED PARAMETERS IN PATIENTS WITH SYSTEMIC SCLEROSIS." Annals of the Rheumatic Diseases 81, Suppl 1 (2022): 1085.3–1086. http://dx.doi.org/10.1136/annrheumdis-2022-eular.2585.
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BackgroundAlthough the hand involvement is one of the first manifestations in the disease course of Systemic Sclerosis (SSc), hand functions are generally inquired by using patient-reported tools. Sollerman Hand Function Test (SHFT) is developed to evaluate the performance-based hand functions.ObjectivesThe aim of this study was to investigate the reliability of the SHFT and the associations with disease- and hand-related parameters in patients with SSc.MethodsThirty-six patients (30 females) were included in the study. SHFT includes 20 different hand functions which are scored between 0 (unable to perform) and 4 (performed within 20 seconds with normal quality) (1). In the present study, item 12 ‘put on Tubigrip stocking on the other hand’ was not evaluated, thus, the SHFT was scored over a total score of 76. Inter-rater reliability was investigated by comparing the scores of two different investigators, and test-retest reliability was investigated by assessing the scores obtained at 2-hour intervals. Modified Hand Mobility in Scleroderma Test (mHAMIS), modified Rodnan skin score (mRSS), grip and pinch strengths were measured to evaluate hand-related physical characteristics. Duruoz Hand Index, Disability of Arm, Shoulder and Hand Questionnaire (DASH), Health Assessment Questionnaire (HAQ), and Scleroderma Health Assessment Questionnaire (SHAQ) were used as patient-reported outcomes.Table 1.Associations between the Sollerman Hand Function Test scores and disease- and hand-related parametersn= 36Median (IQR 25/75)rhopmHAMIS (score 0-4)0 (0/0)-0.3660.072mRSS-Fingers (score 0-3)2.5 (2/3)-0.0700.684mRSS-Hands (score 0-3)1.5 (1/2)-0.0560.747mRSS-Forearms (score 0-3)1 (0/2)-0.0320.855mRSS-Upper Arms (score 0-3)0 (0/1)0.0080.962mRSS-Total (0-51)10 (6/27.5)-0.1580.356Hand Grip Strength (kg)19.9 (12.0/24.9)0.612<0.001*Tip to Tip Pinch Strength (kg)3.1 (2.3/3.9)0.5170.001*Three Jaw Pinch Strength (kg)2.7 (1.9/3.4)0.554<0.001*Lateral Pinch Strength (kg)3.9 (3.3/5.3)0.4610.005*Duruoz Hand Index (score 0-90)5.5 (0/17)-0.751<0.001*DASH (score 30-150)61.5 (47/84)-0.645<0.001*HAQ (score 0-3)0.3 (0.1/0.9)-0.632<0.001*SHAQ-Raynaud’s Phenomenon (score 0-3)0.9 (0.1/1.4)-0.2460.161SHAQ-Digital Ulcers (score 0-3)0.1 (0/1.2)-0.3720.030*SHAQ-Gastrointestinal (score 0-3)0.2 (0/1.5)-0.1770.315SHAQ-Pulmonary (score 0-3)0.6 (0.1/1.5)-0.2700.123SHAQ-Patient Global Assessment (score 0-3)1.4 (0.1/2.1)-0.5470.001*p<0.05, rho: Spearman correlation coefficient, mHAMIS: modified Hand Mobility in Scleroderma Test, mRSS: modified Rodnan skin score, lcSSc: limited cutaneous Systemic Sclerosis, dcSSc: diffuse cutaneous Systemic Sclerosis, DASH: Disability of Arm, Shoulder, and Hand Questionnaire; HAQ: Health Assessment Questionnaire; SHAQ: Scleroderma Health Assessment QuestionnaireResultsSHFT demonstrated excellent inter-rater reliability (75 (72/76) vs. 75 (72/76), ICC: 0.987) and moderate test-retest reliability (75 (72/76) vs. 76 (75/76), ICC: 0.645). SHFT scores correlated significantly with grip and pinch strengths, Duruoz Hand Index scores, HAQ scores, SHAQ-Patient Global Assessment scores, and SHAQ-Digital Ulcer Scores (p<0.05). No significant correlations were observed between other parameters and SHFT (p>0.05). The hardest task was determined as ‘do up buttons’ which cannot be completed within 20 seconds by the half of the patients. All the patients completed ‘put key into Yale lock, turn 90o’, ‘lift iron over edge 5 cm in height’, and ‘lift telephone receiver, put to ear’ tasks within 20 seconds with normal quality.ConclusionThe results of the present study suggest that SHFT is a reliable tool to evaluate hand functions in patients with SSc.References[1]Sollerman C, Ejeskär A. Sollerman hand function test. A standardised method and its use in tetraplegic patients. Scand J Plast Reconstr Surg Hand Surg 1995; 29: 167-176.Disclosure of InterestsNone declared
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RAVEN, ERIC E. J., DANIËL HAVERKAMP, INGER N. SIEREVELT, et al. "Construct Validity and Reliability of the Disability ofArm, Shoulder and Hand Questionnaire for Upper Extremity Complaints in Rheumatoid Arthritis." Journal of Rheumatology 35, no. 12 (2008): 2334–38. http://dx.doi.org/10.3899/jrheum.080067.
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ObjectiveThe Disability of Arm, Shoulder and Hand (DASH) questionnaire is a tool for measuring physical function and symptoms of the upper extremity. Although widely used, it is not validated for rheumatoid arthritis (RA). In this study the DASH was validated for this patient group.MethodsIn total, 102 patients participated in this study. For the validation, the questionnaires of the DASH, the Health Assessment Questionnaire (HAQ), the Medical Outcomes Study Short Form-36 (SF-36), and the Arthritis Impact Measurement Scale (AIMS2) were used. Patients were examined clinically before completing the questionnaires. Pain was scored by each patient using a visual analog scale (VAS). The DiseaseActivity Score (DAS28) was obtained and grip strength was measured. Reliability was tested by a second DASH questionnaire after 2 days. Validity was tested using a Pearson correlation analysis for the relevant domains of the questionnaires and for the clinical aspects.ResultsThe reliability of the DASH was excellent (intraclass correlation coefficient 0.97). Internal consistency was strong (Cronbach’s alpha 0.97). Validity was proven with excellent results for Pearson correlation with the relevant domains of the questionnaires: HAQ, r = 0.88; SF-36, r = 0.70; and AIMS2, r = 0.85. The clinical scores had a relatively low correlation with the DASH (DAS28, r = 0.42; and grip strength, r = 0.41–0.48), except for the VAS (r = 0.60–0.65).ConclusionThe DASH is a reliable and valid questionnaire in patients with RA. It can be used as a measurement tool of physical disability of the upper extremity.
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Putra, Ryan. "Strong Correlation Between Disabilities of Arm, Shoulder and Hand Score and Modified Mayo Wrist Score Affected by Radius Union Scoring System and C-Reactive Protein in Patients with Conservatively Managed Distal Radius Fracture." Jurnal Orthopaedi dan Traumatologi Indonesia 7, no. 2 (2024): 1–4. https://doi.org/10.31282/joti.v7n2.129.
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Introduction: Fractures of the distal radius are the most common fractures in the upper extremity. The conservative management of these fractures often yields favorable outcomes, which can be measured using various scoring systems, and are often associated with controlled inflammatory response. This study aims to determine whether the Modified Mayo Wrist Score (MMWS) can be an alternative to the gold standard Disabilities of Arm, Shoulder and Hand (DASH) score. Additionally, we investigate the effect of the Radius Union Scoring System (RUSS) and the C-Reactive Protein (CRP) inflammatory marker to those scores. Material & Methods: Patient samples were consecutively taken from a population of patients with conservatively managed distal radius fractures using a cast. The patients were treated with a cast for 6 weeks, followed by a radiographic evaluation to assess the RUSS score and blood sampling in the 9th week to measure CRP level. In the 12th week, the DASH and MMWS were assessed. Result: Correlative analysis showed a strong correlation between MMWS and DASH score, and a predictive correlation between RUSS and CRP level toward MMWS and DASH score. Conclusion: The MMWS scoring system correlates with the DASH score, making it a promising scoring system in clinical practice, while a high RUSS score and low 9th-week CRP level can cause better functional outcomes in patients with conservatively managed distal radius fracture.
