Nerve Conditions of the Upper Limb: How Not to Miss or Mismanage.

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Abstract

[Indexed for MEDLINE] 20. Arch Orthop Trauma Surg. 2022 Jul;142(7):1697-1703. doi: 10.1007/s00402-022-04367-8. Epub 2022 Feb 2. Reliability and validity of the modified McGowan grade in patients with cubital tunnel syndrome. Choi SW(1), Bae JY(1), Shin YH(2), Moon SH(2), Kim JK(3). Author information: (1)Department of Orthopedic Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea. (2)Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic road 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. (3)Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic road 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea. orth4535@gmail.com. INTRODUCTION: This study aimed to assess the reliability and validity of the modified McGowan grading system and to determine its ability to distinguish the severity of cubital tunnel syndrome (CuTS) between the different grades. MATERIALS AND METHODS: We prospectively enrolled 39 consecutive patients with CuTS from March 2018 to December 2020. Inter- and intra-observer reliability was assessed by two orthopaedic surgeons with a minimum 2-week interval using Cohen kappa coefficients. Validity was assessed by Spearman's correlation with objective clinical outcomes (grip strength, Semmes-Weinstein monofilament test [SWMT], static two-point discrimination [2PD], and motor conduction velocity [MCV]). In addition, the relationship between the grading system and patient-reported outcomes (Disabilities of the Arm, Shoulder and Hand score and Boston Questionnaire) was evaluated using Spearman's correlation. The ability to distinguish the severity between the different grades was assessed using the Kruskal-Wallis analysis. RESULTS: The inter-observer kappa value was 0.54 and intra-observer kappa value was 0.59, which imply a moderate reliability. The modified McGowan grade had a moderate correlation with objective clinical outcomes (grip strength [r = - 0.350, p = 0.029], SWMT [r = 0.552, p