Background and Objectives: Lateral compression injuries of the pelvic ring are most common among young and elderly patients. Of all pelvic ring fracture injuries, the B2.1 type—involving lateral compression of the pelvic ring—is the most common. Despite this, we still have no high-level evidence to consult when choosing between the surgical and non-operative approaches. The purpose of this research was to compare the short-term functional and quality of life outcomes between operatively and non-operatively treated young patients after a B2.1 type pelvic fracture. Materials and Methods: Patients aged 18 to 65 years with pelvic B2.1 type fractures—according to AO/Tile classification—that were hospitalized in a single trauma center between 2016 November and 2019 September were included in the research. Patients were retrospectively divided into two groups regarding their treatment: non-operative and operative. Functional outcomes were evaluated using Majeed score, and SF-36 was used for the evaluation of quality of life. Patients completed these questionnaires twice: first during hospitalization, regarding their pre-traumatic condition (timepoint I); and again 10 weeks after the injury, regarding their current condition (timepoint II). Results: A total of 55 patients (70.6% of whom were female) with type B2.1 pelvic fractures were included in the analysis, with an average age of 37.24 ± 13.78 years. There were 21 (38.18%) patients with high injury severity, and 37 (67.3%) patients were treated operatively versus 18 (32.7%) non-operatively. Between the two timepoints, Majeed score reduced by 34.08 ± 18.95 for operatively and 31.44 ± 14.41 for non-operatively treated patients. For operatively and non-operatively treated patients, the physical component summary (PCS) of the SF-36 questionnaire reduced by 19.45 ± 9.95 and 19.36 ± 7.88, respectively, while the mental component summary (MCS) reduced by 6.38 ± 11.04 and 7.23 ± 10.86, respectively. Conclusions: We observed that operative treatment of B2.1 type pelvic fractures for young patients is not superior to non-operative in the short-term, because the functional outcomes and quality of life are similar in both groups.

Acromioclavicular joint (ACJ) dislocation is a common injury among young and physically active persons. Evaluating surgical outcomes clinically and radiographically is widely accepted, but it is not known which clinical tests or radiological indicators are the most important. Our hypothesis is that there is a significant correlation between clinical and radiological findings and outcomes after the early surgical treatment of Tossy type III ACJ dislocation. A retrospective study was conducted on 23 patients who underwent early surgical treatment after Tossy type III ACJ dislocation. We used the constant score (CS) and the simple shoulder test (SST) to measure the outcomes. For clinical evaluation, Paxinos, O’Brien’s, Bell-van Riet’s, and horizontal adduction tests were used. Standard A-P view radiographs were evaluated for redislocation, ACJ arthrosis, coracoclavicular (CC) space ossification, and for the presence of osteolysis. The mean time of follow-up was 16 months (range, 12-22 months). During the follow-up, all patients had one or more pathological radiological signs. All clinical tests were negative in 12 patients, seven had one positive test, three had two positive tests, and one had three positive tests. The mean CS result at the follow-up was 93.44 ± 4.90 (range, 84-100), and the mean SST result was 10.78 ± 1.51 (range, 6-12). There was no statistically significant association between the CS results and either shoulder tests or radiological findings. The SST results were statistically significantly lower for patients with positive O’Brien’s test compared to those with a negative one. In contrast, the SST results were statistically significantly higher for patients with CC space ossification, compared to those who did not have this radiological sign. Other clinical tests and radiological findings did not have any associations with the SST results. We found that positive O’Brien’s test was associated with worse outcomes of early surgical treatment after Tossy type III ACJ dislocation. Despite the presence of pathological radiological signs, patients may have good or even perfect clinical outcomes after the early surgical treatment of a Tossy type III injury.

