Context: Shoulder range of motion (ROM) and strength are key injury evaluation components for overhead athletes. Most normative values are derived from male baseball players with limited information specific to female softball players. Objective: To determine between-limb differences in shoulder ROM and strength in healthy collegiate softball players. Design: Descriptive laboratory study. Setting: University research laboratory and collegiate athletic training room Participants: Twenty-three healthy collegiate softball players (age=19.9 ± 1.2y; height=170.5 ± 4.3cm; mass=78.4 ± 11.3kg). Interventions: Outcome measures included shoulder ROM (internal [IR] and external rotation [ER]), isometric strength (IR, ER, flexion, abduction [135 degrees], and horizontal abduction), and a measure of dynamic strength (Upper Quarter Y Balance Test [UQYBT]). Main Outcome Measures: Paired sample t-tests were used to determine between limb differences for each outcome measure. Results: Participants had significantly more ER ROM (12° more) and significantly less IR ROM (12° less) on the dominant arm, relative to the non-dominant arm. There were no significant differences between limbs for any of the isometric strength measures or for the UQYBT reach directions. Conclusions: While female collegiate softball players demonstrated typical changes in ER and IR ROM in the dominant arm, they demonstrated relatively symmetrical performance across strength measures, which contrasts with previous studies using male baseball players.

The purpose of our study was to evaluate a new region-specific outcome measure in hand and upper limb surgery: the Patient Outcomes of Surgery (POS)-Hand/Arm questionnaire using the generic Short Form Health Survey (SF)-36 questionnaire as a 'gold standard' comparative measure. The POS-Hand/Arm preop questionnaire and the SF-36 questionnaire were completed by 214 patients on the day of their hand or upper limb surgery; and a postop POS-Hand/Arm and the SF-36 questionnaire were completed by patients 3 months after their initial surgery. The POS-Hand/Arm questionnaire responses were psychometrically evaluated and it was shown to have high internal consistency; high total-item correlations; signification scale correlations with the SF-36; and a low proportion of missing data. The POS-Hand/Arm questionnaire is a psychometrically sound instrument that can be used pre- and post-surgery to evaluate patient-based outcomes for a wide range of conditions in hand and upper limb surgery.

Introduction: Clavicular non-unions are rare, however they can account for severe disability, including pain, restriction of motion and brachial plexus compression neuropathy. Materials and methods: Twenty-one patients (18 males, three females, mean age 34 years, range 15-52) with symptomatic non-union of the clavicular shaft were included. The non-union was hypertrophic in 14 cases and atrophic in two cases. The major indication for surgery in 18 patients was pain at the non-union site. Furthermore, cosmetic deformity bothered four patients and five had symptoms of neurologic compression caused by the callus mass. Surgery was performed at a mean of 12 months (range 4-16) after injury and consisted of plating of the anterior or anterosuperior aspect of the clavicle. Stability was enhanced with an interfragmentally lag screw in ten patients and autologous cancelous bone graft was used in two cases. The patients simply rested in a sling and were mobilised as comfort allowed. None received physiotherapy and all had discarded the sling completely between 3 and 4 weeks postoperatively. There were no complications. The average follow-up was 12.9 months (range 9-24 months). Results: Fifteen of the 16 fractures healed with complete resolution of the pre-operative pain except one case that failed union and required revision. Conclusion: Plating of the clavicle is an effective method of management painful non-union and malunion and it has minimal complications.Background/aim: The role of scoring systems as predictors of functional outcome in complex upper limb injuries was examined and a new evaluation system is proposed. Methods: We propose a scoring system which considers several parameters and details about the lesion together with general information about the patient. All severe upper extremity injuries treated over a 5 year period were retrospectively scored using our system. The functional outcomes were evaluated after a 1 to 6 year follow-up time. Final disabilities were validated by the Italian Public Health Disability Rate and by the DASH questionnaire, which measures disability from the patient's perspective. Results: A statistically significant correlation was found between the severity of the injuries, as measured with our evaluation and scoring system, and the Italian Public Health Disability Final Rate. A positive correlation was found with the results of the Dash questionnaire too. Conclusions: The presented results indicate the potential of our scoring system for predicting the final impairment after complex upper limb injuries and its utility as a guide in the planning of the reconstructive program.Background: The Patient Outcomes of Surgery (POS)hand/arm is a new questionnaire measuring patientbased outcomes on a range of upper limb conditions. The psychometric soundness of this questionnaire has only been proved so far on a sample of 132 patients and therefore requires further testing before it can become accepted in routine clinical practice. Aims: The purpose of this study was to psychometrically eval...