scholarly journals Which Are the Most Relevant Questions in the Assessment of Outcome after Distal Radial Fractures?

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Donald Buchanan ◽  
D. Prothero ◽  
J. Field

A study was designed to determine which wrist scoring system best correlates with patient satisfaction and which individual variables predict a satisfactory outcome. We looked at forty-five females and 5 males with wrist fractures at 12 weeks after injury and compared their level of satisfaction with various respected outcome measures. The mean age was 66 years. Multivariate regression analysis was carried out using a statistical software package. Patient satisfaction correlated best with the MacDermid, Watts, and DASH scores. The variables in these scoring systems that predicted satisfaction were pain and ability to perform household chores or usual occupation, open packets, and cut meat. The four most important questions to ask in the clinic following wrist fractures are about severity of pain and ability to open packets, cut meat, and perform household chores or usual occupation. This may provide simple and more concise means of assessing outcome after distal radial fractures. Level of evidence is level 4.

2019 ◽  
Vol 45 (1) ◽  
pp. 77-84 ◽  
Author(s):  
Kevin C. Chung ◽  
Sarah E. Sasor ◽  
Kelly A. Speth ◽  
Lu Wang ◽  
Melissa J. Shauver ◽  
...  

The Wrist and Radius Injury Surgical Trial (WRIST) collaboration is the largest clinical trial ever conducted in hand surgery. We applied data from this study to examine the relationship between functional outcomes and patient satisfaction after treatment of distal radial fractures. Patients aged 60 years and older with isolated distal radial fractures were enrolled at 24 health systems. Grip strength and the arc of wrist motion were measured after treatment. The Michigan Hand Outcomes Questionnaire was used to measure patient satisfaction. Receiver operating characteristic curves were created using patient satisfaction as the reference standard and each functional measure as a predictor. At 12 months after treatment, mean grip strength was 82% of normal and mean arc of motion was 88% of normal. The optimal cut-off points to distinguish satisfaction from dissatisfaction occurred when patients recovered 59% of hand strength and 79% of wrist motion. Continuing therapy to increase functional gains beyond this point unnecessarily utilizes healthcare resources without additional patient-reported gains. Level of evidence: IV


2019 ◽  
Vol 39 (10) ◽  
pp. NP411-NP415
Author(s):  
Francisco García-Purriños ◽  
Alberto Raposo ◽  
Alberto Guilllén ◽  
Juan Calero ◽  
Ana Giribet ◽  
...  

Abstract Background To understand the level of satisfaction among patients undergoing otoplasty using the combined Mustardé-Furnas technique. To evaluate surgery outcomes using McDowell/Wright (MW) criteria. Objectives The authors sought to analyze any possible correlation between satisfaction level and surgery outcome. Methods The authors conducted a retrospective study on patients who underwent combined Mustardé and Furnas otoplasty between 1996 and 2016. All patients were assessed 12 months after surgery employing MW goals and satisfaction surveys. Results The study includes 172 patients who underwent 343 otoplasty procedures. There were 134 patients (77.9%) who had all 6 of the criteria for surgical success as defined by MW 12 months after surgery, reporting satisfaction levels of 9 to 10. Fifteen patients (9.3%) had 5 of the 6 MW criteria, reporting satisfaction levels of 9 to 10, and 22 patients (12.79%) had only 4 MW objectives and reported satisfaction levels of 7 to 10. The Spearman rho coefficient was 0.545 and the Kendall coefficient was 0.375, with a statistically significant association (P < 0.001). Conclusions Patient satisfaction increases as the number of MW goals are met, although the correlation is moderate to low. Patients perceive the results of the surgery as satisfactory or very satisfactory, even when ENT surgeons consider outcomes to be poor according to MW criteria. Level of Evidence: 4