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Rodrigues, J. N., W. Zhang, B. E. Scammell, et al. "Recovery, responsiveness and interpretability of patient-reported outcome measures after surgery for Dupuytren’s disease." Journal of Hand Surgery (European Volume) 42, no. 3 (2016): 301–9. http://dx.doi.org/10.1177/1753193416677712.
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This prospective cohort study investigated the responsiveness and interpretability of the Disabilities of the Arm, Shoulder and Hand (DASH) and Unité Rhumatologique des Affections de la Main (URAM) outcome measures for assessing recovery after fasciectomy and dermofasciectomy for Dupuytren’s disease. DASH outcome scores at 1 year were significantly better than at 6 weeks, suggesting that recovery is not complete by 6 weeks. Of the 101 patients recruited to the DASH cohort, 71 completed preoperative, 6 week and 1 year postoperative DASH scores; 68 of them completed preoperative and 1 year postoperative DASH scores and an external anchor question. In the URAM cohort, 30/44 completed the preoperative and the 1 year postoperative URAM scores and the anchor question. The DASH score exhibited moderate responsiveness but poor interpretability on receiver operating characteristic curve analysis, such that a minimal important change could not be estimated. The URAM score showed acceptable responsiveness, and an MIC of 10.5 on receiver operating characteristic analysis. Level of evidence: II
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Behr, B., C. Heffinger, C. Hirche, A. Daigeler, M. Lehnhardt, and B. Bickert. "Scaphoid nonunions in skeletally immature adolescents." Journal of Hand Surgery (European Volume) 39, no. 6 (2013): 662–65. http://dx.doi.org/10.1177/1753193413491041.
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Scaphoid nonunions in children requiring operative treatment are rare. The aim of this study was to analyze our own patient population of the last 13 years to assess the postoperative outcome of these operations. Seven patients, under aged 14 years, were treated for scaphoid nonunions. Patients were clinically and radiologically examined and subjective outcomes were measured, such as the visual analogue pain scale (VAPS), Disability of the Arm, Shoulder and Hand (DASH) score, and Krimmer score. All patients showed an excellent outcome, as determined by the DASH score, Krimmer score, and VAPS. No differences between grip strength and range of motion between the operated and non-operated hand were observed. Therefore, we propose that scaphoid nonunions in skeletally immature adolescents can be treated satisfactorily with excision of the nonunion and bone grafting.
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Coppers, B., S. Bayat, E. T. Godonou, et al. "POS0020 DOES SUBJECTIVELY PERCEIVED LOSS OF HAND FUNCTION SUFFICIENTLY REPRESENT ULTRASONOGRAPHY-DETECTED SYNOVITIS AND TENOSYNOVITIS IN PATIENTS WITH PSORIASIS AND PSORIATIC ARTHRITIS?" Annals of the Rheumatic Diseases 82, Suppl 1 (2023): 215.1–216. http://dx.doi.org/10.1136/annrheumdis-2023-eular.2286.
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BackgroundIn the clinical routine patient reported outcome measures (PROMs) such as the ‘Disability of the Arm, Shoulder and Hand Questionnaire’ (Quick-DASH) [1], ‘Score for the Assessment and quantification of Chronic Rheumatic Affections of the Hands’ (SF-SACRAH) [2] and the ´Health Assessment Questionnaire´ (HAQ) [3] are common for assessing functional status and hand involvement in rheumatic diseases [4] while ultrasonography (US) is a cost-effective, reliable imaging technology for grading and monitoring synovitis and tenosynovitis [5]. However, it is unclear, if subjective perceived impairment can be associated with US-detected synovitis or tenosynovitis in patients with psoriatic arthritis (PsA) and psoriasis (Pso).ObjectivesTo correlate subjective hand function with the grade of synovitis and tenosynovitis by US (greyscale (GS), power Doppler (PD) activity) in patients with PsA and Pso.MethodsPsA and Pso patients recruited from the Rheumatology Department at the University Hospital Erlangen were enrolled in this cross-sectional study after giving written informed consent. Patients completed the HAQ-DI, SF-SACRAH and Quick-DASH questionnaires and subject characteristics (age, sex, disease) were recorded. The examining physician performed a bilateral US (Samsung HS40, South Korea; Esaote Mylab Twice, Italy) of the flexor tendons of all fingers and metacarpophalangeal (MCP) joints 2-5 and both wrists. Each joint was examined by GS (score 0-3) and PD (score 0-3) and flexor tendons were scanned in GS (0/1) and with PD (0-3) following the EULAR-OMERACT scoring system [5]. For statistical analysis patients with either a positive synovitis or tenosynovitis score ≥1 were included. A repeated measure correlation analysis was performed, at the intra-individual level, to measures the overall strength and direction of the linear relationship between the PROMs with US scores.ResultsA total of 106 patients (40 PsA/66 Pso: age 47.5(12.3)/43.6(14.1) years, 63%/61% male) participated in this study. US-activity is listed in Table 1. Moderate positive correlations were detected for GS tenosynovitis score in digit 1 with both, Quick-DASH (r=0.352, p=0.038) and HAQ-DI (r=0.399, p=0.036) and also for GS tenosynovitis score in digit 4 with Quick-DASH (r=0.354, p=0.037). Overall GS synovitis score (MCP 2-5 + wrist) shows a moderate negative correlation with Quick-DASH (r=-0.323, p=0.031) and HAQ-DI (r=-0.477, p=0.002), as does PD tenosynovitis score in digit 1 (r=-0.386, p=0.022) and 3 (r=-0.386, p=0.022) with SF-SACRAH. HAQ-DI, SF-SACRAH and Quick-DASH correlated strongly with each other (r>0.7, p<0.001).Table 1.Ultrasound activity versus non-activity by group.Ultrasound Scores, active (score≥1)/non-activePsoriatic ArthritisPsoriasisGreyscale Synovitis20/2013/53Doppler Synovits7/331/65Greyscale Tenosynovitis14/267/59Doppler Tenosynovitis11/291/65ConclusionOnly the grade of chronic tenosynovitis is partially represented in Quick-DASH and HAQ-DI, while synovitis scores are negatively related to them. Surprisingly, worse hand function detected by the most hand-specific questionnaire, SF-SACRAH, was associated with less acute tenosynovitis. While Quick-DASH and HAQ-DI focus on tasks which require sufficient hand strength, the SF-SACRAH focuses on activities demanding fine motor skills, which seems to be less affected by tenosynovitis. Varying correlations of the different PROMs with the US scores have already been described for patients with rheumatoid arthritis [6]. Subjectively perceived hand function does not sufficiently reflect grade of synovitis and tenosynovitis and therefore more sensible functional outcome parameters are required.References[1]Franchignoni F et alJ Orthop Sports Phys Ther 2014[2]Rintelen B et alOsteoarthritis Cartilage 2009[3]Maska L et alArthritis Care Res 2011[4]Kucukdeveci A A et alRMD Open 2021[5]D’Agostino M A et alRMD Open 2017[6]Ozer P K et alIndian J Med Res 2017AcknowledgementsThis work was partly funded by Novartis Pharma GmbH, Germany and the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) – SFB 1483 – Project-ID 442419336, EmpkinS.Disclosure of InterestsBirte Coppers: None declared, Sara Bayat: None declared, Elie Tino Godonou: None declared, Larissa Valor: None declared, David Simon: None declared, Filippo Fagni: None declared, Giulia Corte: None declared, Koray Tascilar: None declared, Axel Hueber: None declared, Verena Schönau: None declared, Michael Sticherling: None declared, Georg Schett: None declared, Arnd Kleyer: None declared, Anna-Maria Liphardt Grant/research support from: Novartis Pharma GmbH, Germany.
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Adams, Jo, J. Burridge, M. Mullee, Alison Hammond, and Cyrus Cooper. "Self-Reported Hand Functional Ability measured by the DASH in Individuals with Early Rheumatoid Arthritis." British Journal of Hand Therapy 10, no. 1 (2005): 21–24. http://dx.doi.org/10.1177/175899830501000104.
