{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T11:32:43Z","timestamp":1781782363244,"version":"3.54.5"},"reference-count":39,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Orthop Unfall"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background Patient-reported outcome measures (PROMs) are gaining increasing importance in the context of quality management. Different PROMs and scoring tools are available to assess shoulder function after proximal humeral fracture (PHFx). In Europe, these include the Constant-Murley Score (CS), Neer Score (NS), Oxford Shoulder Score (OSS), University of California at Los Angeles Score (UCLA) and Disabilities of the Arm, Shoulder and Hands Score (DASH). In addition, the health-related quality of life can be assessed by the PROMs Short Form 36 (SF-36) and EuroQol (EQ-5D). Although all these test instruments assess shoulder function, the components to be answered objectively and subjectively vary and thus the possibility of independent assessment. The aim of the present study is to compare the correlation between the results of the different PROMs and the clinical screening tools in patients with PHFx.<\/jats:p><jats:p>\n          Methods 76 patients who were treated with angular stable plate osteosynthesis for a proximal humeral fracture between 01\/2001 and 12\/2005 were included in this trial. The outcome was measured with PROMs or clinical scoring tools such as CS, NS, OSS, UCLA, DASH, SF-36 and EQ-5D and a correlation coefficient between those evaluation tools was calculated. In addition, a distinction was made between the two force measurement methods (wrist [HG] vs. deltoid muscle [DM]) for CS.<\/jats:p><jats:p>\n          Results The correlation of the results of CS and NS (HG: r\u2009=\u20090.85; p\u2009&lt;\u20090.001\/DM: r\u2009=\u20090.93; p\u2009&lt;\u20090.001), CS and UCLA (HG: r\u2009=\u20090.83; p\u2009&lt;\u20090.001\/DM: r\u2009=\u20090.86; p\u2009&lt;\u20090.001), NS and UCLA (r\u2009=\u20090.91; p\u2009&lt;\u20090.001) as well as DASH and OSS (r\u2009=\u20090.88; p\u2009&lt;\u20090.001) was strongly expressed. A good comparability of the results was demonstrated between CS and OSS (HG: r\u2009=\u20090.63; p\u2009&lt;\u20090.001\/DM: r\u2009=\u20090.66; p\u2009&lt;\u20090.001) and between CS and DASH (HG: r\u2009=\u20090.62; p\u2009&lt;\u20090.001\/DM: r\u2009=\u20090.61; p\u2009&lt;\u20090.001). The correlation of CS (HG\/DM) and UCLA with the EQ-5D index was also good. Assessment of the physical components of SF-36 with CS, NS, OSS, UCLA and DASH showed a moderate to good association, while the mental components of SF-36 showed a low correlation (p\u2009&gt;\u20090.05).<\/jats:p><jats:p>\n          Conclusion The assessment of shoulder function after proximal humerus fracture showed a very strong correlation within the clinical questionnaires (CS\/NS\/UCLA) and the PROMs (OSS\/DASH). A strong correlation also exists between the clinical questionnaires and the PROMs. There was only a moderate correlation with the EQ-5D. The moderate to strong correlation between the physical components of SF-36, with almost no correlation between the mental components of SF-36, indicates that the quality of life restriction is based on a physical, but not on a mental impairment.<\/jats:p>","DOI":"10.1055\/a-1200-2797","type":"journal-article","created":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T23:04:32Z","timestamp":1600729472000},"page":"638-648","source":"Crossref","is-referenced-by-count":8,"title":["Comparability of Patient-reported Outcome Measures and Clinical Assessment Tools for Shoulder Function in Patients with Proximal Humeral Fracture"],"prefix":"10.1055","volume":"159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8724-9009","authenticated-orcid":false,"given":"Elke","family":"Maurer","sequence":"additional","affiliation":[{"name":"Department for Trauma and Reconstructive Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Bahrs","sequence":"additional","affiliation":[{"name":"Department for Trauma and Reconstructive Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luise","family":"K\u00fchle","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, St Josefs Hospital, Wiesbaden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Ziegler","sequence":"additional","affiliation":[{"name":"Department for Trauma and Reconstructive Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Gonser","sequence":"additional","affiliation":[{"name":"Department for Trauma and Reconstructive Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1758-5688","authenticated-orcid":false,"given":"Laura Emine","family":"Stollhof","sequence":"additional","affiliation":[{"name":"Department for Trauma and Reconstructive Surgery, BG Unfallklinik Tuebingen, Eberhard Karls University Tuebingen"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,9,21]]},"reference":[{"key":"ref1","first-page":"591","article-title":"The treatment of proximal humeral fracture in adults","volume":"110","author":"K J Burkhart","year":"2013","journal-title":"Dtsch Arztebl Int"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/j.jse.2014.08.009","article-title":"Which parameters affect medium- to long-term results after angular stable plate fixation for proximal humeral fractures?","volume":"24","author":"C Bahrs","year":"2015","journal-title":"J Shoulder Elbow Surg"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1302\/0301-620X.96B7.32894","article-title":"The outcome of proximal humeral fractures in the elderly: predictors of mortality and function","volume":"96-B","author":"N D Clement","year":"2014","journal-title":"Bone