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Comparison of the Modified Nelson Thumb Score to the DASH for Patient Outcome Assessment of Basal Joint Arthritis
Michael Fitzmaurice, MD; Scottsdale Healthcare Hospital
Brown Hand Center, Scottsdale, AZ, USA

Comparison of the Modified Nelson Thumb Score to the DASH for Patient Outcome Assessment of Basal Joint Arthritis

Patient reported outcome questionnaires are an important tool for evaluating and comparing different surgical techniques. The Disability of the Arm, Shoulder and Hand (DASH) outcome measure is a common questionnaire for upper extremity pathology, however, it is a generalized outcome measure, has 25 questions and not specific to thumb pain. The Nelson score is a 10 question assessment recently developed as a more specific outcome measure of basal joint arthritis. We modified the Nelson score so the lower score was better on a scale of 0-100 similar to the DASH. The DASH and Modified Nelson score were then given to all patients undergoing CMC arthritis surgery including arthroscopic trapeziectomy and arthroscopic hemitrapeziectomy. These questionnaires were then repeated at 3 month follow up. The response was evaluated by calculating the effect size (ES) and standardized response mean (SRM). The ES and SRM for the DASH was 1.57 and 1.09 respectively. The ES and SRM for the Modified Nelson score was 2.06 and 1.58 respectively. The shorter and much easier to deliver Modified Nelson thumb score is more responsive than the DASH score for assessing outcomes following basal joint arthritis surgery.


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