The 36-item Short-Form Health Survey outcome evaluation for multiple lower-extremity nerve decompressions in diabetic peripheral neuropathy: a pilot study.

BACKGROUND: Diabetic neuropathy can be disabling owing to pain and loss of sensibility. Theoretically, surgical restoration of sensation and relief of pain may prevent these complications and improve quality of life. A study was conducted to perform outcome analysis of patients after these surgical procedures using the 36-Item Short-Form Health Survey. METHODS: The 36-Item Short-Form Health Survey was used to evaluate patients with diabetic neuropathy after nerve decompression surgery. These results were compared with those reported in the literature related to diabetic patients without neuropathy, patients with low-back pain, and an age-matched normative population. The pilot study group included six patients with diabetic neuropathy, three of whom underwent multiple nerve decompression surgery bilaterally. Mean follow-up was 6 months. RESULTS: Single-tailed t tests demonstrated that postoperative patients were not statistically significantly different from the other groups in the domains of Physical Functioning, Bodily Pain, General Health, Vitality, Social Functioning, and Mental Health; in the domains of Role-Physical and Role-Emotional, a statistically significant difference was found, with the postoperative patients scoring lower. CONCLUSIONS: Although this study is limited by the lack of preoperative administration of the 36-Item Short-Form Health Survey and by its small sample size, we conclude that the survey can evaluate the results of surgical decompression of lower-extremity peripheral nerves and should be added to the traditional assessments of recovery of sensibility and the visual analog scale for pain.

Flexible flatfoot treatment with arthroereisis: radiographic improvement and child health survey analysis.

This study was designed to ascertain if there was a statistically significant correction in the foot and to determine the overall health of a child after an arthroereisis procedure. Thirty-seven patients (67 feet) who had undergone Maxwell-Brancheau arthroereisis were retrospectively reviewed at an average of 18.4 months after surgery. The pre- and postoperative lateral talo-first metatarsal and talar declination and the anteroposterior talo-first metatarsal and talocalcaneal angles were measured by using an X-Caliper device (Eisenlohr Technologies, Davis, CA); significance was determined with a t test. Child health questionnaire answers were calculated and converted to a 0 to 100 scaled score and statistically compared with population norms by using a single-sample t test. The lateral radiographic average preoperative talo-first metatarsal and talar declination angles were 11.3 and 27.5, respectively, and were 3.7 and 21.9, respectively, postoperatively. The preoperative average anteroposterior talo-first metatarsal and talocalcaneal angles were 13.8 and 25.6, respectively, and were 6.4 and 19.4, respectively, postoperatively. The t test showed the postoperative angles had a statistically significant (P <.01) change from the preoperative angles. The results of the Child health questionnaire of our 34 pediatric patients (92%) showed scores in 3 domains (role emotional behavior, global behavior, parent time) that were better than population norms, and there was no difference in the remaining domains.