Anterior approach for pediatric supracondylar humerus fractures: A systematic review.

BACKGROUND AND PURPOSE: Open reduction is rarely performed in pediatric supracondylar humerus fractures. However, clear evidence is lacking regarding the optimal open approach to achieve satisfactory results. The anterior approach provides direct visualization of the fracture and excellent exposure to neurovascular structures, although its utilization is less common. The objective of this study was to review the indications, outcomes, and complications associated with the anterior approach for open reduction of these fractures. METHODS: Our protocol was registered at PROSPERO: CRD42023446923. MEDLINE/PubMed, Embase, Web of Science, Clinicaltrials.gov, and Cochrane Library were searched from database inception to search date (December 2023) and screened in duplicate for relevant studies. Data were collected regarding patient demographics, indications for open reduction, Flynn's functional and cosmetic outcomes, and complications. Study quality was assessed using the Methodological Index for Non-Randomized Studies Criteria. RESULTS: A total of 19 studies involving 483 patients were included. One study was classified as Level 2 evidence, ten as Level 3, and eight as Level 4. The mean MINORS score was 13.05±3.47. The primary indication for open reduction was failed closed reduction, observed in 46% of patients. 97.7% and 98.6% of patients achieved Flynn's functional and cosmetic satisfactory results, respectively. The postsurgical neurovascular injury rate was 1.4%. One patient required reintervention. CONCLUSION: The anterior approach is safe and effective for managing pediatric supracondylar humerus fractures requiring open reduction. LEVEL OF EVIDENCE: Systematic review of Level 2-4 evidence studies.

Validación de la versión española de la escala de Harris modificada / Validation of the Spanish version of the modified Harris score

Antecedentes y objetivos: La escala de Harris modificada (EHM) es una de las herramientas más utilizadas para valorar pacientes con patología de cadera. A pesar de contar con una adaptación transcultural al español realizada por Lara et al., no cuenta con estudios que sustenten su validez. Se pretende obtener una validación de la versión adaptada de la EHM (ES-EHM), comparándola con la escala WOMAC. Materiales y métodos: La ES-EHM se aplicó a 100 pacientes operados de prótesis total de cadera: (1) previamente a la cirugía (ES-EHM prequirúrgica), (2) 2 años tras la cirugía (ES-EHM posquirúrgica) y (3) 6 meses después de la aplicación de la ES-EHM posquirúrgica (ES-EHM final). Se aplicó también, en una ocasión, el cuestionario WOMAC. Se compararon las medias de la ES-EHM prequirúrgica, posquirúrgica y final, así como la totalidad y los parámetros de dolor y función de la ES-EHM con la escala WOMAC. Se obtuvieron parámetros de fiabilidad, validez y sensibilidad al cambio. Resultados: Al comparar la ES-EHM prequirúrgica y la posquirúrgica, se observó una mejoría clínicamente relevante (46,54 puntos). Al comparar la ES-EHM posquirúrgica y la final, no se detectaron diferencias. Se obtuvo una correlación fuerte entre: (1) la ES-EHM posquirúrgica y la ES-EHM final, (2) ES-EHM y WOMAC y (3) parámetros de dolor y función de la ES-EHM y la WOMAC. El índice de respuesta media estandarizada fue de 2,99, la fiabilidad test-retest representada por el coeficiente de correlación intraclase de 0,90 y el índice de consistencia interna alfa de Cronbach de 0,95. Conclusiones: La adaptación transcultural de la ES-EHM muestra ser fiable, válida y sensible al cambio. Por lo tanto, el personal médico de la población española podrá aplicar la ES-EHM con el respaldo científico y la certeza de estar midiendo los parámetros deseados.(AU)

Background and objectives: Modified Harris Hip Score (HHS) is one of the most used scales in the assessment of patients with hip pathology. Although a Spanish cross-cultural adaptation has been recently published, there are many studies supporting its validity yet. Therefore, the aim of this study is to validate the newly adapted Spanish version of the HHS (ES-EHM), comparing it with the WOMAC scale. Materials and methods: The ES-EHM scale was applied to 100 patients who underwent a total hip replacement, in three different situations: (1) prior to surgery (pre-surgical ES-EHM), (2) after surgery, with at least 2 years of follow up (after surgery ES-EHM), and (3) 6 months after the postsurgical registration (final ES-EHM). WOMAC questionnaire was also applied once. We analyzed data of scale main score, pain score, function-related score as well as the mean of pre-surgical, postsurgical and final postsurgical ES-EHM scale, in both the ES-EHM and the WOMAC scales. Parameters of reliability, validity and sensitivity to change were obtained. Results: Clinically relevant improvement was observed (46.55 points) when comparing pre-surgical and post-surgical ES-EHM scores. However, no differences between postsurgical and final ES-EHM were detected. Even so, strong correlation was obtained between the following: (1) postsurgical ES-EHM and final ES-EHM scores, (2) ES-EHM and WOMAC scores, and (3) pain and function-related parameters of ES-EHM and WOMAC scores. Standardized response mean (SRM) was 2.99, test–retest reliability expressed by the intraclass correlation coefficient was 0.90 and Cronbach index 0.95. ConclusionsThe Spanish cross-cultural adaptation of the EHM scale shows to be reliable, valid and sensitive to change. Thus, the Spanish medical staff will be able to apply the ES-EHM scale with good scientific support.(AU)

Validation of the Spanish version of the modified Harris score. / Validación de la versión española de la escala de Harris modificada.

