A patient-reported outcome measure for patients with Dupuytren's disease.

INTRODUCTION: A Danish validated patient-reported outcome measure (PROM) specific to Dupuytren's disease (DD) does currently not exist. Such a PROM would be useful in the assessment of DD patients. The aim of this study was to translate the Southampton Dupuytren's Scoring Scheme (SDSS) into Danish and validate the translated version of the PROM. METHODS: The SDSS was translated according to guidelines by Swaine-Verdier et al. A total of 110 patients diagnosed with DD completed the translated SDSS and evaluated the PROM. The severity of DD was assessed clinically using the Tubiana classification method. In all, 16 patients treated with collagenase injections were re-evaluated with the SDSS and the Tubiana post treatment. The reliability of the SDSS was tested in terms of internal consistency expressed as Cronbach's alpha and test-retest expressed by the intraclass correlation coefficient (ICC). Construct validation was calculated by Spearman's correlation coefficient between the SDSS and the Tubiana, and the responsiveness of the PROM was tested using point-biserial correlation and standardised response mean (SRM). RESULTS: Cronbach's alpha was 0.76 and an ICC of 0.82 (95% confidence interval (CI): 0.53-0.93, p less-than 0.0001). Spearman's correlation coefficient was 0.26 (95% CI: 0.08-0.43, p = 0.007) preoperatively and 0.39 (95% CI: -0.13-0.74, p = 0.14) post treatment. The SRM was 1.96 (95% CI: 1.42-2.48), and the point-biserial correlation coefficient was 0.52 (95% CI: 0.03-0.81, p = 0.039). CONCLUSIONS: The PROM shows good reliability, has substantial responsiveness to change and enjoys a high level of patient approval. The PROM is therefore recommended for patients with DD. FUNDING: none. TRIAL REGISTRATION: The study was reported to the Danish Data Protection Agency.

Arthroscopically Assisted Bone Grafting Reduces Union Time of Scaphoid Nonunions Compared to Percutaneous Screw Fixation Alone.

Purpose Minimally invasive techniques have been recommended in the treatment of painful but stable scaphoid nonunions. The purpose of this study was to determine if arthroscopically assisted bone grafting provided superior results in healing as compared to percutaneous screw fixation. Materials and Methods One hundred sixty-four consecutive patients with scaphoid nonunions were retrospectively analyzed. One hundred forty-eight patients were treated with the open grafting techniques either with iliac or distal radius bone, leaving 16 patients treated with minimally invasive surgery. In the group treated percutaneously ( n = 8), the time from injury to surgery was 2.5 months (range: 2-4 months) and it was 27.3 months (range: 3-180 months) in the arthroscopic group ( n = 8). The mean age was 39 years (range: 20-66) in the percutaneous group and 22 years (range: 16-32) in the arthroscopic group. In all cases, the Mini Acutrak headless fully threaded compression screw was used. Healing was assessed clinically and radiographically at a minimum follow-up of 12 weeks, mean 7 months (range: 3-12 months). Data were calculated with two-tailed Mann-Whitney U test based on p -value of < 0.05 that was considered statistically significant. Results We recorded no complications in any of the groups. Patients treated arthroscopically received cancellous bone grafting from the distal radius and all patients but one healed at a median of 7.8 weeks (range: 5-18 weeks). Seven patients in the percutaneous group healed at a mean of 10.5 weeks (range: 7-24 weeks), thus leaving one patient from each group without achieving union. Mann-Whitney U test showed the U value of 11, the critical value of U to be 13 ( p < 0.05), thus significantly faster healing was observed in the arthroscopically treated group. Conclusions Arthroscopically treated patients achieved faster healing despite shorter time to surgery in the percutaneous group. Local bone grafting is considered as the main reason for this outcome. Younger population in the arthroscopically treated group may have influenced the result. Level of Evidence This is a Level III comparative study.