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Self-report accounts of functional ability are important for clinicians to gain insight into individuals’ perspectives of the personal impact of injury or disease. This short report describes a study of self-report upper limb ability using the Disability of the Arm, Shoulder and Hand (DASH) questionnaire in a sample of people with early rheumatoid arthritis. The DASH is a reliable and valid tool for use within rheumatology. The most difficult upper limb tasks to complete were reported to be activities that required sustained force and power, followed by tasks that required fine finger movements and prehension tasks. The DASH questionnaire proved to be an outcome measure that discriminated well between different levels of reported functional upper limb ability; it was reported to be easy to complete by patients, and was straightforward and quick to score. The compact summary score makes it a useful clinical and research tool and one that can be recommended in an early rheumatoid arthritis population.
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Muhammad Arsalan Azmat Swati, Muhammad Suhail Amin, Javaid Iqbal Niazi, Zainullah Kakkar, Zeeshan Aslam, and Adeel Habib. "Comparison of Functional Outcome of Conservative Management and Operative Treatment for Displaced Mid-Shaft Clavicle Fractures." Pakistan Armed Forces Medical Journal 73, no. 5 (2023): 1317–20. http://dx.doi.org/10.51253/pafmj.v73i5.8018.
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Objective: To compare functional outcomes of conservative management and operative treatment for Displaced Mid-shaft Clavicle fractures. Study Design: Prospective comparative study. Place and Duration of Study: Department of Orthopaedics Combined Military Hospital, Rawalpindi, Pakistan, from Dec 2020 to Sep 2021. Methodology: In a cohort of 80 patients with displaced midshaft clavicle fractures, 40 patients were managed conservatively with an arm sling, and 40 were managed operatively with an anatomical clavicle plate. All these patients were followed up for three months. The functional efficacy of different treatment options in displaced midshaft clavicle fractures was assessed using a Disability of Arm, Shoulder and Hand (DASH) score. Results: The DASH Score showed Functional outcomes were significantly better (p<0.01) in the Operative-Group at 4 weeks, 2 months and 3 months. At two-month follow-up, the Conservative Group had a DASH score of 21.2±2.1, whereas the Surgical Group had a DASH score of 11.7±1.8. The DASH score at three months follow-up was 5.5±1.3 and 12.5±1.9 for the Operative and Conservative Groups, respectively. Conclusion: Plate fixation improves the functional results for individuals with a displaced mid-shaft clavicle fracture. This study showed that DASH scores are lower in the operative Group. When it comes to non-displaced mid-shaft clavicle fractures, conservative management has always been the best option.
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Selles, R., J. Dias, H. Singh, et al. "Results of the Universal 2 Prosthesis in Noninflammatory Osteoarthritic Wrists." Journal of Wrist Surgery 07, no. 02 (2017): 121–26. http://dx.doi.org/10.1055/s-0037-1606258.
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Background/Purpose Many treatment options are available for wrist osteoarthritis, with the objective of decreasing pain and preserving function. In later stages when midcarpal and radiocarpal osteoarthritis occur, two choices remain: total wrist arthrodesis or total wrist arthroplasty. The purpose of this study is to present the short-term functional changes following total wrist arthroplasty with the Universal 2 total wrist system (Integra Life Sciences) in patients with noninflammatory wrist osteoarthritis. Patients and Methods Patients with severe noninflammatory wrist osteoarthritis were assessed preoperatively, 6 and 12 months after surgery using a range of motion, grip strength, pain, and the disabilities of the arm, shoulder, and hand (DASH) score. The additional assessment was performed after 1 year for a range of motion using a biaxial electrogoniometer, grip strength, DASH, and the Michigan hand questionnaire. Results All range of motion directions and grip strength did not change from preoperative values. The DASH score improved from 53 preoperatively to 14 during latest follow-up. Median patients' satisfaction score decreased with approximately 20 points during the last follow-up. Conclusion The relatively good DASH score combined with the partly maintained wrist range of motion indicates that reconstruction with the Universal 2 total wrist prosthesis should be considered in patients with end-stage noninflammatory wrist osteoarthritis. Level of Evidence Level IV, therapeutic study.
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Khan, Wasim S., Rohit Jain, Bernice Dillon, Lawrence Clarke, Max Fehily, and Mark Ravenscroft. "The ‘M2 DASH’—Manchester-Modified Disabilities of Arm Shoulder and Hand Score." HAND 3, no. 3 (2008): 240–44. http://dx.doi.org/10.1007/s11552-008-9090-6.
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Siriwittayakorn, Wuttipong, Nath Adulkasem, Pichet Sangthongsil, et al. "Single Buried Intramedullary K-Wire Fixation in Nonthumb Metacarpal Shaft Fractures with Immediate Postoperative Mobilization without Any Immobilization." Advances in Orthopedics 2023 (October 16, 2023): 1–9. http://dx.doi.org/10.1155/2023/1439011.
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Objective. This study aims to evaluate the outcomes of single intramedullary K-wire fixation in nonthumb, metacarpal shaft fractures with immediate postoperative hand mobilization without any immobilization. Method. This is a retrospective case series conducted from January 2019 to December 2022. We included patients with closed, simple transverse, or short oblique metacarpal shaft fracture treated with single, 1.4 mm, intramedullary K-wire fixation. Gentle postoperative range of motion exercise was encouraged in every patient without any hand, finger, or wrist motion restriction material. Clinical outcomes were evaluated with total active flexion; grip strength; disability of arm, shoulder, and hand (DASH) score; and the American Society for Surgery of the Hand Total Active Flexion (ASSH TAF) score. Results. This study included 34 patients, 25 males and 9 females with a mean age of 33.14 years (ranging 18–59). A total of 43 metacarpal shafts were treated. The mean DASH score at two and 6 weeks postoperative was 41.5 (ranging 19.16–60.34) and 9.58 (ranging 0.83–23.27). The mean final DASH score at last follow-up was 3.48 (ranging 0–8.33). Mean TAF at 2 weeks postoperative, 6 weeks postoperative, and at final follow-up was 203.8 (ranging 185–240), 238.2 (ranging 220–270), and 259.25 (ranging 240–270) degrees, respectively. The mean grip strength of the injured hand was 66.14 and 86.1% of the uninjured hand at 6 weeks and 3 months postoperative. There was no nonunion, malrotation, or infection. In conclusion, single intramedullary K-wire fixation gives excellent outcomes in the treatment of single or multiple, simple, metacarpal shaft fractures without the need of postoperative immobilization.
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Colovic, Hristina, Ivona Stankovic, Lidija Dimitrijevic, Vesna Zivkovic, and Dejan Nikolic. "The value of modified DASH questionnaire for evaluation of elbow function after supracondylar fractures in children." Vojnosanitetski pregled 65, no. 1 (2008): 27–32. http://dx.doi.org/10.2298/vsp0801027c.
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Background/Aim. The Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Questionnaire represents a region- specific instrument for functional outcome measurement of hand function. The aim of the study was to analyze the correlation between the values of modified DASH questionnaire and change of elbow function after supracondylar fracture (SCF) of humerus and to analyze the effects of early rehabilitation. Methods. The study included 35 schoolaged children with flexion of SCF of humerus without lesion of nerves. The patients were divided into two groups: group A in which rehabilitation started up to 14 days after the removal of fixation (20 children), and group B in which rehabilitation started after 15 days and more (15 children). The effects of the applied rehabilitation procedures were analyzed by measuring the range of motion of elbow and using modified DASH questionnaire. Testing was performed during the first examination, on the first day of rehabilitation (retest) and after the rehabilitation. Pearson's coefficient of liner correlation was applied. Results. Statistically significant negative correlation of DASH score and extension was verified in all three measurements. The values for the first test and for the final test were highly significant (p < 0.001), as well as negative correlation of DASH score and flexion on the first test and retest (p < 0.01), and at the end of rehabilitation (p < 0.001) in the group B. For all three tests in the group A negative correlation without significant differences for DASH score and flexion was found. Conclusion. A modified DASH questionnaire correlates with objective parameters of final status of elbow after SCF in children and it is applicable to small series of patients. A positive effect of early rehabilitation of children with SCF was found.
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Sonohata, Motoki, Toshiyuki Tsuruta, Hiroko Mine, Tadatsugu Morimoto, and Masaaki Mawatari. "The Relationship Between Neuropathic Pain, and the Function of the Upper Limbs Based on Clinical Severity According to Electrophysiological Studies in Patients with Carpal Tunnel Syndrome." Open Orthopaedics Journal 7, no. 1 (2013): 99–102. http://dx.doi.org/10.2174/1874325001307010099.