BACKGROUND AND OBJECTIVES: Modified Harris Hip Score (HHS) is one of the most used scales in the assessment of patients with hip pathology. Although a Spanish cross-cultural adaptation has been recently published, there are many studies supporting its validity yet. Therefore, the aim of this study is to validate the newly adapted Spanish version of the HHS (ES-EHM), comparing it with the WOMAC scale. MATERIALS AND METHODS: The ES-EHM scale was applied to 100 patients who underwent a total hip replacement, in three different situations: (1) prior to surgery (pre-surgical ES-EHM), (2) after surgery, with at least 2 years of follow up (after surgery ES-EHM), and (3) 6 months after the postsurgical registration (final ES-EHM). WOMAC questionnaire was also applied once. We analyzed data of scale main score, pain score, function-related score as well as the mean of pre-surgical, postsurgical and final postsurgical ES-EHM scale, in both the ES-EHM and the WOMAC scales. Parameters of reliability, validity and sensitivity to change were obtained. RESULTS: Clinically relevant improvement was observed (46.55 points) when comparing pre-surgical and post-surgical ES-EHM scores. However, no differences between postsurgical and final ES-EHM were detected. Even so, strong correlation was obtained between the following: (1) postsurgical ES-EHM and final ES-EHM scores, (2) ES-EHM and WOMAC scores, and (3) pain and function-related parameters of ES-EHM and WOMAC scores. Standardized response mean (SRM) was 2.99, test-retest reliability expressed by the intraclass correlation coefficient was 0.90 and Cronbach index 0.95. CONCLUSIONS: The Spanish cross-cultural adaptation of the EHM scale shows to be reliable, valid and sensitive to change. Thus, the Spanish medical staff will be able to apply the ES-EHM scale with good scientific support.

[Translated article] Validation of the Spanish version of the modified Harris score.

BACKGROUND AND OBJECTIVES: Modified Harris Hip Score (HHS) is one of the most used scales in the assessment of patients with hip pathology. Although a Spanish cross-cultural adaptation has been recently published, there are many studies supporting its validity yet. Therefore, the aim of this study is to validate the newly adapted Spanish version of the HHS (ES-EHM), comparing it with the WOMAC scale. MATERIALS AND METHODS: The ES-EHM scale was applied to 100 patients who underwent a total hip replacement, in three different situations: (1) prior to surgery (pre-surgical ES-EHM), (2) after surgery, with at least 2 years of follow up (after surgery ES-EHM), and (3) 6 months after the postsurgical registration (final ES-EHM). WOMAC questionnaire was also applied once. We analysed data of scale main score, pain score, function-related score as well as the mean of pre-surgical, postsurgical and final postsurgical ES-EHM scale, in both the ES-EHM and the WOMAC scales. Parameters of reliability, validity and sensitivity to change were obtained. RESULTS: Clinically relevant improvement was observed (46.55 points) when comparing pre-surgical and post-surgical ES-EHM scores. However, no differences between postsurgical and final ES-EHM were detected. Even so, strong correlation was obtained between the following: (1) postsurgical ES-EHM and final ES-EHM scores, (2) ES-EHM and WOMAC scores, and (3) pain and function-related parameters of ES-EHM and WOMAC scores. Standardised response mean (SRM) was 2.99, test-retest reliability expressed by the intraclass correlation coefficient was 0.90 and Cronbach index 0.95. CONCLUSIONS: The Spanish cross-cultural adaptation of the EHM scale shows to be reliable, valid and sensitive to change. Thus, the Spanish medical staff will be able to apply the ES-EHM scale with good scientific support.

Cross-cultural adaptation for the Spanish population of the modified Harris score for functional and symptomatic hip joint assessment. / Adaptación transcultural para la población española de la escala de Harris modificada para la valoración funcional y sintomática de la articulación de la cadera.

BACKGROUND AND OBJECTIVES: The modified Harris hip score, is one of the most widely used scales for the functional assessment of hip pathology of the patients. However, there is no cross-cultural adaptation for the Spanish society. Therefore, this study aims to obtain a cross-cultural adaptation of the modified Harris hip score for the Spanish population. MATERIALS AND METHODS: For the cross-cultural adaptation the Beaton method was used, which includes: 2 translations into Spanish; expert review of the 2 provisional versions and obtaining a single Spanish version; reverse translation (into English) of the Spanish version; and application of the adapted version. The adapted version was applied twice to 100 patients, 6 months apart. RESULTS: Between the initial and final application of the adapted version, no clinically relevant differences were found. CONCLUSIONS: A cross-cultural translation and adaptation of the modified Harris hip score for the Spanish population was obtained, which should be applied to the Spanish population and to all Spanish-speaking countries, as long as they do not have an adapted version for the population to which they belong.

