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Alejo AL, Rascoe A, Kim CY, Heimke IM, Vallier HA. Associations of musculoskeletal dysfunction, time to brake, and patient reported outcomes following lower extremity trauma. Injury 2024; 55:111285. [PMID: 38134489 DOI: 10.1016/j.injury.2023.111285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023]
Abstract
INTRODUCTION Inability to drive a motor vehicle due to lower extremity injury is a major inconvenience. Timing of safe return to driving has not been much studied. Objective measurements such as time to brake (TTB) have been proposed; however, utility and concordance of functional outcome measurements have not been previously evaluated. The purpose of this project is to measure these parameters and to assess for associations with ability to safely return to driving, improving the ability of clinicians to assess for measurements of driving readiness without specifically measuring TTB. METHODS A prospective, cohort study of 232 patients with complex lower extremity injuries to the pelvis, acetabulum, hip, femur, knee, tibia, ankle, and foot was performed. Time to brake (TTB) was measured once weightbearing was allowed. Function was assessed by the Musculoskeletal Function Assessment (MFA) questionnaire, and pain, mobility, and physical functions, via patient reported outcome measurement information system (PROMIS) surveys. RESULTS Patients with longer TTB had significantly elevated MFA scores indicating increased musculoskeletal dysfunction post-injury. As the MFA score increased by 1 point, TTB increased by 0.013 s (p<0.001). PROMIS metrics were also significantly associated with patients experiencing more pain and worse mobility as TTB increased. DISCUSSION Many patients continue to exhibit musculoskeletal dysfunction several months post-treatment for complex lower extremity injuries. Patients with better PROMIS metrics and MFA scores, and shorter TTB are more appropriate to return to driving. Surgeons may be better informed about safe driving ability by considering these measurements. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Andrew L Alejo
- Department of Orthopaedic Surgery, Case Western Reserve University, Cleveland, Ohio, United States
| | - Alexander Rascoe
- Department of Orthopaedic Surgery, Case Western Reserve University, Cleveland, Ohio, United States
| | - Chang-Yeon Kim
- Department of Orthopaedic Surgery, Case Western Reserve University, Cleveland, Ohio, United States
| | - Isabella M Heimke
- Department of Orthopaedic Surgery, Case Western Reserve University, Cleveland, Ohio, United States
| | - Heather A Vallier
- Department of Orthopaedic Surgery, Case Western Reserve University, Cleveland, Ohio, United States.
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Czerwonka N, Desai SS, Arciero E, Greisberg J, Trofa DP, Chien BY. Contemporary Review: An Overview of the Utility of Patient-Reported Outcome Measurement Information System (PROMIS) in Foot and Ankle Surgery. Foot Ankle Int 2023; 44:554-564. [PMID: 37114948 DOI: 10.1177/10711007231165752] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Patient-Reported Outcome Measurement Information System (PROMIS) has favorable psychometric and administrative properties in orthopaedic clinical research. It facilitates clinically meaningful data collection while minimizing administration time and survey fatigue and improving compliance. PROMIS is a critical component of patient-centered care and shared decision making, as it provides enhanced communication and engagement between patients and providers. As a validated instrument, it may also aid in measuring value-based health care quality. The goal of the current work is to provide an overview of PROMIS metrics used in orthopaedic foot and ankle, including advantages and disadvantages compared to legacy scales and PROMIS's applicability in specific foot and ankle conditions based on psychometric properties. We provide a review of the literature regarding the utilization of PROMIS as an outcome measure for specific foot and ankle procedures and conditions.
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Affiliation(s)
- Natalia Czerwonka
- New York Medical College, Valhalla, NY, USA
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York-Presbyterian, New York, NY, USA
| | - Sohil S Desai
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York-Presbyterian, New York, NY, USA
- Department of Orthopedic Surgery, Columbia University Medical Center, New York, NY, USA
| | - Emily Arciero
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York-Presbyterian, New York, NY, USA
- University of Connecticut School of Medicine, Farmington, CT, USA
| | - Justin Greisberg
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York-Presbyterian, New York, NY, USA
| | - David P Trofa
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York-Presbyterian, New York, NY, USA
| | - Bonnie Y Chien
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York-Presbyterian, New York, NY, USA
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Wiffen J, Mah E. Determining functional outcomes after resection and reconstruction of primary soft tissue sarcoma in the lower extremity: A review of current subjective and objective measurement systems. J Surg Oncol 2023; 127:862-870. [PMID: 36683344 DOI: 10.1002/jso.27202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/27/2022] [Accepted: 01/02/2023] [Indexed: 01/24/2023]
Abstract
The surgical management of soft-tissue sarcoma has evolved significantly over the last two decades due to the routine use of adjunct therapies, with an increased focus on postoperative functional outcome. The literature suffers from methodological inconsistency and use of low quality outcome measures to assess an already heterogeneous population. This article aims to review the most frequently used subjective and objective methods of functional outcome assessment and highlight the current benefits and limitations of these.