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Carpal tunnel syndrome (CTS) is an entrapment neuropathy of the median nerve, and CTS can cause neuropathic pain. The aim of this study was to evaluate the relationship between neuropathic pain, function of the upper limb, and the electrophysiology in patients with CTS. The terminal latency of median nerve was measured in 34 patients diagnosed with CTS, and they were asked to fill out the Japanese Society for Surgery of the Hand version of the Disability of Arm, Shoulder, and Hand questionnaire (DASH-JSSH) as the patient’s assessment of the function of upper limbs and pain DETECT as an assessment for neuropathic pain. There was no significant correlation between the terminal latency and the pain DETECT score, or the terminal latency and the DASH-JSSH score. However, there was a significant correlation between the pain DETECT and DASH-JSSH scores. Neuropathic pain affects the function of the upper extremities in patients with CTS.
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Marinkovic, Marija, Zlata Janjic, and Jelena Nikolic. "Estimating disability and quality of life after different degrees of hand and forearm trauma." Vojnosanitetski pregled 72, no. 2 (2015): 155–59. http://dx.doi.org/10.2298/vsp1502155m.
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Background/Aim. Hand injuries comprise up to one fourth of all injuries and require excellent skills and aggressive physical therapy with still a high potential to cause long term physical and functional disability which affects one?s quality of life. The aim of this study was to evaluate disability and quality of life in patients with different degrees of hand and forearm injuries using the two different scoring systems and to examine the correlation between them. Methods. This retrospective study was performed among patients operated on at our clinic due to acute hand and forearm trauma during the period of two years. Four groups of patients were made according to the Modified Hand Injury Severity Score (MHISS). One year after the treatment, phone interviews were made with those patients to answer to the Disability of Arm Shoulder and Hand (quick-DASH) score for estimating disability and to the World Health Organization Quality of Life BREF (WHOQoL-BREF) score to estimate the quality of life regerding four domains: physical, social, environmental and psychological. Results. Out of 182 patients who satisfied the inclusion criteria, only 60 completely answered to the questionnaires, 46 (17%) men and 14 (23%) women. Most of the patients were in the group with moderate injuries according to the MHISS, followed by the group with major and severe injuries. A weak correlation was found between the MHISS and quick DASH score in the group with minor injuries, compared to no correlation between these parameters in other groups. The lowest quality of life was registered in the physical domain, while the highest in the social one. A negative correlation was found among the four domains of the WHOQoL BREF score and quick- DASH score in all the groups. Conclusion. Severity of hand and forearm injuries does not necessarily correlate with patient?s perception of disability. The quality of life was less affected by severity of injury than by the patient?s perception of disability.
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Duman Şahin, Zehra, Aylin AYYILDIZ, Selda Çiftci İnceoğlu, and Banu Kuran. "The The relationship between injury severity, grip strength and functionality in traumatic hand injuries." Anales de la Facultad de Medicina 11, no. 2 (2024): e206. https://doi.org/10.25184/anfamed2024v11n2a11.
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Purpose: This study aimed to investigate the relationship between injury severity and functionality in traumatic hand injuries.Methods: Forty-four patients with traumatic injuries to the hand were included. Patients who were grouped as minor, moderate, and severe-major by Modified Hand Injury Severity Score (mHISS) score, were evaluated with grip strength, lateral grip strength, and Sollerman Hand Function Test (SHFT) at the 4th and 12th weeks. Among the functional scales, The Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) and the Patient-Rated Hand and Wrist Evaluation (PRWHE), Health Assessment Questionnaire (HAQ) were used.Results: According to the patients’ total mHISS score, 27.2% were classified as having minor injuries, 43.1% as having moderate injuries, and 29.4% as having serious-major injuries. The first 4 weeks of the rehabilitation period showed a statistically significant increase in both grip strength and SHFT scores. Furthermore, grip strength and SHFT scores were significantly lower across all mHISS groups, with greater reductions observed in the group with more severe injuries. A significant positive correlation was observed between the total mHISS score and PRWHE, DASH, and HAQ scores in all follow-ups. As the severity score increased, functionality worsened.Conclusion: Assessing the severity of injury and functionality in these patients allows for effective management of treatment and rehabilitation, ultimately improving their functional status and general health.
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Haroon Yousaf, Abdus Samad Khan, Aiman Zia, Zahir Khan, Maria Ahmad, and Shafqat Ullah Khan. "The use of corticosteroid injection in the treatment of chronic shoulder pain." Professional Medical Journal 31, no. 06 (2024): 967–71. http://dx.doi.org/10.29309/tpmj/2024.31.06.8045.
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Objective: To determine the short term outcome of intra-articular corticosteroid injection the treatment of chronic shoulder pain. Study Design: Descriptive Study. Setting: Mardan Medical Complex, MTI. Period: 12th August 2023 to 15th December 2023. Methods: All patients of chronic shoulder pain fulfilling inclusion criteria were administered intra-articular corticosteroid injection. Pre intervention demographic and visual analogue scale (VAS) score and DASH (Disabilities of the Arm, Shoulder and Hand) scores were noted. All patients underwent through intraarticular corticosteroid injection procedure. VAS score and DASH score was calculated again on four week follow up visit. Both scores were compared by paired t test using SPSS version 23. The pre and post injection VAS and DASH scores were compared and p value calculated using paired t test. P value <0.05 was considered significant. Results: Total of 50 patients were included in the study. The mean age of patients was 50.08+6.43yrs and mean duration of symptoms was 5.7+1.6 months. 64% (n=32) of the patients were male, while 36% (n=18) were female about a total of 64% (n=32) of the patients were diabetic. Majority (56%, n=28) of patients exhibited left-side involvement, while 44% (22) presented with right-side involvement. The mean pre intervention VAS score was 79.86 + 6.32 and DASH score was 59.98+8.44. The mean post intervention VAS score was 15.7+4.1and DASH score was 49.78+6.33. After applying paired t-test on pre and post intervention scores, both VAS and DASH score was statistically significant with p value of <0.001. Conclusion: Intra-articular corticosteroid injection significantly relieved shoulder pain and improved functional outcome in short term follow up in patients with chronic shoulder pain.
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van Laarhoven, Cecile M. C. A., Verena J. M. M. Schrier, Mark van Heijl, and Arnold H. Schuurman. "Arthrodesis of the Carpometacarpal Thumb Joint for Osteoarthritis; Long-Term Results Using Patient-Reported Outcome Measurements." Journal of Wrist Surgery 08, no. 06 (2019): 489–96. http://dx.doi.org/10.1055/s-0039-1694062.
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Abstract Background Results following carpometacarpal (CMC) arthrodesis of the thumb for osteoarthritis vary widely in literature. Data on long-term patient-reported outcome measurements (PROMs) after thumb CMC joint arthrodesis for osteoarthritis are scarce. Purpose We report the long-term outcomes of PROMs (function, pain, and satisfaction) after arthrodesis of the thumb CMC joint. We evaluated the correlation of function and pain with patient satisfaction. Methods Long-term PROMs after thumb CMC arthrodesis for osteoarthritis were evaluated using a retrospective cohort (1996–2015). Three different PROM questionnaires (Disabilities of the Arm, Shoulder, and Hand Questionnaire, Dutch Language version [DASH-DLV], the Patient-Related Wrist and Hand Questionnaire Dutch Language version [PRWHE-DLV], and a questionnaire concerning satisfaction) were sent to all patients. Results Twenty-five arthrodeses (21 patients) were available for long-term follow-up. The median follow-up time was 10.8 years (interquartile range [IQR]: 9.7–13.0). The median DASH score was 29.2 (IQR: 14.4–38.3), median PRWHE score was 25.0 (IQR: 12.5–44.3). The median satisfaction after the operation and satisfaction with outcome of the operation was 10 for both (on a Likert's scale with 1 worse and 10 excellent satisfaction). There was a statistically significant correlation between the PRWHE total score and PRWHE pain score and satisfaction with surgery and satisfaction with the result. There was no correlation between PRWHE function score and satisfaction or DASH and satisfaction. Results after hardware removal showed no significant differences compared with patients without hardware removal. Conclusion Patients who underwent arthrodesis for thumb CMC osteoarthritis showed high satisfaction at long-term follow-up, despite moderate results as measured using the DASH and PRWHE. The PRWHE total and PRWHE pain scores correlated significantly with satisfaction with surgery and satisfaction with the result, respectively, whereas no correlation was observed with the PRWHE function score or DASH and satisfaction. This therapeutic study reflects level of evidence IV.
