Validity and internal consistency of the thoracic outlet syndrome index for patients with thoracic outlet syndrome

Background: No validated scales exist specifically for measuring quality of life (QoL) and functioning level in patients with thoracic outlet syndrome (TOS). This cross-sectional survey examined whether some items adopted from validated QoL scales could be suitable for patients with TOS.Methods: To find an optimal thoracic outlet syndrome index (TOSI), a panel of 14 specialists experienced in treating TOS independently evaluated the relevance of 19 items adopted from scales used in other upper-extremity syndromes. After undergoing surgery for TOS, 52 patients rated the relevance of those items found by experts to be relevant. Content validity was measured by a content validity index, content validity ratio, and modified κ. The internal consistency of 15 retained items was assessed with the Cronbach α, and its construct validity was assessed by an exploratory factor analysis.Results: Of the 19 items, 15 were considered relevant for TOS by the panelists, with an overall test content validity index of 0.93. The internal consistency of these 15 items was excellent. The exploratory factor analysis accompanied by a parallel analysis confirmed the uni-dimensionality of the TOSI. All 15 items that the panelists considered relevant were also items that the patients marked with scores over 7 points on an 11-point scale of relevance.Conclusion: The internally consistent, face- and content-valid TOSI scale is proposed for use in evaluating specifically the QoL in TOS patients, as well as improving future longitudinal studies comparing functioning before and after interventions or spontaneous recovery in TOS patients.</p

The importance of radiological results in distal radius fracture operations : Functional outcome after long-term (6.5years) follow-up

Background and Aims: Whether or not radiological results correlate with functional outcome after operative treatment of distal radius fractures still remains controversial. We carried out a retrospective study to analyse the long-term (6.5year) outcome of radius fractures treated by means of surgery in our hospital. The aim of the study was to explore whether step-off on radius joint surface, shortening of the radius versus ulnar height and dorsal or volar tilt of the radius correlate with long-term Patient-Rated Wrist Evaluation or Quick Disability of the Arm, Shoulder and Hand scores among 100 consecutive patients after surgical treatment. Materials and Methods: Of these, 60 patients (63 wrists) participated. They were examined radiologically, clinically and by means of a questionnaire. Results: Shortening of the radius correlated significantly with both Patient-Rated Wrist Evaluation and Quick Disability of the Arm, Shoulder and Hand scores. Step-off on the radius joint surface correlated significantly with worse PRWE scores, with no difference in Quick Disability of the Arm, Shoulder and Hand evaluation. Dorsal or volar tilt showed no statistical correlation (though it was mild in this group). The age of the patients (below 60years vs 60years or above) did not affect the PRWE or Quick Disability of the Arm, Shoulder and Hand results. Conclusion: Our results indicate that when it comes to conserving the radial height and congruence of the joint surface, the more precise the reduction of the fracture achieved by surgical means, the better the functional outcome.Peer reviewe