Transcultural validation of the Oxford Shoulder Score for the French-speaking population.

PURPOSE: Patient-reported outcome measures (PROMs) have been gaining in popularity over the last decade. The Oxford Shoulder Score (OSS) is a well-established self-administered questionnaire for shoulder evaluation adapted for the English-speaking population. The aim of the present study was to develop a translation and a transcultural adaptation of the OSS and to assess its validity in native French-speaker patients with shoulder pain. METHODS: The translation process was carried out following a translation/back-translation methodology by two translators. All patients completed the French OSS, the Subjective Shoulder Value (SSV), and the Constant score. Internal consistency was tested using Cronbach's α coefficient. Validity was assessed by calculating the Pearson correlation coefficient between the OSS and the Constant score and the SSV. RESULTS: One hundred forty-four patients suffering from degenerative or inflammatory diseases of the shoulder were included in this study. The average time required to complete the French OSS was 2min and 45s. Seventy patients were asked to complete the questionnaire twice (test/retest reliability). Internal consistency was high with Cronbach's α coefficient=0.93. The intraclass correlation coefficient was 0.91 (95% CI: 0.88-0.94) for test/retest reliability. The French OSS score was significantly correlated with the Constant-Murley score (r=0.73 and P<0.0001) and with the SSV (r=0.68 and P<0.0001). CONCLUSIONS: The present study shows that the French version of the OSS is reliable, valid, and reproducible. The sensitivity to change now needs to be evaluated. This score was adapted to the French-speaking population for the self-assessment of patients with degenerative or inflammatory disorders of the shoulder. LEVEL OF EVIDENCE: Level 1, Test of previously developed criteria, diagnostic test study.

[Specificities in children wound healing]. / Particularités de la cicatrisation de l'enfant.

Children have specific characteristics of wound healing. The aim of this study was to describe the specific clinical characteristics of wounds healing in children and to present the current knowledge on the specific mechanisms with regard to infant age. The tissue insult or injury in fetus can heal without scar, mainly due to reduced granulation tissue associated to diminished or even no inflammatory phase, modified extracellular matrix such as the concentration of hyaluronic acid in amniotic liquid, expression and arrangement of collagen and tenascin. Thickness of children skin is a serious negative factor in case of trauma, whereas poor co-morbidities and efficient growth tissue mechanisms are beneficial to good evolution, even in cases of extensive damage and loss of tissue. The subsequent tissue mechanical forces, wound healing during childhood, spanning from the age of 2 until the end of puberty, is associated with more hypertrophic scars, both in duration and in intensity. Consequently, unnecessary surgery has to be avoided during this period when possible, and children with abnormal or pathologic wound healing should benefit from complementary treatments (hydration, massage, brace, silicone, hydrotherapy…), which represent efficient factors to minimize tissue scarring. After wound healing, the growth body rate can be responsible for specific complications, such as contractures, alopecia, and scar intussusceptions. Its evolutionary character implies the need of an attentive follow-up until adult age. Psychologic repercussions, as a consequence of pathologic scars, must be prevented and investigated by the surgeon.