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However, long\u2010term outcomes of complex reconstruction performed in the resource\u2010limited setting are not known. This hinders understanding of outcomes and disability from these injuries and prevents systematically addressing care delivery around upper extremity trauma in the developing world. This project aims to analyze the details of the unique Ganga Hospital reconstruction experience and use patient\u2010reported outcome measures for the first time in this patient population to evaluate post\u2010injury recovery and disability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty\u2010six patients were evaluated 6\u00a0months or more after massive proximal upper extremity reconstruction at Ganga Hospital. Patients completed functional tests, Jebsen\u2013Taylor test (JTT), and patient\u2010reported outcomes (PROs)\u2014Michigan Hand Questionnaire (MHQ), Disability of Arm, Shoulder, and Hand questionnaire (DASH), and Short\u2010Form 36 (SF\u201036). Correlations between metrics were assessed with Pearson\u2019s correlation coefficients. Linear regression modeling evaluated associations between severity, reconstruction, and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>MHQ and DASH results correlated with functional test performance, JTT performance, and SF\u201036 scores (Pearson\u2019s coefficients all \u22650.33, <jats:italic>p<\/jats:italic> \u2264 0.05). In this cohort, mean MHQ score was 79 \u00b1 15 and mean DASH score was 13 \u00b1 15, which are not significantly different than scores for long\u2010term outcomes after other complex upper extremity procedures. The following factors predicted PROs and functional performance after reconstruction: extent of soft tissue reconstruction, multi\u2010segmental ulna fractures, median nerve injury, and ability for patients to return to work and maintain their job after injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Complex proximal upper extremity salvage can be performed in the resource\u2010limited setting with excellent long\u2010term functional and patient\u2010reported outcomes. PRO questionnaires are useful for reporting outcomes that correlate to functional and sensory testing and may be used to assess post\u2010traumatic disability.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-017-3902-1","type":"journal-article","created":{"date-parts":[[2017,2,6]],"date-time":"2017-02-06T16:49:47Z","timestamp":1486399787000},"page":"1420-1434","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Outcomes and Disability After Massive Proximal Upper Extremity Reconstruction in a Resource\u2010Limited Setting"],"prefix":"10.1002","volume":"41","author":[{"given":"Aviram M.","family":"Giladi","sequence":"first","affiliation":[{"name":"Department of Surgery, Section of Plastic Surgery University of Michigan Health System 2130 Taubman Center, SPC 5340, 1500 E. Medical Center Drive 48109\u20105340 Ann Arbor MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. Raja","family":"Shanmugakrishnan","sequence":"additional","affiliation":[{"name":"Department of Plastic, Hand, and Reconstructive Microsurgery and Burns Ganga Hospital Coimbatore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hari","family":"Venkatramani","sequence":"additional","affiliation":[{"name":"Department of Plastic, Hand, and Reconstructive Microsurgery and Burns Ganga Hospital Coimbatore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Raja Sekaran","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Ganga Hospital Coimbatore India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin C.","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Plastic Surgery University of Michigan Health System 2130 Taubman Center, SPC 5340, 1500 E. 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