Reliability and Validity of Upper Extremity Patient-Reported Outcome Measures in Assessing Traumatic Finger Amputation Management

Yoon, Alfred P.; Kaur, Surinder; Chou, Ching-Han; Chung, Kevin C.; Malay, Sunitha; Shauver, Melissa J.; Wang, Lu; Zhong, Lin; Sommers, Katie; Hume, Keith M.; Sawada, Hideyoshi; Hsu, Chung Chen; Tsai, Tai‐Jung; Yang, Guang; Zhang, Zhan; Giladi, Aviram M.; Fleming, Ike; Sabapathy, S Raja; Kumaran, M. Senthil; Ishiko, Toshihiro; Nishizuka, Takanobu; Kawamura, Kenji; Sebastin, Sandeep J.; Yong, Jasmine; Jain, Sonu A.; Colvell, Kara; Lacey, Martin S.; Hillard, Christopher; Fowler, Jason C.; Neumeister, Michael W.; Lovel, Breana; Kao, Dennis S.; Arif, Hikmatullah; Spiess, Alexander; Grybowski, Damian; Michelotti, Brett; Costa, B. A.; Drolet, Brian C.; Bueno, Reuben A.; Spear, Marcia; Woo, Sang Hyun; Kim, Young Woo; Moore, Amy M.; Bettlach, Carrie Roth; Linkugel, Andrew; Dalton, Jay F.

doi:10.1097/prs.0000000000006326

Cited by 14 publications

(12 citation statements)

References 33 publications

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“…Furthermore, we propose the concept of a digital amputation registry via ever-growing collaborative research communities. It will be designed to collect robust functional and patient-reported [ 23 ] outcome data from UK hand centres to facilitate the replant vs terminalisation discussions for future surgeons and patients.…”

Section: Discussionmentioning

confidence: 99%

Survival Statistics of Digital Replantation in the UK

Smith¹,

Nikkhah²,

Wade³

2021

Cureus

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BackgroundDigital replantation is associated with a substantial risk of failure. There is considerable variation in survival rates globally, and the current data are limited by poor statistical methods and bias of selection, which limits its translation to Europe and the USA. We aimed to establish a more representative survival rate of digit replantation for western populations and evaluate espoused prognostic variables using robust statistical methodology. Materials and MethodsRetrospective data were collected from 58 consecutive patients who underwent digital replantation following traumatic amputation in three tertiary care hand centres in the UK over seven years. The unit of analysis was the digit. Generalized linear modelling was used to estimate the odds ratio (OR) of digit survival. ResultsForty-six of 68 replanted digits survived (68%). The typical replant candidate was a 40-year-old male manual worker. Digit survival was more likely with guillotine injuries (adjusted OR 25.5 [95% CI 5.60, 115]) and when intraoperative skeletal shortening was performed (adjusted OR 15.3 [95% CI 2.62, 89.5]). The age of the patient, seniority of the operating surgeon, and use of vein grafts was not associated with digit survival. ConclusionWe provide robust data to show that guillotine amputations have more favourable survival rates, which can be further improved by skeletal shortening at the time of replantation. We suggest that research networks worldwide set up digit amputation registries to capture individual patient data on this uncommon injury.

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Section: Discussionmentioning

confidence: 99%

Survival Statistics of Digital Replantation in the UK

Smith¹,

Nikkhah²,

Wade³

2021

Cureus

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“…Higher scores represent better outcomes, except for pain, in which higher scores represent higher levels of pain. It compares favourably with other hand outcome instruments in test-retest reliability, validity and responsiveness (Shauver and Chung, 2013), and has been shown to outperform other self-reported outcome measures of function and quality of life after finger amputation (Yoon et al., 2020).…”

Section: Methodsmentioning

confidence: 99%

Comparative outcome analysis of osseointegrated reconstruction and replantation for digital amputations

Shepherd

Gray

et al. 2021

J Hand Surg Eur Vol

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The long-term outcomes of osseointegration for digital amputations are not well established, and it is not known whether osseointegration can achieve similar function and patient satisfaction to conventional surgical options such as replantation and microsurgical toe transfer. We compared the long-term outcomes after digital osseointegration and replantation. Six patients treated by osseointegration and seven patients treated by replantation were included, with median follow-ups of 8 years and 4.6 years, respectively. Outcomes were assessed using the Michigan Hand Outcomes Questionnaire, grip and pinch strength, range of motion, two-point discrimination, Semmes-Weinstein tests, Jebsen-Taylor Hand Function Test and clinical photography. Osseointegration was associated with poorer sensibility and range of motion than replantation; no other differences reached statistical significance. Long-term osseointegration is a safe and effective reconstructive option that can deliver excellent outcomes in appropriately selected patients. Level of evidence: IV

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“…The DASH has been extensively used in the upper limb prosthesis user population 2 , 9 , 10 , 12 , 16 and validated in the partial hand/finger amputee population. 17 …”

Section: Methodsmentioning

confidence: 99%

Understanding the Relationship Between Patient-Reported Function and Actual Function in the Upper Limb Prosthesis User Population: A Preliminary Study

Zhang

Baun

Trent

et al. 2021

Archives of Rehabilitation Research and Clinical Translation

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Objective To understand how perceived function relates to actual function at a specific stage in the rehabilitation process for the population using upper limb prostheses. Design Quantitative clinical descriptive study. Setting Clinical offices. Participants A sample of 61 participants (N=61; mean age, 43.0±12.8y; 51 male/10 female) with upper limb amputation who use a prosthetic device and were in the definitive stage of a prosthesis fitting process. Interventions Not applicable. Main Outcome Measures A patient-reported outcome measure, the Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH), and 2 performance-based outcome measures, Box and Blocks Test (BBT) and Capacity Assessment of Prosthesis Performance for the Upper Limb (CAPPFUL), were used as variables in multiple linear regression models. Results The multiple linear regression models, which controlled for prosthesis type and amputation level, did not show evidence that changes in the independent variable (DASH) are significantly associated with changes in the dependent variables (log(BBT) ( B =−0.007; 95% confidence interval [CI], −0.015 to 0.001; P =.0937) and CAPPFUL ( B =−0.083, 95% CI, −0.374 to 0.208; P =.5623)). In both models, individuals with elbow, transhumeral (above elbow), and shoulder disarticulation showed a significant negative association with the dependent variable (CAPPFUL or logBBT). In the CAPPFUL model, there was a significant negative association with individuals using a hybrid prosthesis ( B =−20.252; 95% CI, −36.562 to −3.942; P =.0170). In the logBBT model, there was a significant positive association with individuals using body-powered prostheses ( B =0.430; 95% CI, 0.089-0.771; P =.0157). Conclusions Although additional data and analyses are needed to more completely assess the association between self-reported measures and performance-based measures of functional abilities, these preliminary results indicate that patient-reported outcomes alone may not provide a complete assessment of an upper limb prosthesis users’ functional ability and should be accompanied by population-specific performance-based measures.

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Reliability and Validity of Upper Extremity Patient-Reported Outcome Measures in Assessing Traumatic Finger Amputation Management

Cited by 14 publications

References 33 publications

Survival Statistics of Digital Replantation in the UK

Survival Statistics of Digital Replantation in the UK

Comparative outcome analysis of osseointegrated reconstruction and replantation for digital amputations

Understanding the Relationship Between Patient-Reported Function and Actual Function in the Upper Limb Prosthesis User Population: A Preliminary Study

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