Evaluating Immediate and Short-Term Postoperative Clinical Outcomes of Patients Undergoing Ulnar Shortening for Ulnar Impaction Syndrome Using PROMIS

Bernstein, David N.; Lander, Richard D.; Hammert, Warren C.

doi:10.1055/s-0041-1726292

Cited by 2 publications

(2 citation statements)

References 20 publications

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“…Not only can this inform patients of what they should expect, but it is also plausible that it puts them at ease given that they know other patients have gone through the same journey. This type of insight is becoming more popular in the orthopaedic literature, including in hand and upper extremity, 52,53 for example.…”

Section: Using Patient-reported Outcome Measures Clinically-from the ...mentioning

confidence: 99%

Operationalizing PROMs at the Musculoskeletal Practice and Policy Levels

Bernstein

Baumhauer

2023

J Am Acad Orthop Surg

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There continues to be growing interest in patient-reported outcome measures (PROMs), especially as value-based healthcare initiatives gain more traction. Although it is well-established that PROMs can be useful in clinical research, how to operationalize PROMs in clinical care and policy initiatives remains a "work in progress." Following the design of a comprehensive PROM administration and routine collection system, orthopaedic surgeons and their patients can reap the benefits of PROMs in practice through improved shared clinical decisionmaking discussions at the individual patient level and closer symptom monitoring on a large scale, with improved resource allocation at the population health level. Although certain government and payer incentives exist to collect PROMs at present, it is reasonable to assume that future policy initiatives will begin to use the actual PROM scores to assess clinical outcomes. Orthopaedic surgeons with interest in this area should prioritize their involvement in policy discussion to ensure PROMs are being used appropriately in novel payment models and policy endeavors so that they are both evaluated and compensated fairly. Specifically, orthopaedic surgeons can help ensure appropriate risk adjustment of patients when this is being done. Undoubtedly, PROMs will only become a larger part of musculoskeletal care moving forward. Healthcare systems globally-including the United States-are unsustainable, with expenditures far outpacing gross domestic product and wages in many countries. 1 At the same time, quality is inconsistent and the outcomes that matter most to patients (eg, function, pain, mental health, and quality of life) are collected infrequently, measured by using unvalidated instruments, and are rarely used even when available. In the United States, there is a general consensus that this healthcare delivery system is broken; this has led to movement toward a system that focuses on optimizing value for patients. 2 The overarching goal of value-based health care (VBHC) is

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Section: Using Patient-reported Outcome Measures Clinically-from the ...mentioning

confidence: 99%

Operationalizing PROMs at the Musculoskeletal Practice and Policy Levels

Bernstein

Baumhauer

2023

J Am Acad Orthop Surg

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“…It is one of the common wrist diseases in clinics 2 . The causes of UIS include malunion of radius fractures, congenital positive ulnar variation, and chronic strain leading to the long‐term impact of the ulnar wrist joint 3 . Conservative treatment can only temporarily relieve wrist pain but cannot be treated thoroughly.…”

Section: Introductionmentioning

confidence: 99%

Clinical Study of Wrist Arthroscopy Combined with Oblique Ulnar Shortening Osteotomy in the Treatment of Ulnar Impaction Syndrome

Wang

Zhang

et al. 2022

Orthopaedic Surgery

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Objective To explore the clinical effects of wrist arthroscopy combined with oblique ulnar shortening osteotomy in the treatment of ulnar impaction syndrome. Methods This was a retrospective study of 60 patients with ulnar impaction syndrome who were admitted to our department from January 2016 to December 2019. According to different surgical methods, they were divided into an observation group and a control group, with 30 cases in each group. The control group was treated with oblique ulnar shortening osteotomy, and the observation group used wrist arthroscopy based on the control group. The two groups of patients were compared in terms of wrist function before and 12 months after surgery. We compared the Disabilities of the Arm, Shoulder, and Hand Score (DASH Score), Patient‐Rated Wrist Evaluation Score (PRWE Score), Visual Analog Score (VAS), and ulnar variation between the two groups at 12 months after surgery. The excellent and good rates by Mayo wrist score were compared between the two groups at the last follow‐up. Results All patients were followed up for 12–36 months, with an average of 14.5 months. Bone union was achieved at the oblique osteotomy of the ulna, with an average healing time of 13.6 weeks. The observation group was examined by wrist arthroscopy, and the triangular fibrocartilage complex (TFCC) Palmer classification was confirmed in three cases of type IIA, seven cases of type IIB, 14 cases of type IIC, and six cases of type IID. Compared with before surgery, the grip strength, flexion‐extension, ulnar radial deflection, and forearm rotation of the two groups of patients were significantly improved at 12 months after surgery. The DASH score, PRWE score, and VAS score of the observation group were better than those of the control group, and the difference in ulnar shortening length was not statistically significant between the two groups. The excellent and good rates of the observation group (93.3%) were better than those of the control group (87.5%) at the last follow‐up, and the difference was statistically significant. Conclusion Compared with oblique ulnar shortening osteotomy alone, combined wrist arthroscopy can better reduce the pain of patients with ulnar impaction syndrome, restore wrist function, and improve the excellent and good rates. Therefore, it is clinically worthy of promotion.

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Evaluating Immediate and Short-Term Postoperative Clinical Outcomes of Patients Undergoing Ulnar Shortening for Ulnar Impaction Syndrome Using PROMIS

Cited by 2 publications

References 20 publications

Operationalizing PROMs at the Musculoskeletal Practice and Policy Levels

Operationalizing PROMs at the Musculoskeletal Practice and Policy Levels

Clinical Study of Wrist Arthroscopy Combined with Oblique Ulnar Shortening Osteotomy in the Treatment of Ulnar Impaction Syndrome

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