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CAVADAS, P. C., L. LANDIN, and J. IBAÑEZ. "Bilateral Hand Transplantation: Result at 20 Months." Journal of Hand Surgery (European Volume) 34, no. 4 (2009): 434–43. http://dx.doi.org/10.1177/1753193409102898.
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On November 2006, a bilateral hand allotransplantation was performed for a 47-year-old female who had suffered radiocarpal amputations 28 years before. Technical aspects of the operation are detailed. Alemtuzumab induction, and triple therapy of tacrolimus, mycophenolate mofetil and prednisone were used to control rejection. The evolution of the result and functioning at 20 months are presented in detail. Two acute rejection episodes occurred and were successfully treated with steroids. In addition the patient developed a factitious visual disorder and a facial basal cell carcinoma. Functionally, at 20 months, the patient had a Hand Registry Functional Score of 69 (good), and a DASH score of 19.
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Geethan, K. S. Anandha, A. K. Arumugam, S. H. Syam Nath, Venkatesh Kumar, and Rohini Venkatesh. "Functional Outcome of De Quervain’s Tenosynovitis by Population Characteristics in South Indian Population – A Prospective Study." Journal of Orthopaedic Case Reports 15, no. 5 (2025): 279–84. https://doi.org/10.13107/jocr.2025.v15.i05.5634.
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Introduction: The purpose of this study was to evaluate the functional outcome of population characteristics in South Indian patients with chronic De Quervain’s Tenosynovitis. Materials and Methods: This prospective study was conducted in a tertiary care hospital in South India. A total of fifty chronic dequervain’s tenosynovitis patients were included in the study after getting clearance from the ethical committee. The main outcome measures data were VAS and DASH scores among the variables such as age, size, gender and occupation in all our patients. Results: By considering VAS score and DASH scores postsurgery, patients aged < 45 years of age, patients with nondominant hand involvement complaints, and homemakers had greater reductions in pain scores yet statistically insignificant. The female patients had a good reduction in DASH score postsurgery, which was statistically insignificant. However, males had a greater reduction in pain scores postsurgery females, and the difference was statistically significant. By considering VAS score and DASH scores poststeroid instillation, patients aged more than or equal to 45 years of age, males, patients with dominant hand complaints, and patients who were employed had a greater reduction in pain score following steroid therapy. However, the difference is not statistically significant. Conclusion: Male patients, nondominant side involvement, and younger patients (age < 45 years) appear to fare well in both the surgical and steroid instillation groups. However, the employed patients do well after receiving a steroid injection, and the homemakers appear to do well in the postsurgery group. Keywords: Dequervain’s tenosynovitis; Functional Outcome; South Indian Population; Population Characteristics
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Rodrigues, J., W. Zhang, B. Scammell, et al. "Validity of the Disabilities of the Arm, Shoulder and Hand patient-reported outcome measure (DASH) and the Quickdash when used in Dupuytren’s disease." Journal of Hand Surgery (European Volume) 41, no. 6 (2015): 589–99. http://dx.doi.org/10.1177/1753193415601350.
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This study investigated aspects of the validity and reliability of the 30-item Disabilities of the Arm, Shoulder and Hand patient-reported outcome measure (DASH) and its relationship with the shorter 11-item QuickDASH in patients with Dupuytren’s disease. Seven hundred and fifty-nine DASH questionnaires were studied, covering pre- and postoperative patients undergoing different treatments for Dupuytren’s disease. Items related to pain rose early after treatment before returning to baseline, suggesting that studying pain is relevant during postoperative recovery. Across all 759 sets of responses, the QuickDASH agreed closely with the DASH. In exploratory factor analysis, the DASH was not unidimensional, questioning the validity of the DASH summary score in Dupuytren’s disease. Further validation of existing PROMs for use in Dupuytren’s disease is needed. These data suggest that pain is a relevant symptom to study during postoperative recovery following treatment for Dupuytren’s disease. Level of evidence: III.
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Ansari, Saif A., James A. Kennedy, and Fizan Younis. "Postoperative Outcomes of Volar Plate Fixation in Cases of Scaphoid Deformity or Nonunion: A Case Series." Journal of Wrist Surgery 09, no. 04 (2020): 304–11. http://dx.doi.org/10.1055/s-0040-1710383.
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Abstract Background Fractures through the waist of scaphoid are a common injury, resulting in deformity or nonunion. Recently, a locking plate has been shown to fix deformity or nonunion of scaphoid, with limited observation of functional postoperative outcomes. Objectives We present a case series of 16 patients, with the disabilities of the arm, shoulder, and hand (DASH) score evaluation in primary fixation of scaphoid fractures with humpback deformity (n = 11) and revision open reduction internal fixation (ORIF) for nonunion (n = 5), using the Medartis TriLock 1.5 scaphoid plate and bone grafting. Patients and Methods DASH scores were obtained preoperatively and postoperatively at 3, 6, and 12 (if required) months. Patient demographics, smoking status, employment type, and grip strengths were recorded. Results Thirteen patients attended follow-up. Union was clinically and radiologically assessed with 13 achieving union. The mean preoperative DASH score was 34.0 (n = 16) and at treatment completion (discharge or DNA) was 11.5 (n = 13), with mean reduction of 18.5 (p = 0.03). At treatment completion, mean reduction in DASH score of revision ORIF was 13.7 (p = 0.27; n = 4), compared with 20.7 (p < 0.01; n = 9) in primary fixation with plate. Conclusions Deformity correction, reduction in DASH score, and rate of union make the plate system useful in the management of scaphoid fractures with humpback deformity and revision for nonunion. Level of Evidence This is a Level IV study.
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Melikyan, E. Y., M. S. A. Beg, S. Woodbridge, and F. D. Burke. "The Functional Results of Ray Amputation." Hand Surgery 08, no. 01 (2003): 47–51. http://dx.doi.org/10.1142/s0218810403001388.
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Twenty patients (14 males, six females) were assessed at an average of 32 months (ten to 156 months) after ray amputation using the disability shoulder, arm, hand (DASH) questionnaire, physical examination and functional testing. There were 14 border (eight index, six little) and six central ray (five middle, one ring) amputations. Our results showed on average 27% less grip and 22% three-point pinch strength in the operated hands. Peak power output was 22% and average work output 14% less on the operated side than the contralateral hand. The DASH function score was 29.2 (range 3.3–74.2). Nine patients returned to their previous occupation, two had to change jobs and two did not return to work. Six patients were not working, one was of school age. The ensuing disability remained within limits reflected by our measurements and the acceptance of the patients.
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Thillemann, J. K., T. M. Thillemann, B. Munk, and K. Krøner. "High revision rates with the metal-on-metal Motec carpometacarpal joint prosthesis." Journal of Hand Surgery (European Volume) 41, no. 3 (2015): 322–27. http://dx.doi.org/10.1177/1753193415595527.
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We retrospectively evaluated a consecutive series of 42 Motec thumb carpometacarpal total joint arthroplasties. The primary endpoint was revision with implant removal and trapeziectomy. At follow-up the disability of the arm shoulder and hand (DASH) score, pain on numerical rating scale at rest and with activity and serum chrome and cobalt concentrations were assessed for both unrevised and revised patients. At a mean follow-up of 26 months, 17 patients had been revised. The 2 year cumulative revision rate was 42% (95% CI, 28–60%). The DASH score and pain scores at rest and with activity were comparable between the patients whose thumbs remained unrevised and those revised. Patients with elevated serum chrome and cobalt levels had significantly higher DASH and pain scores, but elevated levels were not associated with revision. The revision rate in this study is unacceptably high. However, pain and DASH scores after revision are acceptable and comparable with patients with non-revised implants. Level of evidence: IV
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Braziulis, Kęstutis, Rytis Rimdeika, Rima Kregždytė, and Šarūnas Tarasevičius. "Associations Between the Fracture Type and Functional Outcomes After Distal Radial Fractures Treated With a Volar Locking Plate." Medicina 49, no. 9 (2013): 62. http://dx.doi.org/10.3390/medicina49090062.
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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.
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Müller, Marcus, and Isabelle Gunselmann. "Ergebnisse ambulanter orthopädischer Rehabilitation Ergebnismessung mittels Funktionsfragebogen-Hannover-Rücken, DASH- und WOMAC-Score." Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 28, no. 05 (2018): 291–98. http://dx.doi.org/10.1055/s-0044-102010.
