Long-Term Subjective and Functional Evaluation After Thumb Replantation With Special Attention to the Quick DASH Questionnaire and a Specially Designed Trauma Score Called Modified Mayo Score

Abstract

Functional results were independent of amputation level, length of ischemia, and patients age. Although sensory recovery and functional outcomes of the extrinsic muscle system were moderate, patients were able to use their thumb to perform work and daily living activities. The significant correlations of objective clinical tests and a mixed trauma score (modified Mayo score) with the Quick DASH allows the clinician to compare the postoperative result with the patient' functional competence in daily activities.

Analysis of functional outcome after posttraumatic thumb reconstruction in comparison to nonreconstructed amputated thumbs at the proximal phalanx of the thumb ray

“…Averages of the questions related to self-image and social functioning were also higher than those for symptoms. Similar results were seen in the reports from Dabernig et al, 14 Zimmermann, 17 and Haas et al 18 Zimmermann et al 17 evaluated the functional outcome after callus distraction and thumb phalangization after traumatic amputation at the first metacarpal. The mean DASH score was 25 in their study; in our series it was 18.55 and represented a markedly lower disability level than in that study.…”

“…The mean DASH score was 25 in their study; in our series it was 18.55 and represented a markedly lower disability level than in that study. In contrast, the DASH/Quick DASH scores from Dabernig et al, 14 Unglaub et al, 18 and Haas et al 19 after thumb, single, and multiple finger replantation ranged from 10.0 to 16.7. In this regard, there is no thumb reconstructive procedure that can be compared with the result of a successfully replanted thumb, and thus, the significance of Buncke's statement that the thumb is a "must try" situation becomes clear for all types of thumb amputations, and particularly for bilateral thumb amputations.…”

Computerized Adaptive Testing of Psychological Factors

“…However, reducing items in a questionnaire has the downside of losing redundancy of items, which has psychometric value 27 . The aim of this study was to evaluate the correspondence between the novel PROMIS Pain Interference CAT questionnaire and QuickDASH (the abbreviated version of the Disabilities of the Arm, Shoulder and Hand [DASH] questionnaire), a frequently employed and validated instrument in upper-extremity illness that measures perceived disability [28][29][30][31] . Our null hypothesis is that there is no correlation between the PROMIS Pain Interference CAT and QuickDASH in patients with hand and upper-extremity illness.…”

The Influence of Psychological Factors on the Michigan Hand Questionnaire

“…8,15 The correlation of objective measures of pathophysiology (eg, stiffness, arthritis, injury severity) 9 with patient-reported outcome measures is consistently much less than the correlation with psychosocial factors. 1,3,4,[10][11][12]18,22,23 These findings are important given the increasing emphasis on value and patient-reported outcome measures. All hand-and upper extremity-related patient-reported outcome measures studied to data are strongly influenced by psychological and sociological factors.…”

“…2,10,11,14 Mounting evidence suggests that patient-to-patient variation in the PROMIS Upper Extremity and DASH scores is more strongly related to mood, coping strategies, and circumstances than to pathophysiology and objective impairment. 1,3,5,[10][11][12]18,22,23 The role of psychological factors in variation in MHQ scores is less well studied. 6,10,13,21,24 London et al noted that the mean MHQ scores were lower in patients categorized as having a high score on the Pain Catastrophizing Scale (PCS), but did not evaluate the correlation of ineffective coping strategies with hand-specific symptoms and limitations on the continuum on which they occur.…”