Online ArticlesReliability, validity, responsiveness, and minimal important change of the Disabilities of the Arm, Shoulder and Hand and Constant-Murley scores in patients with a humeral shaft fracture
Section snippets
Materials and methods
Data of the first 140 consecutive patients included in a multicenter, prospective cohort study comparing operative and nonoperative treatment of adults with a humeral shaft fracture were used. This study is registered at the Netherlands Trial Register (NTR3617). The study protocol for this trial has been published elsewhere.23 All patients provided signed informed consent.
Study population
The study population comprised 140 patients who sustained a humeral shaft fracture; of these, 19 patients were lost to follow-up (4 after 2 weeks, 5 after 6 weeks, 6 after 3 months, and 4 after 6 months). In addition, 7 patients missed 1 follow-up visit (5 missed at 2 weeks, 1 at 6 weeks, and 1 at 6 months). The median age was 58 years (25th percentile-75th percentile, 41-68) and 63 patients (45.0%) were male. The right arm was affected in 65 patients (46.4%), and the dominant arm was affected
Discussion
Results of the current study show that the DASH and Constant-Murley are valid instruments to describe symptoms and disability experienced by patients who sustained a humeral shaft fracture over time. The DASH was also found to be reliable.
The DASH instrument and the Constant-Murley ROM subscale demonstrated sufficient internal consistency in this population, as reflected by Cronbach α values of at least 0.70. The observed value for the DASH was consistent with previously published values, which
Conclusions
This study confirms, for the first time, that the DASH and Constant-Murley scores are valid for evaluating outcome over time in patients who sustained a humeral shaft fracture. Reliability was confirmed only for the DASH, making this the most suitable instrument. Ceiling effects were noted at the 1-year follow-up, likely owing to increasing numbers of patients with full recovery. For the DASH, the MIC was 6.7 (95% CI, 5.0-15.8) and the SDC was 19.0 (SEM, 6.9). For the Constant-Murley score, the
Disclaimer
This work was funded by a grant from the Osteosynthesis and Trauma Care (OTC) Foundation (reference number 2013-DHEL).
The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
Acknowledgments
Dr. Wim E. Tuinebreijer (clinical epidemiologist, Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands) is acknowledged for statistical advice on the MIC analysis. Tim Van der Torre, Jelle E. Bousema, Boyd C. Van der Schaaf, Joyce Van Veldhuizen, Marije C.A.W. Notenboom, Yordi Claes, and Boudijn S.H. Joling (medical students, Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam,
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2021, Orthopaedics and Traumatology: Surgery and ResearchCitation Excerpt :Patients’ sociodemographic characteristics, fracture characteristics (side, type of trauma, AO/OTA classification of the fracture), implant type, complications (pseudoarthrosis, infection, screw backout) and time to union were recorded. The Disabilities of the Arm, Shoulder and Hand (DASH) score: high scores represent worse results in this questionnaire that evaluates various topics including difficulty in daily life activities, symptoms, sociability and sleep [15]. MAYO Wrist score: in this scoring system, pain, functional status, range of motion and grip strength are evaluated.
This study was exempted by the Medical Research Ethics Committee Erasmus MC (No. MEC-2015-217).
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A list of the HUMMER Trial Investigators is available in the online Appendix (available on the journal's website at www.jshoulderelbow.org).