Translation into Greek, cross-cultural adaptation and validation of the Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH).

The purpose of this study was to translate, adapt, and validate a Greek version of the Disabilities of the Arm, Shoulder, and Hand (DASH) Questionnaire. The English version of DASH was translated into Greek (DASH-GR) and cultural adaptation was performed. Subsequently, psychometric properties and validity were assessed in 106 consecutive eligible patients presenting with a variety of unilateral upper limb disorders. All patients completed the Short Form 36 Health Survey questionnaire and the DASH-GR. Test-retest reliability was assessed in a subgroup of 35 patients who filled in the questionnaire seven days later. The internal consistency of the 30 items of the DASH-GR, estimated by the internal consistency coefficient (Cronbach's alpha) was 0.96. The difference between the individual scores of the initial assessment and reassessment of the DASH ranged from -6.5 to 14.5 (mean difference was 3.74 (SD+/-6.1)). The correlation coefficient between total scores of the initial assessment and reassessment was high (Pearson's r=0.918, p<0.0005) (Kentall tau-b=0.72, p<0.001). The correlation coefficient between the DASH-GR and SF-36 total scores was 0.625 (p<0.001), showing a strong correlation between the two questionnaires. The Greek version of the DASH retains the characteristics of the English original and is a reliable and valid instrument that can provide a standardized measure of patient-centered outcomes in Greek-speaking patients with unilateral disorders of the upper limb.

Multiple level noncontiguous fractures of the spine.

From 1970 to 2000, 81 patients with noncontiguous fractures of the spine were evaluated. Of these 81 patients, 36 had a neurologic deficit. Sixty-six patients with stable injuries were treated conservatively, whereas 15 patients with unstable injuries required surgical stabilization. There was no neurologic deterioration either in the patients who had surgical stabilization or in the patients who were treated conservatively. Thirteen patients with an A score on the American Spinal Injury Association neurologic impairment scale did not improve and had a high mortality rate (61.5%). Although multiple level noncontiguous fractures of the spine are uncommon, they constitute a threat to neurologic function, and therefore warrant radiographic evaluation of the entire spine with multiple injuries.