Health-related quality of life after TAPP repair for the sportsmen's groin.

BACKGROUND: Sportsmen's groin (SG) is a clinical diagnosis of chronic, painful musculotendinous injury to the medial inguinal floor in the absence of a groin hernia. Long-term results for laparoscopic inguinal hernia repair, especially data on health-related quality of life (HRQOL), are scant and there are no available data whatsoever on HRQOL after SG. The main goal of this study was to compare postoperative QOL data in the long term after transabdominal preperitoneal hernioplasty (TAPP) in groin hernia and SG patients with QOL data of a normal population. METHODS: This study included all patients (n = 559) who underwent TAPP repair between 2000 and 2005. Forty seven patients (8.4 %) were operated on for SG. We sent out the Short Form 36 Health Survey (SF-36) questionnaire for QOL evaluation. QOL data were compared with data from an age- and sex-matched normal population. RESULTS: Ultimately, 383 completed questionnaires were available for evaluation (69 % response rate). The mean follow-up time was 94 ± 20 months. In the SG group there were statistically significant differences in three subscales of the SF-36 and the mental component summary measure, showing better results for the SG group compared to the sex- and age-matched normal group data. There were no statistically significant differences between groin hernia patients and the sex- and age-matched normal population. CONCLUSION: TAPP repair for SG as well as groin hernia results in good HRQOL in the long term. Results for SG patients are comparable with QOL data of a normal population or even better.

Quality of life after pertrochanteric femoral fractures treated with a γ nail: a single center study of 62 patients.

BACKGROUND: Intramedullary nailing of pertrochanteric femoral fractures has grown in popularity over the past 2 decades likely because this procedure is associated with a low risk for postoperative morbidity and a fast recovery of function. The evaluation of outcomes associated with pertrochanteric nailing has mainly been based on objective measures. The purpose of the present study is to correlate patients' health-related quality of life results after intramedullary nailing of pertrochanteric fractures with objective outcome measures. METHODS: We conducted a single-center study including 62 patients (mean age 80 ± 10 years) with pertrochanteric fractures treated with a Gamma 3 Nail. Health related quality of life was measured using the Short Form-36. These results were compared to both US and Austrian age and sex-adjusted population norms. The objective outcome measures studied at one year postoperatively included Harris Hip Score, range of motion, leg length, body mass index, neck-shaft angle and grade of osteoarthritis. RESULTS: According to the Harris Hip Score 43 patients (67%) had excellent or good results. There was no significant difference in the average neck-shaft angle comparing affected hip to non-affected hip at 12 months postoperatively. The average osteoarthritis score, for both the injured and uninjured hip, did not differ significantly. We found significant differences between the bodily pain, social functioning and mental health subscales and two summary scores of the Short-Form 36 in comparison to Austrian population norms. Complication rate was 8%. CONCLUSIONS: The results of this study confirm that intramedullary nailing with the use of a Gamma Nail is a safe treatment option for stable and unstable pertrochanteric fractures. Despite good functional and radiographic results we noticed a substantial fall off in patients' quality of life up to 12 months after operation.

Quality of life after volar plate fixation of articular fractures of the distal part of the radius.

BACKGROUND: Outcome measurement following surgery is increasingly the focus of attention in current health-care debates because of the rising costs of medical care and the large variety of operative options. The purpose of the present study was to correlate quality of life after volar locked plate fixation of unstable intra-articular distal radial fractures with functional and radiographic results as well as with quality-of-life data from population norms. METHODS: Fifty-four consecutive patients with intra-articular distal radial fractures and a mean age of sixty-three years were managed with a volar locked plate system. Range of motion, grip strength, and radiographs were assessed at a mean of six years postoperatively. The wrist-scoring systems of Gartland and Werley and Castaing were adopted for the assessment of objective outcomes. The Disabilities of the Arm, Shoulder and Hand and Short Form-36 questionnaires were completed as subjective outcome measures, and the results were compared with United States and Austrian population norms. RESULTS: Functional improvement continued for two years postoperatively. At the time of the latest follow-up, >90% of all patients had achieved good or excellent results according to the scoring systems of Gartland and Werley and Castaing. The results of the Short Form-36 questionnaire were similar to the United States and Austrian population norms. The mean Disabilities of the Arm, Shoulder and Hand score was 5 points at two years, and it increased to 13 points at six years. The twenty patients with radiocarpal arthritis had significantly poorer results in the physical component summary measure of the Short Form-36 questionnaire (p = 0.012). CONCLUSIONS: The results of the present single-center study show that, following distal radial fracture fixation, wrist arthritis may affect the patient's subjective well-being, as documented with the Short Form-36, without influencing the functional outcome. Well-designed longitudinal clinical trials are needed to confirm the findings of the present investigation in terms of quality of life after surgical treatment of intra-articular distal radial fractures.

Volar plate fixation of AO type C2 and C3 distal radius fractures, a single-center study of 55 patients.

OBJECTIVES: We hypothesized that volar locked plate fixation of AO type C2 or C3 fractures could effectively maintain radiographic reduction as shown by comparison of immediate postoperative alignment and that seen after more than 12 months' follow-up. DESIGN: Prospective cohort study. SETTING: Level II trauma center located in a suburban area. PATIENTS: Fifty-five adult patients with intra-articular fractures of the distal radius. INTERVENTION: Open reduction and internal fixation with a locked volar plate and screws. MAIN OUTCOME MEASUREMENTS: Volar tilt, radial inclination, radial length, and articular incongruity were radiologically assessed immediately postoperatively and at the time of final follow-up (mean follow-up: 29 +/- 7 months). RESULTS: At final radiographic examination, the average loss of volar tilt was 1.9 +/- 3.3 degrees (P < 0.001) and the average loss of radial inclination was 1.4 +/- 2.8 degrees (P < 0.001). Four patients had more than 5 degrees loss of radial inclination (7.8%), and 22 patients (43.1%) had more than 5 degrees loss of volar tilt. Radial shortening was not statistically significant (P > 0.05). CONCLUSIONS: The treatment of intra-articular fractures of the distal radius with a volar locked plating system is associated with a small but statistically significant loss of volar tilt and radial inclination upon comparison of immediate postoperative alignment with that seen after more than 12 months' follow-up.