Background and Objectives: There are no valid patient-based pelvic ring function assessment tools in Lithuania. The most widely used instrument is the Majeed Pelvic Score (MPS), which is proven to be an effective tool for assessing pelvic function after pelvic injuries. The aims of our study were: (1) the translation and cross-cultural adaptation of the MPS for the Lithuanian-speaking population, (2) to test the psychometric properties of the Lithuanian version of the MPS (MPS-LT) at follow-up two-time points after pelvic fractures. Materials and Methods: The MPS was translated and culturally adapted. Psychometric properties of the MPS-LT were determined in one patient group (n = 40) at two time-points during follow-up examination from 1.5 to 3 months (mean 2 months) and from 11 to 20 months (mean 12 months). Results: At the mean time of 2 months after trauma, Cronbach’s α of the MPS-LT was 0.65. Correlation of the MPS-LT with the Iowa Pelvic Score (IPS) was r = 0.84 (p < 0.001), and with the Lithuanian SF-36, PCS was r = 0.53 (p < 0.001). At the mean time follow-up of 12 months, Cronbach’s α was 0.86, correlation with the IPS was r = 0.92 (p < 0.001), and with the Lithuanian SF-36, PCS – r = 0.82 (p < 0.001). At the 2-month follow-up, neither floor nor ceiling effects were reached, but at 12 months, 27.5% of patients reached the ceiling effect, while none reached the floor effect. The effect size of the MPS-LT was 1.66. Conclusions: The MPS-LT has limited ability to measure functional outcomes at 2 months after pelvic fracture. In contrast, at the 12-month follow-up examination, the MPS-LT had a good ability to assess pelvic function, and it was sensitive to health changes. The MPS-LT can be used as a pelvic function assessment tool after pelvic fractures for the Lithuanian-speaking population.

Background and Objectives: The Western Ontario Shoulder Instability Index (WOSI) is a disease-specific self-administered questionnaire which is designed to measure health-related quality of life for patients with shoulder instability. The objective of this study was to translate and adapt the WOSI questionnaire for the Lithuanian-speaking population and investigate the psychometric properties of the Lithuanian version of the WOSI questionnaire (WOSI-LT): validity, reliability, and responsiveness. Materials and Methods: The WOSI scale was translated into Lithuanian using D. E. Beaton’s systematic and standardized guidelines for cross-cultural adaptation of patient-administered scales. Subsequently, the psychometric properties of the Lithuanian version of the scale (WOSI-LT) were investigated. The study involved 40 patients who reported shoulder instability and underwent surgical treatment. All patients completed the WOSI-LT, QuickDASH, and SF-12 scales. A subset of 10 patients was selected for the reproducibility and responsiveness evaluation. Based on the obtained data, the reliability, validity, and responsiveness of WOSI-LT were examined using statistical analysis methods. Results: The Lithuanian adaptation of the WOSI questionnaire exhibited a high degree of internal consistency, evidenced by a Cronbach’s alpha of 0.93. Its reproducibility was commendable with an intraclass correlation coefficient (ICC) value of 0.90. When assessing correlations, WOSI-LT demonstrated a stronger relationship with QuickDASH (r = 0.64) than with SF-12 (physical component score (PCS) 0.61, mental component score (MCS) 0.33). Six months post-operation, the responsiveness of the WOSI-LT was particularly notable, with a standardized response mean (SRM) of 0.91, the highest among the three scales. Furthermore, no floor or ceiling effects were identified in the scores of the Lithuanian WOSI. Conclusions: WOSI-LT is a valid, reliable, and responsive questionnaire that correlates excellently with the original English version of the scale. This scale can be used in Lithuanian medical institutions to assess the severity of patients’ shoulder instability and evaluate their progress during treatment.

