The Internal Consistency and Validity of the Patient Evaluation Measure for Outcomes Assessment in Distal Radius Fractures

Forward, D. P.; Sithole, Jabulani; Davis, T. R. C.

doi:10.1016/j.jhsb.2007.01.010

Cited by 21 publications

(15 citation statements)

References 19 publications

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“…The DASH and Patient Evaluation Measure were both validated for assessing hand function, unlike the assessments of function used in many previous investigations of the distal radius. [11][12][13] A comparative Patient Evaluation Measure was also calculated by obtaining scores for the uninjured and injured arms separately, and subtracting the uninjured score from that of the injured one. This attempted to eliminate any symptoms present from other problems such as trapeziometacarpal arthritis, which is prevalent in this group of patients and a confounding factor not usually considered when reviewing outcome.…”

Section: Methodsmentioning

confidence: 99%

Do young patients with malunited fractures of the distal radius inevitably develop symptomatic post-traumatic osteoarthritis?

Forward

Davis²,

Sithole

2008

The Journal of Bone and Joint Surgery. British volume

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117

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Fractures of the distal radius occurring in young adults are treated increasingly by open surgical techniques, partly because of concern that failure to restore the alignment of the fracture accurately may cause symptomatic post-traumatic osteoarthritis in future years. We reviewed 106 adults who had sustained a fracture of the distal radius between 1960 and 1968 and who were below the age of 40 years at the time of injury. We carried out a clinical and radiological assessment at a mean follow-up of 38 years (33 to 42). No patient had required a salvage procedure. While there was radiological evidence of post-traumatic osteoarthritis after an intra-articular fracture in 68% of patients (27 of 40), the disabilities of the arm, shoulder and hand (DASH) scores were not different from population norms, and function, as assessed by the Patient Evaluation Measure, was impaired by less than 10%. Ordinal logistic regression analysis showed a significant relationship between narrowing of the joint space and extra-articular malunion (dorsal angulation and radial shortening) as well as intra-articular injury. Multivariate analysis revealed that grip strength had fallen to 89% of that of the uninjured side in the presence of dorsal malunion, but no measure of extra-articular malunion was significantly related to either the Patient Evaluation Measure or DASH scores. While anatomical reduction is the principal aim of treatment, imperfect reduction of these fractures may not result in symptomatic arthritis in the long term, and this should be considered when counselling patients on the risks and benefits of the many treatment options available.

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Section: Methodsmentioning

confidence: 99%

Do young patients with malunited fractures of the distal radius inevitably develop symptomatic post-traumatic osteoarthritis?

Forward

Davis²,

Sithole

2008

The Journal of Bone and Joint Surgery. British volume

Self Cite

117

View full text Add to dashboard Cite

show abstract

“…The Disabilities of Arm, Shoulder and Hand has been crossculturally adapted in various languages, including Dutch, and has been validated in patients with upper extremity injuries. 17,[28][29][30][31][32] Lower Extremity Functional Scale. The Lower Extremity Functional Scale is a body region-specific questionnaire that can be used to assess lower extremity function.…”

Section: Outcome Measuresmentioning

confidence: 99%

The Short Musculoskeletal Function Assessment: a study of the reliability, construct validity and responsiveness in patients sustaining trauma