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ZusammenfassungDie vorliegende Studie dient der Evaluation der Behandlungsergebnisse einer ambulanten orthopädischen Rehabilitationseinrichtung im Zeitraum 2013–2016. Die Ergebnisse dokumentieren deutliche Verbesserungen im Rehabilitationsverlauf für die verwendeten Assessments Funktionsfragebogen-Hannover-Rücken (FFbH-R, Rückenpatienten), Disability-of-Arm,-Shoulder,-Hand-Score (DASH, Patienten mit Läsionen der oberen Extremitäten) und Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC, Patienten mit Läsionen der unteren Extremitäten). Bei insgesamt 3210 Patienten wurden für alle Scores und Diagnosesubgruppen signifikant positive Veränderungen nachgewiesen. Unterschieden wurde nach: • FFbH-R: lumbale Bandscheiben-OP, cervicale Bandscheiben-OP, Spinalkanaldekompression, konservative Rückenschmerzbehandlung, sonstige; • DASH: Rotatorenmanschettenrekonstruktion, Schultergelenk-Endoprothese, Fraktur (konservativ oder osteosynthetisch versorgt), sonstige; • WOMAC: Hüftgelenk-Endprothese, Kniegelenk-Endoprothese, vordere-Kreuzbandplastik, sonstige. Die mittlere Scoredifferenz betrug beim FFbH-R 20,3 Punkte, -24,0 Punkte für den DASH-Score und für den dreigeteilten WOMAC-Score -8,1 (Schmerz), -4,0 (Steifigkeit) sowie -34,0 (Schwierigkeiten). Männer schätzten sich im Vergleich zu Frauen jeweils zu Beginn und Ende der Rehabilitation signifikant günstiger ein. Die Scoredifferenz von Beginn und Ende zeigte jedoch keinen Geschlechtsunterschied. Damit zeigt diese Untersuchung deutlich positive Effekte orthopädischer Rehabilitation im ambulanten Setting.
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Tore, N. G., F. Sari, Z. Tuna, et al. "Validity and reliability study of the Turkish version of SACRAH (Score for Assessment and quantification of Chronic Rheumatic Affections of the Hands)." Reumatismo 71, no. 3 (2019): 148–53. http://dx.doi.org/10.4081/reumatismo.2019.1180.
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Rheumatic diseases cause deformities in the hands and affect daily living activities. Therefore, assessment of hand disabilities is important in rheumatic disease. The aim of this study was to test the validity and reliability of the Turkish version of the A Score For Assessment and Quantification of Chronic Rheumatic Affections of the Hands (SACRAH). A translation and back-translation of the SACRAH were performed, according to the Beaton guidelines. Patients who were between 18-65 years old, who were literate in Turkish, who had rheumatic disease diagnosis and whose hands were affected, were included in the study. Patients who were using a splint during daytime were excluded from the study. They completed the Turkish version of Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH-T) once and the final version of the SACRAH Questionnaire twice with a 7 days’ interval. The internal consistency (Cronbach’s α) and reliability (test-retest reliability) of the questionnaire were assessed. Besides, correlations between SACRAH and DASH-T scores were analyzed using the Spearman correlation coefficient. One hundred and twenty patients participated in the study. The Turkish version of the SACRAH met set criteria of reliability and validity. Internal consistency was excellent (Cronbach’s α=0.88) and test-retest reliability were very good (r=0.73). SACRAH showed a positive and statistically significant correlation with DASH-T scores (r=0.83, p<0.001). Our results show that the Turkish version of the SACRAH has excellent test-retest reliability and validity. As a result of this study we determined that SACRAH is a valid and reliable instrument for assessing functional status and subjective manual function in Turkish-speaking patients.
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Akatay, E. A., D. Bayraktar, E. Otman Akad, et al. "POS1533-HPR COMPARISON OF HAND FUNCTIONS AND FUNCTIONAL STATUS IN PATIENTS WITH LIMITED CUTANEOUS SYSTEMIC SCLEROSIS AND DIFFUSE CUTANEOUS SYSTEMIC SCLEROSIS." Annals of the Rheumatic Diseases 81, Suppl 1 (2022): 1111.2–1112. http://dx.doi.org/10.1136/annrheumdis-2022-eular.2883.
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BackgroundSystemic Sclerosis (SSc) is an autoimmune connective tissue disorder which is characterised by the fibrotic changes in the skin effecting especially fingers and hands. Regarding skin manifestations, SSc is classified into two different subtypes as limited cutaneous SSc (lcSSc) and diffuse cutaneous SSc (dcSSc).ObjectivesThe aim of the present study was to compare hand functions and functional status in patients with lcSSc and dcSSc.MethodsTwenty-three patients with lcSSc and thirteen patients with dcSSc were included in the study. Modified Hand Mobility in Scleroderma Test (mHAMIS), modified Rodnan skin score (mRSS), grip and pinch strengths were measured to evaluate hand-related physical characteristics. Duruoz Hand Index, Disability of Arm, Shoulder and Hand Questionnaire (DASH), Health Assessment Questionnaire (HAQ), and Scleroderma Health Assessment Questionnaire (SHAQ) were used as the outcomes.ResultsWhile differences were detected in mRSS scores between disease subtypes (p<0.05), hand functions and functional status were comparable between groups (p>0.05).Table 1.Comparison of the groupslcSSc Group Median (IQR 25/75) (n= 23)dcSSc Group Median (IQR 25/75) (n=13)p*mHAMIS (score 0-4)0 (0/1)0 (0/0)0.745mRSS Fingers (score 0-3)2 (1.5/3)3 (2/3)0.100mRSS Hands (score 0-3)1 (0.5/2)2 (2/3)0.020*mRSS Forearms (score 0-3)0 (0/1)2 (1/2)0.013*mRSS Upper Arms (score 0-3)0 (0/0)1 (0/1)0.003*mRSS Total (0-51)8 (5/13)27 (18/29)0.006*Hand Grip Strength (kg)19.7 (11.2/24.6)20.9 (14.4/24.8)0.649Tip to Tip Pinch Strength (kg)3 (2.2/3.9)3.3 (2.4/2.9)0.721Three Jaw Pinch Strength (kg)2.4 (1.7/3.2)2.8 (2/3.5)0.226Lateral Pinch Strength (kg)3.8 (3.4/5.1)4 (3.2/5.3)0.948Duruoz Hand Index (score 0-90)5 (0/17)6 (0/15)0.770DASH (score 30-150)62 (47/84)61 (53/77)0.770HAQ (score 0-3)0.3 (0.1/0.9)0.3 (0.8/0.9)1.000SHAQ-Raynaud’s Phenomenon (score 0-3)0.8 (0/1.4)1.3 (0.3/1.5)0.363SHAQ-Digital Ulcers (score 0-3)0 (0/0.6)0.3 (0/1.7)0.136SHAQ-Gastrointestinal (score 0-3)0 (0/1.5)0.7 (0.1/1.4)0.466SHAQ-Pulmonary (score 0-3)0.5 (0/1.5)1 (0.2/1.5)0.534SHAQ-Patient Global Assessment (score 0-3)1.1 (0.1/2)1.4 (0.8/2.2)0.345p<0.05, *: Mann-Whitney U test, IQR 25/75: Interquartile range between the 25th and 75th percentiles, n: number, mHAMIS: modified Hand Mobility in Scleroderma Test, mRSS: modified Rodnan skin score, DASH: Disability of Arm, Shoulder, and Hand Questionnaire, HAQ: Health Assessment Questionnaire, SHAQ: Scleroderma Health Assessment Questionnaire, lcSSc: limited cutaneous Systemic Sclerosis, dcSSc: diffuse cutaneous Systemic SclerosisConclusionAccording to our results, even though, patients with dcSSc present higher skin thickening compared to patients with lcSSc, hand functions and functional status seem to be similar between SSc subtypes.Disclosure of InterestsNone declared
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Kim, Asall, Eun Joo Yang, Myungki Ji, Jaewon Beom, and Chunghwi Yi. "Distorted body schema after mastectomy with immediate breast reconstruction: a 4-month follow up study." PeerJ 10 (October 3, 2022): e14157. http://dx.doi.org/10.7717/peerj.14157.
