The Polish version of the Michigan Hand Outcomes Questionnaire: Cross-cultural adaptation, reliability, construct validity, and measurement error.

The aims of this study were to translate the Michigan Hand Outcomes Questionnaire into the Polish language and to test the measurement properties of its quality criteria. A total of 120 patients with hand complaints completed the Polish Michigan Hand Outcomes Questionnaire and the Disabilities of the Arm, Shoulder, and Hand questionnaire on the first assessment, along with the grip test, pinch test, and pain sore assessed using a visual analogue scale during activity. After 7 days, 76 patients completed the Michigan Hand Outcomes Questionnaire the second time. The Cronbach alpha of the Michigan Hand Outcomes Questionnaire subscales ranged from 0.79 to 0.96. The intraclass correlation coefficient varied from 0.82-0.97, and the Bland-Altman method indicated the Michigan Hand Outcomes Questionnaire total score limit of agreement was -13.2-12.3 and -9.18-9.62 for the right and left hand, respectively. The construct validity revealed a moderate to strong correlation between every subscale of the Polish Michigan Hand Outcomes Questionnaire and Disabilities of the Arm, Shoulder, and Hand, but they only correlated with the grip test and the visual analogue scale, and neither correlated with the pinch test. The study demonstrated properties similar to the original version, validating the belief that the use of this questionnaire in medical practice in Poland is justified.

[Evaluation of influence of Dupuytryen contracture's operative treatment on increase of quality of hand's function basing on research in use PEM (Patient Evaluation Measure) questionnaire]. / Ocena wplywu operacyjnego leczenia przykurczu Dupuytrena na poprawe funkcji reki w oparciu o badania przeprowadzone z zastosowaniem kwestionariusza PEM (Patient Evaluation Measure).

INTRODUCTION: Dupuytren's contracture is a progressive fibrosis of facial structures of the palmar surface of the hand, gradually leading to a reduction of its functions by impaired range of motion of fingers. MATERIALS AND METHODS: Clinical material consisted of 95 patients treated surgically in the Second Department of Surgery of the Jagiellonian University in 2006 - 2011 because of Dupuytren's contracture. Based on a study using PEM questionnaire (Patient Evaluation Measure) an assessment of the quality of life before and after surgery was made. RESULTS: The average numeric value obtained in the PEM questionnaire before surgery was 30 points (SD ± 14.35). The postoperative controls were found of gradual decrease in the value and so after three months it was 22.39 points (SD ± 14.23), and after a year it reached the value of 18.12 points (SD ± 12.43). Statistically significant correlations (p < 0.001) were demonstrated between test results of PEM taken before and after 3 and 12 months after surgery. CONCLUSIONS: It has been shown that Dupuytren's contracture has negative impact on quality of life but the quality of life improves after surgical treatment.

[Carpal tunnel syndrome- etiology and treatment].

The paper presents the etiology, diagnostics, management, treatment and prognosis of carpal tunnel syndrome. The mechanism of the median nerve compression as well as the predisposing factors that cause the syndrome are discussed, as well as the sequence of specific symptoms and the classification of the level of severity of disease. The diagnostic methods are presented with both the benefits and consequences of each method. The treatment of carpal tunnel syndrome is divided into conservative and surgical approaches. Conservative treatment consists of keeping the wrist immobile using wrist splints, physiotherapy, systemic and local pharmacotherapy, as well as local steroid injections into the carpal tunnel. The results of conservative treatment are often short-term. Operative treatment consists of cutting the flexor retinaculum tendon. This directly eliminates the cause of CTS, the increased pressure in the carpal tunnel of the wrist. A certain percentage of patients experience complications post treatment or disease recurrence.

[Concomitance of Ledderhose's disease with Dupuytren's contracture. Own experience]. / Wspólistnienie choroby Ledderhose'a z przykurczem dupuytrena. Doswiadczenia wlasne.

INTRODUCTION: Ledderhose's disease is a rare fibromatosis affecting plantar aponeurosis. Clinical picture and risk factors resemble the ones found in much more common cases of Dupuytren's disease. MATERIAL AND METHODS: The group of 101 patients with Dupuytren's disease qualified for surgical treatment constituted material for the study. Within that group incidence of Ledderhose's disease was assessed on the basis of clinical and ultrasound examination. Estimation of the presence of risk factors common for both forms of fibromatosis was also evaluated. RESULTS: Ledderhose's disease was found in 15 patients (14.85%) suffering from Dupuytren's contracture. Bilateral Ledderhose's disease was found in 10 of them. Established risk factors were similar to the ones found in Dupuytren's disease--tobacco and alcohol dominated. Indications for the surgical treatment were limited to the symptomatic cases of the disease. Two feet in 4 patients were operated on. Surgical technique was presented in broad outline. Pain relief on walking and normalization of feet pressure distribution were achieved in all cases.

[An attempt to objectify the assessment of extension or recurrence of Dupuytren's disease on the basis of ultrasound]. / Próba obiektywizacji oceny nawrotu lub wznowy choroby Dupuytrena w oparciu o badanie ultrasonograficzne.

Dupuytren's contracture is a disease of unknown etiology, leading with time to decreased hand function caused by increasing contracture of fingers. Excision of contracted longitudinal palmar fascia constitutes the most important way of treatment. Due to fact that disease has progressive course in many patients recurrence (i.e. overgrowth of longitudinal palmar aponeurosis apart from the operated site) or extension (i.e. similar process affecting formerly operated site) occurs. An attempt to objectify the assessment of recurrence or extension of Dupuytren's disease on the basis of sonographic examination of palmar surface of the hand during distant (at least 24 months from surgery) followup constituted the aim of the study. 41 patients operated on from January 2000 to February 2009 in 2nd Department of General Surgery in Krakow due to Dupuytren's contracture constituted the study material. Mean age of the patients reached 62,78 years (SD +/- 9,32), and mean follow up time 5,74 years (SD +/- 2,90). Sonographic assessment was performed in 26 operated on left hands and 24 right hands. 9 patients had both hands operated on. In most of the patients during surgery the contralateral hand was also affected by the disease. Extension of Dupuytren's disease was found in 11 hands, recurrence--in 18 hands, while concurrent extension and recurrence was found in 17 hands. Extension usually was found on the radial side and affected mainly I interphalangeal space followed by disease affecting I and III ray of the hand. In one patient 2 independent foci of the disease were found within I interphalangeal space. Recurrences affected mainly ulnar side of the hand: V and IV rays of the hand. Concurrently found extension and recurrence affected 2 or 3 rays. In the cases of 3 rays affected extension dominated (2 rays vs. 1 ray of recurrence). On sonographic assessment mean diameters of lesions during distant follow- up were 12,69 x 4,62 x 3,95 [mm] with recurrent lesions being larger than mean values found in extensions. With partial fasciectomy being the most commonly performed operation in cases of Dupuytren's disease ultrasound can constitute very important technique of assessment of exacerbation of the lesions of palmar aponeurosis allowing for the choice of appropriate surgical technique for particular case, detection of postoperative extension and/or recurrence and for the cases clinically doubtful.