Comparison of the Subjective Elbow Value with the DASH, MEPS und Morrey Score after Olecranon Fractures

Abstract

Background Olecranon fractures are common injuries that can occur in patients of any age. To assess the postoperative outcome, multiple scoring systems like the DASH, MEPS und Morrey Score have been described. The goal of this paper is to compare the subjective elbow value (SEV) to these commonly used scoring systems. We hypothesized that the SEV would have a high correlation and practicability for the evaluation of elbow function after isolated olecranon injury.

Patients and Methods Clinical data of 40 patients were collected and retrospectively analysed. All patients suffered an isolated olecranon fracture and were surgically treated by tension band wiring or plate fixation. In the follow-up examinations the Mayo Score, DASH Score, Morrey Score and SEV were measured for correlation purposes.

Results The mean follow-up time was 70.5 ± 45.6 months. The median DASH Score was 9.9 (4.1 – 20.4) and 100 (85 – 100) for the MEPS. The median Morrey Score was 98 (92 – 100). The median SEV was 90% (80 – 95%). The Pearson correlation between the DASH and SEV was −0.85 and 0.80 between the MEPS and the SEV.

Conclusions The SEV shows a high correlation to the most commonly used scoring systems for outcome evaluation after elbow injury. It is easy to use and can be seen as a valuable tool to assess patients after olecranon fractures.

Key words

olecranon fracture - scoring systems - DASH Score - subjective elbow function - Mayo Elbow Score

• References/Literatur

• 1 Powell AJ, Farhan-Alanie OM, Bryceland JK. et al. The treatment of olecranon fractures in adults. Musculoskelet Surg 2017; 101: 1-9
• 2 Wilkerson JA, Rosenwasser MP. Surgical techniques of olecranon fractures. J Hand Surg 2014; 39: 1606-1614
• 3 Niéto H, Billaud A, Rochet S. et al. Proximal ulnar fractures in adults: a review of 163 cases. Injury 2015; 46 (Suppl. 01) S18-S23
• 4 Gummesson C, Atroshi I, Ekdahl C. The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: longitudinal construct validity and measuring self-rated health change after surgery. BMC Musculoskelet Disord 2003; 4: 11
• 5 Cusick MC, Bonnaig NS, Azar FM. et al. Accuracy and reliability of the Mayo Elbow Performance Score. J Hand Surg 2014; 39: 1146-1150
• 6 Schneeberger AG, Kösters MC, Steens W. Comparison of the subjective elbow value and the Mayo elbow performance score. J Shoulder Elbow Surg 2014; 23: 308-312
• 7 Tingart M, Bäthis H, Lefering R. et al. [Constant Score and Neer Score. A comparison of score results and subjective patient satisfaction]. Unfallchirurg 2001; 104: 1048-1054
• 8 Beaton DE, Katz JN, Fossel AH. et al. Measuring the whole or the parts? Validity, reliability, and responsiveness of the Disabilities of the Arm, Shoulder and Hand outcome measure in different regions of the upper extremity. J Hand Ther 2001; 14: 128-146
• 9 Angst F, Goldhahn J, Drerup S. et al. How sharp is the short QuickDASH? A refined content and validity analysis of the short form of the disabilities of the shoulder, arm and hand questionnaire in the strata of symptoms and function and specific joint conditions. Qual Life Res 2009; 18: 1043-1051
• 10 Offenbächer M, Ewert T, Sangha O. et al. Validation of a German version of the “Disabilities of Arm, Shoulder and Hand” questionnaire (DASH-G). Z Rheumatol 2003; 62: 168-177
• 11 Cusick MC, Bonnaig NS, Azar FM. et al. Accuracy and reliability of the Mayo Elbow Performance Score. J Hand Surg Am 2014; 39: 1146-1150
• 12 Weseley MS, Barenfeld PA, Eisenstein AL. The use of the Zuelzer hook plate in fixation of olecranon fractures. J Bone Joint Surg Am 1976; 58: 859-863
• 13 Broberg MA, Morrey BF. Results of treatment of fracture-dislocations of the elbow. Clin Orthop Relat Res 1987; (216) 109-119
• 14 Hauser-Bischof C. Schulterrehabilitation in der Orthopädie und Traumatologie. Stuttgart: Thieme; 2003: 236
• 15 Tarlov AR, Ware jr. JE, Greenfield S. et al. The Medical Outcomes Study. An application of methods for monitoring the results of medical care. JAMA 1989; 262: 925-930
• 16 Lenoir H, Micallef JP, Djerbi I. et al. Total elbow arthroplasty: Influence of implant positioning on functional outcomes. Orthop Traumatol Surg Res 2015; 101: 721-727
• 17 Kennedy CA, Beaton DE. A userʼs survey of the clinical application and content validity of the DASH (Disabilities of the Arm, Shoulder and Hand) outcome measure. J Hand Ther 2017; 30: 30-40.e2
• 18 Tongprasert S, Rapipong J, Buntragulpoontawee M. The cross-cultural adaptation of the DASH questionnaire in Thai (DASH-TH). J Hand Ther 2014; 27: 49-54
• 19 Wajngarten D, Campos JÁDB, Garcia PPNS. The Disabilities of the Arm, Shoulder and Hand scale in the evaluation of disability – a literature review. Med Lav 2017; 108: 314-323 doi:10.23749/mdl.v108i4.6336
• 20 Gummesson C, Ward MM, Atroshi I. The shortened disabilities of the arm, shoulder and hand questionnaire (Quick DASH): validity and reliability based on responses within the full-length DASH. BMC Musculoskelet Disord 2006; 7: 44
• 21 Ottink DA, van Zutphen SW, van Doorn R. et al. Successful fixation of Mason type 2 radial head fractures using Meniscus Arrows. Knee Surg Sports Traumatol Arthrosc 2014; 22: 49-52
• 22 Gilbart MK, Gerber C. Comparison of the subjective shoulder value and the Constant score. J Shoulder Elbow Surg 2007; 16: 717-721
• 23 Hume MC, Wiss DA. Olecranon fractures. A clinical and radiographic comparison of tension band wiring and plate fixation. Clin Orthop Relat Res 1992; (285) 229-235
• 24 Tarallo L, Mugnai R, Adani R. et al. Simple and comminuted displaced olecranon fractures: a clinical comparison between tension band wiring and plate fixation techniques. Arch Orthop Trauma Surg 2014; 134: 1107-1114
• 25 Mancuso CA, Lee SK, Saltzman EB. et al. Development of a questionnaire to measure impact and outcomes of brachial plexus injury. J Bone Joint Surg Am 2018; 100: e14
• 26 Turchin DC, Beaton DE, Richards RR. Validity of observer-based aggregate scoring systems as descriptors of elbow pain, function, and disability. J Bone Joint Surg Am 1998; 80: 154-162