2020 ◽  
Vol 7 (1) ◽  
pp. 41-49
Author(s):  
Ajat Sudrajat

Patient satisfaction at the hospital is a benchmark that is a benchmark for patients in getting health care. Each hospital must run a variety of strategies so that patients feel satisfied with health services, one of the strategies is through a good corporate image and trust, where a good corporate image can increase trust. So that affecting patient satisfaction Mitra Medika Narom Hospital Kabupaten Bekasi.             This research was conducted with descriptive and verification methods, namely knowing, analyzing, explaining and testing hypotheses, and making conclusions and suggestions. The sample in this study amounted to 240 respondents using the Eksplanary Survey method. Data analysis techniques used are ordinal scale techniques and path analysis using the Method of Successive Interval (MSI) tool, Microsoft Excel 2016 computer programs and SPSS 16.             The results of this study reveal that the company's image at the Mitra Medika Narom Hospital in Kabupaten Bekasi is in the agreed criteria, meaning that Mitra Medika Narom Hospital has built and made a good company image so that it is better known to all people. Furthermore, trust in Mitra Medika Narom Hospital in Kabupaten Bekasi is in the agreed criteria, meaning that Mitra Medika Narom Hospital has succeeded in building a good and optimal Trust so that patients trust Mitra Medika Narom Hospital to obtain health services. Then the patient satisfaction at the Mitra Medika Narom Hospital in Kabupaten Bekasi is in the agreed criteria, meaning that the patients as respondents feel a high level of satisfaction after completing treatment at the Mitra Medika Narom Hospital. There is a positive, strong and two-way correlation between company image and trust variables of 0.646. There is a partial influence of company image on patient satisfaction at Mitra Medika Narom Hospital significantly by 11.98%. There is a partial influence of trust on patient satisfaction at Mitra Medika Narom Hospital significantly by 25.08%. Then there is a simultan influence of corporate image and trust on patient satisfaction at Mitra Medika Narom Hospital positively and significantly by 37.06% while the remaining 62.94% is contributed by other variables not examined


2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Valentine Frydman ◽  
Ugo Pinar ◽  
Maher Abdessater ◽  
William Akakpo ◽  
Pietro Grande ◽  
...  

Abstract Background Penile prothesis (PP) is the gold-standard treatment of drug-refractory erectile dysfunction (ED). While postoperative outcomes have been widely described in the literature, there are few data about patient satisfaction and intraoperative events. We aimed to assess long-term patient satisfaction and perioperative outcomes after PP implantation in a single-centre cohort of unselected patients using validated scales. Results A total of 130 patients received a PP (median age: 62.5 years [IQR: 58–69]; median International Index of Erectile Function (IEEF-5) score: 6 [IQR: 5–7]). Median follow-up was 6.3 years [IQR: 4–9.4]. Thirty-two (24.6%) patients underwent surgical revision, of which 20 were PP removals (15.4%). Global PP survival rate was 84.6% and previous PP placement was a risk factor for PP removal (p = 0.02). There were six (4.6%) non-life-threatening intraoperative events including two which resulted in non-placement of a PP (1.5%). EAUiaic grade was 0 for 124 procedures (95.4%), 1 for four procedures (3.1%) and 2 for two procedures (1.5%). Of patients who still had their PP at the end of the study, 91 (80.5%) expressed satisfaction. Conclusions PP implantation is a last-resort treatment for ED with a satisfactory outcome. PPs are well accepted by patients.


Author(s):  
Leon Hirvelä ◽  
Pyry N. Sipilä ◽  
Anna Keski-Rahkonen

Abstract Purpose The association of bulimic symptoms with sensation seeking is uncertain; however, both behaviors have been linked to alcohol problems. We assessed in a longitudinal, community-based setting whether sensation seeking in adolescence is associated with bulimic symptoms in early adulthood, also accounting for alcohol problems. Methods Finnish men (N = 2000) and women (N = 2467) born between 1974–1979 completed Zuckerman’s sensation seeking scale (SSS) at age 18. Alcohol problems (Malmö-modified Michigan alcoholism screening test (Mm-MAST) and bulimic symptoms [eating disorder inventory-2, bulimia subscale (EDI-Bulimia), population and clinical scoring systems] were defined at age 22–27. We examined relationships between SSS, Mm-MAST, and EDI-Bulimia using Pearson’s correlation coefficient (r) and linear regression. Results Alcohol problems were moderately correlated with sensation seeking and bulimic symptoms (population scoring) among women and men (r = 0.21–0.31). The correlation between sensation seeking and bulimic symptoms (population scoring) was weak among men (r = 0.06, p = 0.006) and even weaker and non-significant among women (r = 0.03, p = 0.214). Adjustment for alcohol problems removed the association between sensation seeking and bulimic symptoms among men. Furthermore, there were no significant correlations between sensation seeking and bulimic symptoms when assessing EDI-Bulimia clinical scoring. Conclusion Sensation seeking and bulimic symptoms were not associated among women. The association between sensation seeking and bulimic symptoms among men was entirely attributable to increased alcohol problems among those with higher sensation seeking. While this association may be important on the population level, its clinical significance may be minor. Level of evidence Level III, well-designed cohort study.


2021 ◽  
pp. 175319342097778
Author(s):  
Muhammad Tahir ◽  
Faridullah Khan Zimri ◽  
Nadeem Ahmed ◽  
Allah Rakhio Jamali ◽  
Ghulam Mehboob ◽  
...  

This prospective, multi-centred, randomized trial examined outcomes of 3- and 12-month follow-ups of 159 elderly participants aged more than 75 years with isolated distal radial fractures, treated by anterior locking plate or closed reduction and cast immobilization. The primary outcome was the patient-rated wrist evaluation (PRWE) score. The PRWE score at 12 months was not significantly different between the two groups; however, the radiological outcomes and complications rates were worse in the casting group. Level of evidence: III


2020 ◽  
pp. 175319342096623
Author(s):  
James A. Morris ◽  
Max Little ◽  
Thomas Ashdown ◽  
Oliver T. Clough ◽  
Timothy Packer ◽  
...  