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Affiliation(s)
- James Wiffen
- St Vincent's Hospital, The University of Melbourne, Melbourne, Australia
| | - Eldon Mah
- Department of Plastic & Reconstructive Surgery, St Vincent's Hospital, Melbourne, Australia
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Wang Z, Zheng G, Chen W, Chen Y, Ma L, Yang Q, Li Y, Gou X, Wang Y, Liang Y, Tang K, Tao X. Double-bundle reconstruction of the anterior talofibular ligament by partial peroneal brevis tendon. Foot Ankle Surg 2023; 29:249-255. [PMID: 36792413 DOI: 10.1016/j.fas.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/27/2023] [Accepted: 02/02/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Anatomic anterior talofibular ligament (ATFL) reconstruction with autologous single-bundle tendon has been widely used in the treatment of ATFL injury. However, there are few clinical reports of using the peroneus brevis tendon (PBT) for double-bundle ATFL reconstruction. The aim of this study was to investigate the clinical effect of double-bundle ATFL reconstruction with PBT. METHODS This was a retrospective review of all patients diagnosed with ATFL injury presenting from August 2019 to December 2021. Fifty-three patients were selected after screening based on the inclusion and exclusion criteria. The following data were compared before and after surgery: Visual Analogue Scale (VAS) score, American Orthopedic Foot and Ankle Society (AOFAS) score, Karlsson Ankle Functional Score (KAFS), the pain interference (PI) and physical function (PF) scores of the Patient-Reported Outcomes Measurement Information System (PROMIS), the diameter and width of PBT in ultrasound and muscle strength. RESULTS All functional scores (VAS, PI/PF, AO-FAS, KAFS) and muscle strength were significantly improved at the last follow-up (P < 0.05). The diameter and width of the PBT on ultrasound postoperation were smaller than those preoperatively. CONCLUSION Double-bundle ATFL reconstruction with the partial PBT technique is a feasible, anatomic reconstruction technique for chronic lateral instability of the ankle, which meets the anatomical characteristics of the double bundle of the ligament, and the absence of partial PBT does not affect the peroneal muscle strength. LEVEL OF EVIDENCE Level IV, retrospective case series.
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Affiliation(s)
- Zhenyu Wang
- Sports Medicine Center, The First Affiliated Hospital of Army Medical University, Chongqing 400038, China
| | - Guo Zheng
- Sports Medicine Center, The First Affiliated Hospital of Army Medical University, Chongqing 400038, China
| | - Wan Chen
- Sports Medicine Center, The First Affiliated Hospital of Army Medical University, Chongqing 400038, China
| | - Yonghua Chen
- Sports Medicine Center, The First Affiliated Hospital of Army Medical University, Chongqing 400038, China
| | - Lin Ma
- Sports Medicine Center, The First Affiliated Hospital of Army Medical University, Chongqing 400038, China
| | - Qiandong Yang
- Sports Medicine Center, The First Affiliated Hospital of Army Medical University, Chongqing 400038, China
| | - Yuanqiang Li
- Sports Medicine Center, The First Affiliated Hospital of Army Medical University, Chongqing 400038, China
| | - Xiaoli Gou
- Sports Medicine Center, The First Affiliated Hospital of Army Medical University, Chongqing 400038, China
| | - Yunjiao Wang
- Sports Medicine Center, The First Affiliated Hospital of Army Medical University, Chongqing 400038, China
| | - Yan Liang
- Sports Medicine Center, The First Affiliated Hospital of Army Medical University, Chongqing 400038, China
| | - Kanglai Tang
- Sports Medicine Center, The First Affiliated Hospital of Army Medical University, Chongqing 400038, China
| | - Xu Tao
- Sports Medicine Center, The First Affiliated Hospital of Army Medical University, Chongqing 400038, China.
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Atlan F, Pritsch T, Tordjman D, Khabyeh-Hasbani N, Halperin D, Factor S. Wrist arthroscopy for diagnosis and treatment of acute and chronic conditions. SICOT J 2022; 8:17. [PMID: 35593692 PMCID: PMC9121853 DOI: 10.1051/sicotj/2022015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/13/2022] [Indexed: 11/15/2022] Open
Abstract
Wrist arthroscopy is a constantly evolving procedure. Allowing direct visualization and dynamic testing of intra-articular structures led to a novel approach toward traumatic and degenerative lesions based on most of the classifications routinely used in wrist surgery. The development of specific instrumentation, combined with a novel understanding of the local anatomy, progressively allowed wrist surgeons to describe more ambitious and complex surgeries. Wrist arthroscopy has become an increasingly useful tool in hand and wrist surgeons' panoply and seems promised to have further development in the future. This paper discusses the surgical technique and the various pathologies that can be treated by arthroscopy of the wrist.
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Affiliation(s)
- Franck Atlan
- Hand Surgery Unit, Department of Orthopaedic Surgery, Tel Aviv Medical Center, 6 Weitzman Street, Tel Aviv 6423906, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University Tel Aviv Israel
| | - Tamir Pritsch
- Hand Surgery Unit, Department of Orthopaedic Surgery, Tel Aviv Medical Center, 6 Weitzman Street, Tel Aviv 6423906, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University Tel Aviv Israel
| | - Daniel Tordjman
- Hand Surgery Unit, Department of Orthopaedic Surgery, Tel Aviv Medical Center, 6 Weitzman Street, Tel Aviv 6423906, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University Tel Aviv Israel
| | - Nathan Khabyeh-Hasbani
- Hand Surgery Unit, Department of Orthopaedic Surgery, Tel Aviv Medical Center, 6 Weitzman Street, Tel Aviv 6423906, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University Tel Aviv Israel
| | - Dania Halperin
- Hand Surgery Unit, Department of Orthopaedic Surgery, Tel Aviv Medical Center, 6 Weitzman Street, Tel Aviv 6423906, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University Tel Aviv Israel
| | - Shai Factor
- Hand Surgery Unit, Department of Orthopaedic Surgery, Tel Aviv Medical Center, 6 Weitzman Street, Tel Aviv 6423906, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University Tel Aviv Israel
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