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Background After breast cancer, some patients report residual pain-related upper limb disability without physical impairment. Although pain and altered proprioception are known to affect the working body schema (WBS), there is little available evidence investigating the WBS of breast cancer survivors (BrCS). WBS—body representations in the brain—affect the “neuromatrix” that modulates pain sensitivity and the threshold for threatening stimuli. The aim of this study was to investigate whether WBS was disrupted after mastectomy with immediate breast reconstruction (IBR) for breast cancer and whether pain and proprioceptive changes affected WBS. Methods Thirty-five BrCS participated in the 4-month follow-up study. They were observed at 1 and 4 months postoperatively. The main outcome measures were the left right judgement test (LRJT) results, absolute angle error, pectoralis minor length index (PMI), pain, and Quick-Disabilities of the Arm, Shoulder, and Hand (Q-DASH) score. They were measured at each observation, and parametric tests were performed to identify the nature of WBS. Results Both the reaction time and accuracy of the hand LRJT were poorer than those of the foot and back LRJT (p < 0.001). The hand LRJT reaction time and accuracy were unchanged over the total follow-up period (p = 0.77 and p = 0.47, respectively). There was a weak correlation between the LRJT reaction time and PMI (r = −0.26, p = 0.07), pain severity (r = 0.37, p = 0.02), and Q-DASH score (r = 0.37, p = 0.02). There was also a weak correlation between LRJT accuracy and Q-DASH score (r = −0.31, p = 0.04). The LRJT accuracy of BrCS who underwent surgery on their dominant side was higher than that of BrCS who underwent surgery on their non-dominant side (p = 0.002). Regression analysis found a weak but significant relationship between the early hand LRJT results and late pain severity (adjusted R2 = 0.179, p = 0.007). A similar relationship was found between early hand LRJT results and Q-DASH score (adjusted R2 = 0.099, p = 0.039). Conclusion To the best of our knowledge, this is the first study providing the nature of WBS after mastectomy with IBR. In this population, it is necessary to postoperatively preserve WBS integrity for pain and upper limb disability.
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SAUERBIER, M., M. TRÄNKLE, G. LINSNER, B. BICKERT, and G. GERMANN. "Midcarpal Arthrodesis with Complete Scaphoid Excision and Interposition Bone Graft in the Treatment of Advanced Carpal Collapse (SNAC/SLAC Wrist): Operative Technique and Outcome Assessment." Journal of Hand Surgery 25, no. 4 (2000): 341–45. http://dx.doi.org/10.1054/jhsb.2000.0434.
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Thirty-six patients with stage II or III SNAC and SLAC wrists were treated by midcarpal arthrodesis and complete scaphoid excision. When assessed at a mean follow-up of 25 months, pain was significantly reduced both under resting and stress conditions. The active range of motion was 54% of the contralateral wrist and grip strength was 65% of the non-operated hand. The mean DASH score was 28 points, the Mayo wrist score was 63 points, and the Krimmer wrist score was 68. Correlation of the wrist scores with the DASH values demonstrated a significant correlation. Our data demonstrate that midcarpal fusion with complete excision of the scaphoid is a reliable procedure for treating advanced carpal collapse.
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Uppal, L., K. Dhaliwal, and P. E. Butler. "A prospective study of the use of botulinum toxin injections in the treatment of Raynaud’s syndrome associated with scleroderma." Journal of Hand Surgery (European Volume) 39, no. 8 (2013): 876–80. http://dx.doi.org/10.1177/1753193413516242.
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Raynaud’s syndrome contributes to the pain, paraesthesia, ulceration, and gangrene of scleroderma. Botulinum toxin has been shown to improve digital perfusion in patients with Raynaud’s. This is the first study to objectively assess hand function following this treatment in patients with scleroderma. Twenty patients were treated with 100 units of botulinum toxin injected into the hand. An assessment of hand function and symptoms was performed prior to injection and then 8–12 weeks later. The outcomes assessed were change in pain, appearance, cold intolerance, pinch and power grip, ranges of movement, and Disabilities of the Arm, Shoulder and Hand (DASH) score. In total, 80% of patients reported an overall improvement in their symptoms, reduction in pain, and improved DASH score and 65% reported improvement in cold intolerance. Overall, 90% showed an improvement in pinch grip and 65% an improvement in power grip. Objective parameters were statistically significantly improved; however, subjective outcomes only showed a trend. We have found botulinum toxin to be an effective treatment for Raynaud’s syndrome secondary to scleroderma.
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Alnahdi, Ali H. "Responsiveness and Minimal Important Change of the Arabic Disabilities of the Arm, Shoulder and Hand (DASH) in Patients with Upper Extremity Musculoskeletal Disorders." Healthcare 11, no. 19 (2023): 2623. http://dx.doi.org/10.3390/healthcare11192623.
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The aim of this study was to examine the responsiveness of the Arabic Disabilities of the Arm, Shoulder and Hand (DASH) and to quantify its minimal important change (MIC) for improvement. People with upper extremity musculoskeletal problems who were receiving physical therapy were evaluated at baseline and again during a follow-up appointment, with a median time frame of 7 days between the two testing sessions (range of 6 to 72 days). The participants completed the Arabic DASH, Global Assessment of Function (GAF), Numeric Pain Rating Scale (NPRS) and Global Rating of Change Scale (GRC). The responsiveness of the Arabic DASH was assessed by examining the pre-specified hypotheses. The MIC for improvement was determined using the receiver operating characteristic method (MICROC) and the predictive modeling method (MICpred). As hypothesized, a change in the Arabic DASH demonstrated a significant positive correlation with changes in the GAF (r = 0.69), NPRS (r = 0.68) and GRC (r = 0.73). Consistent with our hypotheses, the DASH change scores could be used to differentiate between participants who improved and those who did not improve (area under the receiver operating characteristic curve = 0.87), and they showed a large magnitude of change (effect size = 1.53, standardized response mean = 1.42) in patients who improved. All the hypotheses specified a priori were supported by the results. The Arabic DASH MICROC and MICpred were estimated to be 14.22 and 14.85. The interaction between the DASH change and baseline score was not a significant predictor of status (improved vs. not improved) (p = 0.75), indicating that the DASH MIC was not baseline-dependent. The Arabic DASH demonstrated sufficient responsiveness, supporting the idea that the Arabic DASH is capable of detecting changes in upper extremity function over time. The value of the Arabic DASH MIC was similar when estimated using the predictive modeling and ROC methods, and the MIC was not dependent on baseline status.
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Davis, Derik L., Ranyah Almardawi, and Michael L. Terrin. "Identification of Community-Dwelling Older Adults With Shoulder Dysfunction: A Pilot Study to Evaluate the Disabilities of the Arm, Shoulder and Hand Survey." Geriatric Orthopaedic Surgery & Rehabilitation 13 (January 2022): 215145932211291. http://dx.doi.org/10.1177/21514593221129177.
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Introduction The Disabilities of the Arm, Shoulder and Hand (DASH) survey estimates the upper limbs’ dysfunction in one score, but limited evidence exists to justify use of DASH to screen older adults for shoulder dysfunction at routine health maintenance primary care visits. We sought (1) to determine if the DASH, American Shoulder and Elbow Surgeons (ASES) and Simple Shoulder Test (SST) surveys are related to one another and (2) to determine the relationship of DASH, ASES and SST scores with 36-Item Short Form (SF-36) subscales, shoulder forward flexion range of motion (FF-ROM) and abduction (ABD-ROM) in older adults. Methods Prospective pilot study of 23 community-dwelling adult volunteers [mean age (± standard deviation), 69.3 ± 6.7 years; range, 61-84 years, with no rotator cuff repair or joint replacement. Shoulder MRI, ROM testing, DASH, ASES, SST, SF-36, Katz activities of daily living (ADLs), and Lawton-Brody instrumental ADLs (IADLs) were completed at one time point. Descriptive and correlation analyses were performed. Results Means: DASH, 17.4 ± 19.5; ASES, 81.3 ± 19.7; SST, 71.7 ± 28.5; Katz ADLs, 5.9 ± .3; Lawton-Brody IADLs, 8.0 ± .0; FF-ROM, 140.2° ± 31.5°; and ABD-ROM, 128.3° ± 31.9°. Nearly 48% had supraspinatus tendon tear. Correlation among DASH, ASES, and SST was strong (|rho ≥.88|; P < .001). DASH, ASES, and SST had strong correlation (|rho ≥.71|; P < .001) with shoulder FF-ROM and ABD-ROM. DASH had near equivalent or slightly stronger correlation for all SF-36 subscales relative to ASES and SST. DASH showed strong or moderate correlation ( P < .05) to most SF-36 subscales. Conclusion DASH, ASES and SST strongly correlated with one another. DASH, relative to ASES and SST, has similar correlation to shoulder FF-ROM, ABD-ROM and SF-36 subscales in older adults. Our pilot study suggests that the DASH survey has potential utility to identify occult shoulder dysfunction in community-dwelling older adults who have normal Katz ADLs and Lawton-Brody IADLs if administered during routine health maintenance primary care visits.