We undertook a matched prospective cohort study over a 4-year period to examine the safety of continuing the administration of regular antithrombotic treatment with warfarin, clopidogrel or aspirin during day case surgical fixation of distal radial fractures. One hundred and one patients were identified and consented to participate in this study. There was only one reported complication: a superficial wound infection treated with antibiotics. No episodes of excessive bleeding were noted intraoperatively. All patients were discharged home on the day of surgery and there were no episodes of readmission, significant bleeding, haematoma requiring intervention, compartment syndrome or wound dehiscence. Complication rates were comparable with those of the matched cohort of patients undergoing the same procedure but who were not taking antithrombotic medications. Level of evidence: IV


2019 ◽  
Vol 45 (4) ◽  
pp. 339-347
Author(s):  
Atsuo Shigi ◽  
Kunihiro Oka ◽  
Kohji Kuriyama ◽  
Hiroyuki Tanaka ◽  
Hideki Yoshikawa ◽  
...  

Understanding the complex fragmentation of intra-articular distal radial fractures contributes to achieving anatomical reduction during surgery. This study aimed to clarify three-dimensional displacement patterns of intra-articular fragmentation in dorsally angulated, intra-articular distal radial fractures. We identified five characteristic intra-articular fragments: a key fragment, dorsal ulnar corner, dorsal wall, radial column and anterior radial column. The key fragment was displaced with radial deviation, pronation and extension and with dorsal, proximal and radial translations. The dorsal ulnar corner displacement resulted in a gap, a step-off and a deepened concavity for the lunate facet and sigmoid notch. The dorsal wall displacement resulted in a deepened concavity, a gap and a step-off of the dorsal scaphoid facet. The displacements of the radial column and anterior radial column caused a step-off between the scaphoid and lunate facets. The five characteristic intra-articular fragments each created a characteristic gap and step-off in the articular surface. Level of evidence: IV


2013 ◽  
Vol 39 (7) ◽  
pp. 745-754 ◽  
Author(s):  
A. Bentohami ◽  
K. de Burlet ◽  
N. de Korte ◽  
M. P. J. van den Bekerom ◽  
J. C. Goslings ◽  
...  

The purpose of this systematic review is to assess the prevalence of complications following volar locking plate fixation of distal radial fractures. A computer-based search was carried out using EMBASE and PUBMED/MEDLINE. Only prospective comparative and prospective cohort studies that presented data concerning complications after treatment of distal radial fractures with a volar locking plate in human adults with a minimal follow-up of 6 months were included. Two quality assessment tools were used to assess the methodological quality of the studies (level of evidence rating according to the Oxford Centre of Evidence Based Medicine and the modified version of the Cochrane Bone, Joint and Muscle Trauma Group’s former quality assessment tool). Thirty three studies were eligible for final assessment. Most complications were problems with nerve and tendon function as well as complex regional pain syndrome. With an overall complication rate of 16.5%, most of which were ‘minor’ complications and low rates of nonunion and malunion, volar locking plate fixation can be considered a reasonably safe treatment option for patients with distal radial fractures.


Author(s):  
Stacie J Becker ◽  
Jeffrey E Cassisi

Abstract Background Medical tattooing is often applied in the context of plastic, aesthetic, and reconstructive surgery to help achieve the best cosmetic outcome. Objectives This article reviews various conditions that medical tattooing have been empirically studied in terms of patient satisfaction outcomes; makes practice recommendations; and suggests future directions for research. Methods This review was performed following the PRISMA guidelines. Studies were included if the tattooing application was associated with a medical condition and if outcome data was provided using at least a case series methodology. Where no cohort or clinical series exist, case examples are used from the literature and the author’s practice to illustrate emerging medical tattooing applications that need further evaluation. Results Eighteen studies met the inclusion criteria and were applied to the following conditions: baldness, vitiligo, scars from incisions, lacerations or burns, and nipple areola complex reconstruction following breast surgery. Conclusions The application of medical tattooing has shown high levels of patient satisfaction across various conditions. The practice recommendation grade is “B” or recommend since the level of evidence for these interventions ranged from III to IV according to the ASPS guidelines. This means clinicians can consider this treatment alternative, but they should be alert to new information and be sensitive to patient preferences. Recommendations are made for reporting future research including clearly describing procedural details, identifying the professional performing the procedure, increased use of standardized outcome measures, and that satisfaction ratings be assessed by someone independent of the health service provider. Further research using RCT methodology with waitlist controls is needed.


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