Joint J"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1651","DOI":"10.1016\/j.injury.2012.04.015","article-title":"Calcar comminution as prognostic factor of clinical outcome after locking plate fixation of proximal humeral fractures","volume":"43","author":"G Osterhoff","year":"2012","journal-title":"Injury"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1302\/0301-620X.101B3.BJJ-2018-0802.R1","article-title":"Outcomes of locking plate fixation with fibular allograft augmentation for proximal humeral fractures in osteoporotic patients: comparison with locking plate fixation alone","volume":"101-B","author":"S H Lee","year":"2019","journal-title":"Bone Joint J"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/1754-9493-7-34","article-title":"Complication rates and outcomes stratified by treatment modalities in proximal humeral fractures: a systematic literature review from 1970\u20132009","volume":"7","author":"A Tepass","year":"2013","journal-title":"Patient Saf Surg"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.injury.2010.11.046","article-title":"Measuring shoulder injury function: common scales and checklists","volume":"42","author":"G P Slobogean","year":"2011","journal-title":"Injury"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.jse.2004.10.009","article-title":"Normalization of the Constant score","volume":"14","author":"L I Katolik","year":"2005","journal-title":"J Shoulder Elbow Surg"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1055\/s-2003-38662","article-title":"Normalwerte der Schulterkraft in Abh\u00e4ngigkeit von Alter und Geschlecht \u2013 Vergleich zum Constant-, UCLA-, ASES-Score und SF-36 Fragebogen","volume":"141","author":"M Thomas","year":"2003","journal-title":"Z Orthop Ihre Grenzgeb"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1080\/17453670610012980","article-title":"Outcome assessment of hemiarthroplasty of the shoulder: a 5-year follow-up with 4 evaluation tools","volume":"77","author":"P Krepler","year":"2006","journal-title":"Acta Orthopedica"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"277","DOI":"10.2106\/JBJS.J.01744","article-title":"Upper extremity-specific measures of disability and outcomes in orthopaedic surgery","volume":"94","author":"M V Smith","year":"2012","journal-title":"J Bone Joint Surg Am"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1302\/0301-620X.88B4.17223","article-title":"Does the disabilities of the arm, shoulder and hand (DASH) scoring system only measure disability due to injuries to the upper limb?","volume":"88","author":"A S Dowrick","year":"2006","journal-title":"J Bone Joint Surg Br"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/1471-2474-4-11","article-title":"The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: longitudinal construct validity and measuring self-rated health change after surgery","volume":"4","author":"C Gummesson","year":"2003","journal-title":"BMC Musculoskelet Disord"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1186\/s12891-019-2795-6","article-title":"Evaluation of the Constant score: which is the method to assess the objective strength?","volume":"20","author":"P Ziegler","year":"2019","journal-title":"BMC Musculoskelet Disord"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.jse.2007.06.022","article-title":"A review of the constant score: modifications and guidelines for its use","volume":"17","author":"C R Constant","year":"2008","journal-title":"J Shoulder Elbow Surg"},{"key":"ref16","first-page":"1048","article-title":"Constant-Score und Neer-Score. Ein Vergleich von Scoreergebnis und subjektiver Patientenzufriedenheit","volume":"104","author":"M Tingart","year":"2001","journal-title":"Unfallchirurg"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"44","DOI":"10.5312\/wjo.v6.i2.244","article-title":"Use of scoring systems for assessing and reporting the outcome results from shoulder surgery and arthroplasty","volume":"6","author":"S Booker","year":"2015","journal-title":"World J Orthop"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/S1058-2746(95)80016-6","article-title":"Shoulder function after displaced fractures of the proximal humerus","volume":"4","author":"K Zyto","year":"1995","journal-title":"J Shoulder Elbow Surg"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1007\/s00068-012-0220-z","article-title":"Shoulder outcome measures: is there a right answer?","volume":"38","author":"J E Beastall","year":"2012","journal-title":"Eur J Trauma Emerg Surg"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"86","DOI":"10.4103\/0019-5413.197554","article-title":"Outcome of anatomic locking plate in extraarticular distal humeral shaft fractures","volume":"51","author":"D Jain","year":"2017","journal-title":"Indian J Orthop"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1302\/0301-620X.78B4.0780593","article-title":"Questionnaire on the perceptions of patients about shoulder surgery","volume":"78","author":"J Dawson","year":"1996","journal-title":"J Bone Joint Surg Br"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1007\/s00402-004-0716-z","article-title":"The German version of the Oxford shoulder score \u2013 cross-cultural adaption and validation","volume":"124","author":"W Huber","year":"2004","journal-title":"Arch Orthop Trauma Surg"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1302\/0301-620X.99B3.BJJ-2016-1028","article-title":"Five-year follow-up results of the PROFHER trial comparing operative and non-operative treatment of adults with a displaced fracture of the proximal humerus","volume":"99-B","author":"H H