Sigitas Ryliškis1, Manvilius Kocius1, Robert G Marx21 Vilniaus universiteto Reumatologijos, ortopedijos traumatologijos ir rekonstrukcinės chirurgijos klinika Vilniaus greitosios pagalbos universitetinės ligoninės Ortopedijos traumatologijos centras, Šiltnamių g. 29, Vilnius LT-041302 Specialiosios chirurgijos ligoninės Ortopedijos skyrius, 535 East 70th Street, Niujorkas (NY), Jungtinės Amerikos ValstijosEl paštas: ryliskis.s@gmail.com Įvadas / tikslas Pacientams, sergantiems peties sąnario ir/arba aplinkinių minkštųjų audinių ligomis, peties raumenų jėgos matavimas yra viena iš būtinų klinikinio įvertinimo dalių. Išmatuoti jėgą gali tyrėjas arba pats pacientas. Tyrėjas raumenų jėgą išmatuoja dinamometru, o pacientas, atsakydamas į specialiai suformuluotus klausimus apie tam tikro svorio daiktų kėlimą kasdienėje veikloje, pats išsimatuoja jėgą netiesiogiai. Paciento vertinimas yra paprastesnis, greitas, nereikalauja tyrėjo ir specialios įrangos ir galbūt galėtų pakeisti sudėtingus gydytojo matavimus klinikinėje praktikoje. Šio tyrimo tikslas – palyginti du peties raumenų jėgos matavimo būdus ir nustatyti, ar tyrėjas ir pacientas jėgą matuoja vienodai. Ligoniai ir metodai Perspektyviajame tyrime dalyvavo 108 pacientai, atvykę operacinio gydymo į ligoninę dėl peties sukamųjų raumenų sausgyslių plyšimo. Visiems pacientams pažeisto ir sveiko peties raumenų jėga buvo išmatuota skaitmeniniu dinamometru. Pacientai savo peties raumenų jėgą įvertino patys, atsakydami į tris jėgą matuojančius Paprastojo peties klausimyno klausimus. Statistinei duomenų analizei naudojome tyrėjo išmatuotą peties raumenų jėgą kilogramais (trijų matavimų vidurkius), jėgą vertinančių atskirų klausimų ir visų trijų klausimų atsakymų suminius rezultatus. Tyrėjo ir paciento vertinimų patikimumui nustatyti buvo apskaičiuotas vidinis klasės koreliacijos koeficientas su 95% pasikliautinumo intervalu. Norėdami palyginti du jėgos matavimo būdus, apskaičiavome Spearmano koreliacijos koeficientą. Rezultatai Vertinant tyrėjo matavimų patikimumą buvo gautas 0,951 vidinis klasės koreliacijos koeficientas. Atskiriems jėgą matuojantiems klausimams vidinis klasės koreliacijos koeficientas buvo 0,896, 0,896 ir 0,887, o visų trijų klausimų suminiams rezultatams – 0,952. Tyrėjo išmatuota jėga vidutiniškai koreliavo su atskirų trijų jėgą vertinančių klausimų rezultatais (rho = 0,527, p < 0,001; rho = 0,632, p < 0,001; rho = 0,527, p < 0,001) ir su visų trijų klausimų suminiais rezultatais (rho = 0,702, p < 0,001). Išvada Pacientai, atsakydami į specialiai suformuluotus klausimus, gali patikimai išmatuoti savo peties raumenų jėgą, tačiau šių matavimų tikslumas nėra lygus skaitmeniniu dinamometru išmatuotai jėgai. Reikšminiai žodžiai: peties raumenų jėga, skaitmeninis dinamometras, matavimų patikimumas, Paprastasis peties klausimynas Comparison of patient-based assessment and observer-based measurements of shoulder strength Sigitas Ryliškis1, Manvilius Kocius1, Robert G Marx21 Vilnius University Clinic of Rheumatology, Orthopaedic and Traumatology and Reconstructive Surgery Centre of Orthopaedic and Traumatology, Vilnius University Emergency Hospital, Šiltnamių str. 29, LT-04130 Vilnius, Lithuania2 Orthopaedic Department, Hospital for Special Surgery, 535 East 70th Street, New York, USAE-mail: ryliskis.s@gmail.com Background / objective Shoulder strength measurement of the is mandatory in the evaluation of shoulder function in patients with shoulder pathology. We can use observer-based measurements with the digital dynamometer or self-assessment scales with special questions about elevation of different weights in everyday activities. Patient self-assessment is simple and rapid, it requires no observer and special equipment. This method may replace complex observer-based measurements. The purposes of this study were to compare two different shoulder strength evaluation methods and to determine whether the patient-based evaluation equals the observer-based measurements. Materials and methods In the hospital, 108 patients with a rotator cuff injury were prospectively evaluated. Observer-based measurements of the shoulder muscle strength were performed using a digital dynamometer for both injured and healthy shoulders. For the patient-based evaluation we used the strength subscale (three questions) from the shoulder joint specific self-assessment Simple Shoulder Test instrument. For statistical analysis we used observer-based measurements of the strength in kilograms (means of three measurements), results of separate three questions and the total shoulder strength score. The reliability of observer- and patient-based assessments was determined and the two strength evaluation methods were compared. Results The intraclass correlation coefficient for intraobserver reliability was 0.951. The intraclass correlation coefficients for test–retest reliability of three separate questions were 0.896, 0.896, 0.887, and the total strength score was 0.952. Observer-based measurements showed a moderate correlation with the results of separate three questions (rho = 0.527, p < 0.001; rho = 0.632, p < 0.001; rho = 0.527, p < 0.001) and with the total shoulder strength score (rho =...