Distal Pole Resection of the Scaphoid for the Treatment of Scaphotrapeziotrapezoid Osteoarthritis

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Abstract

Background: Distal pole resection of the scaphoid is one of the surgical techniques applied for the treatment of painful scaphotrapeziotrapezoid osteoarthritis (STT-OA). Methods: In this retrospective study, we evaluated midterm outcomes in a consecutive series of patients who underwent distal pole resection of the scaphoid: 13 patients (15 wrists) with a mean follow-up of 4.1 years. We examined objective functional and patient-reported outcome measures. In addition, we assessed the degree of dorsal intercalated segment instability (DISI) and postoperative complications. Results: All patients scored within a normal range on objective functional and patient-reported outcome measures. We observed a mild postoperative DISI deformity with an average lunocapitate angle of 22° (range, 0°-44°), which did not correlate with pain scores. In the opposite wrists, with and without STT-OA, the average lunocapitate angle was 6° (range, 0°-20°). Conclusions: According to this study, midterm results for distal pole resection of the scaphoid are satisfactory.

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Development of the QuickDASH: comparison of three item-reduction approaches.

Dorcas E. Beaton, James G Wright, Jeffrey Katz (2005)

The purpose of this study was to develop a short, reliable, and valid measure of physical function and symptoms related to upper-limb musculoskeletal disorders by shortening the full, thirty-item DASH (Disabilities of the Arm, Shoulder and Hand) Outcome Measure. Three item-reduction techniques were used on the cross-sectional field-testing data derived from a study of 407 patients with various upper-limb conditions. These techniques were the concept-retention method, the equidiscriminative item-total correlation, and the item response theory (Rasch modeling). Three eleven-item scales were created. Data from a longitudinal cohort study in which the DASH questionnaire was administered to 200 patients with shoulder and wrist/hand disorders were then used to assess the reliability (Cronbach alpha and test-retest reliability) and validity (cross-sectional and longitudinal construct) of the three scales. Results were compared with those derived with the full DASH. The three versions were comparable with regard to their measurement properties. All had a Cronbach alpha of > or = 0.92 and an intraclass correlation coefficient of > or = 0.94. Evidence of construct validity was established (r > or = 0.64 with single-item indices of pain and function). The concept-retention method, the most subjective of the approaches to item reduction, ranked highest in terms of its similarity to the original DASH. The concept-retention version is named the QuickDASH. It contains eleven items and is similar with regard to scores and properties to the full DASH. A comparison of item-reduction approaches suggested that the retention of clinically sensible and important content produced a comparable, if not slightly better, instrument than did more statistically driven approaches.

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The Michigan Hand Outcomes Questionnaire (MHQ): assessment of responsiveness to clinical change.

K. Chung, J Hamill, M R Walters … (1999)

Responsiveness is an important property of an outcomes questionnaire. It can be defined as the ability of an instrument to capture important changes in a patient's health status over time. The authors previously designed the Michigan Hand Outcomes Questionnaire (MHQ), a hand-specific outcomes instrument that contains six distinct scales: (1) overall hand function, (2) activities of daily living, (3) pain, (4) work performance, (5) aesthetics, and (6) patient satisfaction with hand function. In the first study, the authors demonstrated that the MHQ is a reliable and valid instrument for the hand. The purpose of this second study is to assess the responsiveness, or sensitivity, of the MHQ to clinical change in patient status. A total of 187 consecutive patients with chronic hand disorders completed a baseline MHQ prior to receiving treatment at a university plastic surgery clinic. Approximately 6 to 18 months after completing the first questionnaire, patients were sent a follow-up MHQ by mail. The second questionnaire was identical to the first, with the exception of one additional question added to each of the six MHQ scales. This additional question asked patients to rate the change in their hands since completing the last questionnaire using a seven-point response scale. Spearman's correlation coefficient was used to correlate the responses from patients' self-assessment questions with the actual score change (after score - before score). The response rate for the second administration was 49% (92 questionnaires returned)-a fairly good rate of return for mail surveys. There were no significant differences in gender, race, education, and income between responders and nonresponders. When patients' self-assessment of change was correlated with the change in the six scale scores over time, all six correlations were statistically significant, with p < 0.05. The correlations ranged from 0.25 for the aesthetics scale to 0.43 for the pain scale. The MHQ was responsive using patients' self-assessment of their clinical change. Future studies will evaluate the responsiveness of the MHQ compared with objective physiological measures such as grip strength, range of motion, and the Jebson-Taylor test. Additionally, research is underway to assess the responsiveness of the MHQ for specific procedures, including metacarpophalangeal arthroplasties for rheumatoid arthritis and microvascular toe-to-hand reconstructions.

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Proximal row carpectomy: minimum 20-year follow-up.

Lindley Wall, Michael L DiDonna, Thomas Kiefhaber … (2013)

Proximal row carpectomy (PRC) is a motion-sparing procedure for degenerative disorders of the proximal carpal row. Reported results at a minimum 10-year follow-up consistently show maintenance of strength, motion, and satisfaction with an average conversion rate to radiocarpal arthrodesis of 12%. We hypothesized that PRC would continue to provide a high level of satisfaction and function at a minimum of 20 years.

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Author and article information

Journal

Journal ID (nlm-ta): Hand (N Y)

Journal ID (iso-abbrev): Hand (N Y)

Journal ID (publisher-id): HAN

Journal ID (hwp): sphan

Title: Hand (New York, N.Y.)

Publisher: SAGE Publications (Sage CA: Los Angeles, CA )

ISSN (Print): 1558-9447

ISSN (Electronic): 1558-9455

Publication date (Electronic): 02 November 2017

Publication date (Print): March 2019

Volume: 14

Issue: 2

Pages: 230-235

Affiliations

[1 ]VU University Amsterdam, The Netherlands

[2 ]The Hand Clinic, Amsterdam, The Netherlands

Author notes

[*]Merel J.-L. Berkhout, Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, VU University Amsterdam, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam, The Netherlands. Email: berkhout@ 123456gmail.com

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Publisher ID: 10.1177_1558944717735939

DOI: 10.1177/1558944717735939

PMC ID: 6436121

PubMed ID: 29094605

SO-VID: b688ec93-a9b9-4fdf-b478-4a05c53e89aa

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This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

Distal Pole Resection of the Scaphoid for the Treatment of Scaphotrapeziotrapezoid Osteoarthritis

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Most cited references 23

Development of the QuickDASH: comparison of three item-reduction approaches.

The Michigan Hand Outcomes Questionnaire (MHQ): assessment of responsiveness to clinical change.

Proximal row carpectomy: minimum 20-year follow-up.

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