Thirty patients who had sustained a Colles' fracture at least four years previously were examined functionally and radiographically. Seventeen had a good radiological result and 13 were considered to have malunion. Functionally the displaced group performed significantly worse than the undisplaced group. We conclude that malunion of a Colles' fracture results in a weak, deformed, stiff and probably painful wrist.
In studies of hand function recently carried out in Edinburgh, one of the problems was to find valid comprehensive measures of outcome following trauma or elective surgery. A small supplementary study was therefore undertaken to examine some commonly used tests of strength and dexterity, and to compare the results with the use of the hand in activities of daily living (ADL). The results indicated that ADL function was more closely correlated with strength than with dexterity. However, no test used in isolation gave a realistic description of hand function for either rheumatoid or trauma patients. It is therefore suggested that a battery of tests, including ADL assessment related to individual need, is necessary. INTRODUCflONA series of studies into the causes. management and consequences of hand injury has recently been carried out in Edinburgh. I A problem encountered in this work was the apparent lack of reliable comprehensive measures of hand function. despite the obvious necessity for providing reliable. repeatable evidence of outcome when advocating surgical techniques, the provision of orthoses and prostheses, or therapy.It was found that assessment programmes used by therapists were many and varied. Many tests were time consuming, some had no established normal values, and others were difficult to replicate because of inadequate description of method. It is desirable that tests should provide some information on the ability of the hand to carry out everyday tasks. Sollerman and Sperling2 found the handgripstested in the widelyquoted Rancho Los Amigos tests were in fact seldom spontaneously used in everyday life. The correlation between strength, dexterity and other parameters necessary to achieve integrated hand function appears to have been relatively unexplored.The aim of this study was to examine some published tests of strength and dexterity and to compare the results with tests of integrated hand function when used to carry out activities of daily living (ADL). A secondary aim was to see how feasible it was to replicate and use these tests from the published description of them. and to examine the ease with which patients could use the equipment. MATERIAL AND METHODSSix methods of measuring hand function currently in use in the three main hospitals responsible for the hand service in Edinburgh were examined. Twenty-five consecutive patients referred by one consultant for comprehensive hand assessment formed the study sample. These patients were a heterogeneous group referred for assessment and rehabilitation from both trauma and rheumatoid clinics; 16 patients had rheumatoid arthritis (RA) and the remainder were receiving treatment for post-traumatic stiffness, contractures or peripheral nerve injuries. Eleven patients were male and 14 female; the age range was 22-67years and the mean age was 50.8 years. Of the 16 rheumatoid patients, 4 were male and 12 female. Four patients were left handed and 19 had bilateral problems.• Mr Dent is now at the Department of Orthopaedic and Traumatic Surgery, Royal In...
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