A-0081Evaluation of the patient outcomes of surgery (pos)-hand/arm questionnaire in comparison to the short form health survey (sf)-36

Abstract

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...