Adaptación transcultural para la población española de la escala de Harris modificada para la valoración funcional y sintomática de la articulación de la cadera / Cross-cultural adaptation for the Spanish population of the modified Harris score for functional and symptomatic hip joint assessment

Antecedente y objetivos: La Escala de Harris modificada es una de las escalas más utilizadas para la valoración funcional de los pacientes en la patología de cadera. Sin embargo, no existe una adaptación transcultural para la sociedad española. Por tanto, este estudio se plantea obtener una adaptación transcultural para la población española de la escala de cadera de Harris modificada. Materiales y métodos: Para la adaptación transcultural se utilizó el método de Beaton que incluye: 2 traducciones al idioma español; revisión por expertos de las 2 versiones provisionales y obtención de una única versión en español; traducción reversa (a inglés) de la versión en español; y aplicación de la versión adaptada. La versión adaptada fue aplicada en 2 ocasiones a 100 pacientes, con un periodo de separación de 6 meses. Resultados: Entre la aplicación inicial y final de la versión adaptada no se encontró diferencias clínicamente relevantes. Conclusiones: Se obtuvo una traducción y adaptación transcultural para la población española de la escala de cadera de Harris modificada, la misma que debería ser aplicada a la población española y a todos los países hispanohablantes, mientras no cuenten con una versión adaptada para la población a la que pertenecen.(AU)

Background and objectives: The modified Harris hip score, is one of the most widely used scales for the functional assessment of hip pathology of the patients. However, there is no cross-cultural adaptation for the Spanish society. Therefore, this study aims to obtain a cross-cultural adaptation of the modified Harris hip score for the Spanish population. Materials and methods: For the cross-cultural adaptation the Beaton method was used, which includes: 2 translations into Spanish; expert review of the 2 provisional versions and obtaining a single Spanish version; reverse translation (into English) of the Spanish version; and application of the adapted version. The adapted version was applied twice to 100 patients, 6 months apart. Results: Between the initial and final application of the adapted version, no clinically relevant differences were found. Conclusions: A cross-cultural translation and adaptation of the modified Harris hip score for the Spanish population was obtained, which should be applied to the Spanish population and to all Spanish-speaking countries, as long as they do not have an adapted version for the population to which they belong.(AU)

Cross-cultural adaptation for the Spanish population of the modified Harris score for functional and symptomatic hip joint assessment / Adaptación transcultural para la población española de la escala de Harris modificada para la valoración funcional y sintomática de la articulación de la cadera

Background and objectives: The modified Harris hip score, is one of the most widely used scales for the functional assessment of hip pathology of the patients. However, there is no cross-cultural adaptation for the Spanish society. Therefore, this study aims to obtain a cross-cultural adaptation of the modified Harris hip score for the Spanish population. Materials and methods: For the cross-cultural adaptation the Beaton method was used, which includes: 2 translations into Spanish; expert review of the 2 provisional versions and obtaining a single Spanish version; reverse translation (into English) of the Spanish version; and application of the adapted version. The adapted version was applied twice to 100 patients, 6 months apart. Results: Between the initial and final application of the adapted version, no clinically relevant differences were found. Conclusions: A cross-cultural translation and adaptation of the modified Harris hip score for the Spanish population was obtained, which should be applied to the Spanish population and to all Spanish-speaking countries, as long as they do not have an adapted version for the population to which they belong.(AU)

Antecedente y objetivos: La Escala de Harris modificada es una de las escalas más utilizadas para la valoración funcional de los pacientes en la patología de cadera. Sin embargo, no existe una adaptación transcultural para la sociedad española. Por tanto, este estudio se plantea obtener una adaptación transcultural para la población española de la escala de cadera de Harris modificada. Materiales y métodos: Para la adaptación transcultural se utilizó el método de Beaton que incluye: 2 traducciones al idioma español; revisión por expertos de las 2 versiones provisionales y obtención de una única versión en español; traducción reversa (a inglés) de la versión en español; y aplicación de la versión adaptada. La versión adaptada fue aplicada en 2 ocasiones a 100 pacientes, con un periodo de separación de 6 meses. Resultados: Entre la aplicación inicial y final de la versión adaptada no se encontró diferencias clínicamente relevantes. Conclusiones: Se obtuvo una traducción y adaptación transcultural para la población española de la escala de cadera de Harris modificada, la misma que debería ser aplicada a la población española y a todos los países hispanohablantes, mientras no cuenten con una versión adaptada para la población a la que pertenecen.(AU)