Handoll","year":"2017","journal-title":"Bone Joint J"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1016\/j.jse.2011.06.010","article-title":"Responsiveness of the EQ-5D in patients with proximal humeral fractures","volume":"20","author":"P Olerud","year":"2011","journal-title":"J Shoulder Elbow Surg"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"521","DOI":"10.7150\/ijms.4503","article-title":"The 36-item short form health survey: reliability and validity in Chinese medical students","volume":"9","author":"Y Zhang","year":"2012","journal-title":"Int J Med Sci"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1186\/s12955-017-0821-7","article-title":"Patient-related outcome of unstable pelvic ring fractures stabilized with a minimal invasive screw-rod system","volume":"15","author":"M Kerschbaum","year":"2017","journal-title":"Health Qual Life Outcomes"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1007\/s00134-002-1345-z","article-title":"Quality of life after intensive care\u2013evaluation with EQ-5D questionnaire","volume":"28","author":"C Granja","year":"2002","journal-title":"Intensive Care Med"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.jse.2017.08.016","article-title":"An international, multicenter cohort study comparing 6 shoulder clinical scores in an asymptomatic population","volume":"27","author":"J M McLean","year":"2018","journal-title":"J Shoulder Elbow Surg"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"e256","DOI":"10.1097\/BOT.0000000000001462","article-title":"A systematic review and standardized comparison of available evidence for outcome measures used to evaluate proximal humerus fracture patients","volume":"33","author":"L L Nowak","year":"2019","journal-title":"J Orthop Trauma"},{"key":"ref30","first-page":"441","article-title":"Correlation between the UCLA and Constant-Murley scores in rotator cuff repairs and proximal humeral fractures osteosynthesis","volume":"53","author":"E A Malavolta","year":"2018","journal-title":"Rev Bras Ortop"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.3109\/09638288.2013.829529","article-title":"Reliability and validity of shoulder function outcome measures in people with a proximal humeral fracture","volume":"36","author":"A T van de Water","year":"2014","journal-title":"Disabil Rehabil"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jse.2016.07.072","article-title":"Reliability, validity, responsiveness, and minimal important change of the Disabilities of the Arm, Shoulder and Hand and Constant-Murley scores in patients with a humeral shaft fracture","volume":"26","author":"K C Mahabier","year":"2017","journal-title":"J Shoulder Elbow Surg"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.jse.2007.04.019","article-title":"A comparison of the Constant and Oxford shoulder scores in patients with conservatively treated proximal humeral fractures","volume":"17","author":"P Baker","year":"2008","journal-title":"J Shoulder Elbow Surg"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"2217","DOI":"10.1007\/s11136-018-1875-7","article-title":"Constant-Murley Score: systematic review and standardized evaluation in different shoulder pathologies","volume":"27","author":"K Vrotsou","year":"2018","journal-title":"Qual Life Res"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/j.jse.2009.10.021","article-title":"The reliability and validity of the Disabilities of Arm, Shoulder, and Hand, EuroQol-5D, Health Utilities Index, and Short Form-6D outcome instruments in patients with proximal humeral fractures","volume":"19","author":"G P Slobogean","year":"2010","journal-title":"J Shoulder Elbow Surg"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1186\/s12891-016-1014-y","article-title":"A validation of the Swedish version of the WORC index in the assessment of patients treated by surgery for subacromial disease including rotator cuff syndrome","volume":"17","author":"S Zhaeentan","year":"2016","journal-title":"BMC Musculoskelet Disord"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"20","DOI":"10.5312\/wjo.v3.i3.20","article-title":"Evaluation of utility in shoulder pathology: correlating the American Shoulder and Elbow Surgeons and Constant scores to the EuroQoL","volume":"3","author":"B T Bafus","year":"2012","journal-title":"World J Orthop"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.joca.2008.05.017","article-title":"The 12-item Oxford Knee Score: cross-cultural adaptation into German and assessment of its psychometric properties in patients with osteoarthritis of the knee","volume":"17","author":"F D Naal","year":"2009","journal-title":"Osteoarthritis Cartilage"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1007\/s00264-013-2265-y","article-title":"Periprosthetic joint infection\u2013effect on quality of life","volume":"38","author":"P Helwig","year":"2014","journal-title":"Int Orthop"}],"container-title":["Zeitschrift f\u00fcr Orthop\u00e4die und Unfallchirurgie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1200-2797.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T23:51:36Z","timestamp":1638402696000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1200-2797"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,21]]},"references-count":39,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2021,12,1]]},"published-print":{"date-parts":[[2021,12]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1200-2797","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1864-6697","1864-6743"],"issn-type":[{"value":"1864-6697","type":"print"},{"value":"1864-6743","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,21]]}}}