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Marchak, Caitlin, Sarah James, Iris Davidson, Jennifer Brown, and Kristin Houghton. "97 Handwriting Speed in Juvenile Idiopathic Arthritis Using the Detailed Assessment of Speed of Handwriting." Paediatrics & Child Health 28, Supplement_1 (2023): e46-e46. http://dx.doi.org/10.1093/pch/pxad055.097.
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Abstract Background Juvenile idiopathic arthritis (JIA) is the most common cause of arthritis in children. Common symptoms include pain, joint stiffness, joint swelling, fatigue, and decreased physical function. Over 50% of children have hand or wrist involvement and handwriting is the most commonly reported functional limitation in daily activities. To date there has been limited study of the specific limitations of handwriting in children with JIA. Objectives To better understand handwriting limitations in children with JIA, this pilot study aimed to: (a) describe handwriting speed measured by the Detailed Assessment of Speed of Handwriting (DASH), a standardized assessment of handwriting speed; (b) compare the DASH scores with age- and sex-matched normative data; (c) examine the association between DASH scores and active wrist and hand arthritis; and (d) explore associations between DASH scores and grip strength, quality of life, function, and pain. Design/Methods Participants diagnosed with JIA and actively followed by the paediatric rheumatology clinic at a large tertiary care centre underwent physician assessment with active joint count, occupational therapist (OT) assessment including administration of the DASH, and grip strength measurement by a physiotherapist. Participant-reported outcomes included questionnaires on function (Childhood Health Assessment Questionnaire [CHAQ]), pain, and quality of life (QOL). Results A total of 12 participants aged 9-15 years (M = 12.7y) completed the study. The mean DASH score was 35th percentile (SD = 23) for all participants, 58th percentile (SD = 14) with active hand/wrist arthritis, 25th percentile (SD = 19) with history of hand/wrist arthritis, and 24th percentile (SD = 25) with no history of hand/wrist arthritis. Grip strength was low overall (M = 18th percentile, SD = 28), and lower in participants with active hand/wrist arthritis (M = 4th percentile, SD = 5) and history of hand/wrist arthritis (M = 5th percentile, SD = 7). DASH scores were negatively associated with grip strength (r = -.31), and positively associated with QOL (r = .41) and pain (r = .43). There was no relationship between the DASH and the CHAQ. Conclusion Handwriting speed difficulties are common in children with JIA and may not relate to arthritis disease activity, pain, or function. Handwriting speed may be used in the clinic as a screen to identify children who may benefit from a full OT handwriting assessment. In the absence of access to OT, general guidance can be provided to schools to support a child with JIA in the classroom.
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Eeckhoudt, Annelies, and Nadine Hollevoet. "Results of treatment of osteoarthritis of the scaphotrapeziotrapezoidal joint with tendon allograft interposition." Acta Orthopaedica Belgica 87, no. 3 (2021): 533–39. http://dx.doi.org/10.52628/87.3.20.
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The aim of the study was to determine if the use of tendon allografts in combination with distal scaphoid resection for the treatment of isolated STT arthrosis is a save procedure. We reviewed the postoperative complications, re-operations, clinical and radiological results of this treatment modality. A retrospective cohort study was conducted. Investigated parameters include wrist mobility (wrist extension and -flexion), strength (grip- and pinch strength), patient-reported outcome scores : Visual Analogue Scale (VAS), Quick Disabilities of the Arm, Shoulder and Hand score (Q-DASH) and Patient Rated Wrist/Hand Evaluation score (PRWHE) and radiographic measurements : scapholunate (SL) angle, radiolunate (RL) angle and capitolunate (CL) angle. Ten wrists were included in nine patients. No revision surgery was performed. Two patients had transient neuropraxia of the radial nerve. Postoperative flexion-extension arc was 112°. Grip-strength was significantly increased after surgery (20 to 28kg). The average VAS score the past week was 1.75 (range 0-6.7), the average maximum VAS score was 3.0 (range 0-10). The mean PRWHE score was 16.6 (range 0- 69). The mean Q-DASH score was 17.95 (range 0-51). The current study indicates that distal scaphoid resection for isolated STT arthritis is a save procedure with minimal complications. It significantly improves grip strength. Mobility of the wrist was similar to contralateral wrist after surgery. Pain postoperatively was very limited (low VAS scores) and good functional scores (Q-DASH and PRWHE) were noted. Our findings support the prior findings that excisional arthroplasty might worsen carpal instability.
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Gupta, Madhumita, and Prabir Kumar Jash. "The posterior interosseous artery flap versus the adipofascial radial artery perforator flap in reconstruction of firecracker and homemade bomb blast injuries of the hand." International Surgery Journal 8, no. 4 (2021): 1118. http://dx.doi.org/10.18203/2349-2902.isj20210962.
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Background: The soft tissues of the radial aspect of the hand are predominantly affected in firecracker and homemade bomb blast injuries. In such cases, regional flap options are quite appealing for defect coverage. We have compared the outcomes of using two pedicled regional forearm flaps in these injuries, the posterior interosseous artery flap (PIAF) and the adipofascial radial artery perforator flap (ARAPF).Methods: 37 patients underwent reconstruction of the hand with PIAF (20 cases) and ARAPF (17 cases) between January 2014 and December 2019. They were compared with regards to patient demographics, reconstruction techniques, short-term and long-term functional and aesthetic outcomes using the disabilities of the arm, shoulder and hand (DASH) score and the subjective satisfaction score (SSS).Results: All our flaps survived without any major complications affecting long-term outcome. We found no statistically significant difference between the two flaps in terms of patient demographics, flap paddle size, duration of hospital stay, DASH score and SSS for recipient site. However, significant difference was noted in the duration of surgery, method of donor site closure and SSS for the donor site.Conclusions: Both the PIAF and ARAPF can be considered in cases of soft tissue defects of the hand from firecracker or bomb blast injuries. Both preserve the major arteries of the hand while still having reliable vascular pedicle.
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Khaja, Dr Aliaa, Dr Ahmed Bouhamra, Dr Sager Hanna, and Dr Ali Maqdis. "Cross-Cultural Adaptation and Psychometric Properties of an Arabic Version of the Western Ontario Shoulder Instability Index (WOSI)." International Journal of Innovative Research in Medical Science 5, no. 12 (2020): 585–88. http://dx.doi.org/10.23958/ijirms/vol05-i12/1010.
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Background: The Western Ontario Shoulder Instability Index (WOSI) score is a tool that helps with self-assessment of the shoulder’s functional status in patients experiencing instability problems.The purpose of this study was the cross-cultural adaptation of WOSI into Arabic and assessment of its psychometric properties in comparison to a gold standard-questionnaire, namely the Arabic Disability of the Arm, Shoulder and Hand (DASH) score. Material & Methods: 100 patients participated in this survey, tested initially and retest after two months. The internal consistency tests were performed using Cronbach's alpha. Besides, Pearson's Correlation and Standard response mean (SRM) were calculated to estimate criterion validity and responsiveness of the Arabic WOSI in comparison to the Arabic DASH. Results: The Arabic WOSI had a Cronbach's alpha score of 0.85 at the baseline and 0.91 at the follow-up time period. All subscales had an internal consistency greater than 0.7, except Sport/Work (0.69 at follow-up). A strong correlation with Arabic DASH score was observed (r = 0.79 at baseline & 0.87 at Follow-up) which suggested good validity. Also, moderately correlated changes of baseline to follow-up in DASH and WOSI indicated moderate responsiveness. No ceiling and floor effects were observed among the responses. Conclusion: Overall, the Arabic version of WOSI proved to be a good and reliable diagnostic tool for patients with shoulder instability.