et al. 2019

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Objective: To assess test–retest reliability, construct validity and responsiveness of the Dutch Short Musculoskeletal Function Assessment (SMFA-NL) in patients who sustained acute physical trauma. Design: A longitudinal cohort study. Setting: A level 1 trauma center in The Netherlands. Subjects: Patients who required hospital admission after sustaining an acute physical trauma. Intervention: Patients completed the SMFA-NL at six weeks, eight weeks and six months post-injury. Main measure: The measures used were The Dutch Short Musculoskeletal Function Assessment. Test–retest reliability (between six and eight weeks post-injury) using intraclass correlation coefficients, the smallest detectable change and Bland and Altman plots. Construct validity (six weeks post-injury) and responsiveness (between six weeks and six months post-injury) were evaluated using the hypothesis testing method. Results: A total of 248 patients (mean age: 46.5, SD: 13.4) participated, 145 patients completed the retest questionnaires (eight weeks) and 160 patients completed the responsiveness questionnaires (six months). The intraclass correlation coefficients indicated good to excellent reliability on all subscales (0.80 to 0.98). The smallest detectable change was 17.4 for the Upper Extremity Dysfunction subscale, 11.0 for the Lower Extremity Dysfunction subscales, 13.9 for the Problems with Daily Activities subscale and 16.5 for the Mental and Emotional Problems subscale. At group level, the smallest detectable change ranged from 1.48 to 1.96. A total of 86% of the construct validity hypotheses and 79% of the responsiveness hypotheses were confirmed. Conclusion: This study showed that the SMFA-NL has good to excellent reliability, sufficient construct validity and is able to detect change in physical function over time.

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“…The PEM score is also the only outcome measure validated in terms of content regarding distal radial fractures, as it was specifically evaluated for such injuries. 4 They were given to patients in clinic at 12 months after surgery. This was returned on the day or by post.…”

Section: Methodsmentioning

confidence: 99%

Functional Outcome of Fixation of Complex Intra-articular Distal Radius Fractures with a Variable-Angle Distal Radius Volar Rim Plate

Spiteri

Matthews

et al. 2017

J Hand Microsurg

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To evaluate the outcome of these complex fractures using a volar approach and the DePuy Synthes variable-angle 2.4-mm distal radius rim plate. This plate is precontoured to the volar rim for placement distal to the watershed line allowing purchase of the rim fragment of the lunate facet. Its low profile and smooth edges are designed to minimize flexor tendon irritation. We report on a consecutive series of far distal AO-23B3 and AO-23C3 fractures treated using this plate in a tertiary hand center between November 2011 and May 2014. Range of motion, grip strength, and complications were assessed at the final clinical review. Disabilities of the arm, shoulder, and hand (DASH) and patient evaluation measure (PEM) scores were assessed at 12 months after surgery. Twenty-six patients were included in this review. Six patients were lost to follow-up at 3 months. This plate was used in isolation in 17 cases, and in combination with a dorsal plate, in cases of dorsal instability after volar plating, in 10 patients. DASH and PEM scores 1 year after surgery were 17.6 and 27%, respectively. Visual analog scores for patient treatment satisfaction and severity of pain showed good satisfaction with treatment and mild intermittent pain on activity. Postoperative range of motion was variable and grip strength was of 71% of the uninjured contralateral side. There were no cases of flexor or extensor tendon rupture. Tendon irritation was noted in two patients. Removal of metal was performed in four patients. Loss of reduction occurred in one case and neurologic complications in two cases. This implant is specifically designed for the management of far distal complex intra-articular fractures of the distal radius. Despite the complexity of these fracture patterns and the challenge they pose to accurate reduction and stable fixation, outcomes were satisfactory in this small series. There were no cases of tendon rupture. Removal of metal is not necessary in all cases, but prompt removal should be performed in cases of tendon irritation in view of the risk of tendon rupture.

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The Internal Consistency and Validity of the Patient Evaluation Measure for Outcomes Assessment in Distal Radius Fractures

Cited by 21 publications

References 19 publications

Do young patients with malunited fractures of the distal radius inevitably develop symptomatic post-traumatic osteoarthritis?

Do young patients with malunited fractures of the distal radius inevitably develop symptomatic post-traumatic osteoarthritis?

The Short Musculoskeletal Function Assessment: a study of the reliability, construct validity and responsiveness in patients sustaining trauma

Functional Outcome of Fixation of Complex Intra-articular Distal Radius Fractures with a Variable-Angle Distal Radius Volar Rim Plate

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