The average of three consecutive measurements is the most frequently used method for grip strength assessment. The purpose of this study was to compare the consistency of the maximum value with that of the average value of three consecutive measurements of grip strength. One hundred healthy volunteers participated in this study. Three measurements of grip strength were taken on two occasions separated by 2 weeks. For each hand, two average values and two maximum values were obtained. Ninety-five per cent limits of agreement for the average method were - 8.3 (-23%) to +7.2 (+20%)kg and for the maximum method were - 8.8 (-23%) to + 8 (+21%)kg. Both methods of grip strength assessment were found to be highly consistent with no statistically significant difference.

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We reviewed 13 patients with a complex fracture-dislocation of the proximal interphalangeal joint of a finger and one patient with a complex fracture-dislocation of the interphalangeal joint of thumb. We had treated these injuries using a pins and rubbers traction system which had been modified to avoid friction of the pins against the bone during mobilisation of the joint in order to minimise the risk of osteolysis. A Michigan hand outcome questionnaire was used for subjective assessment. The active range of movement (AROM) of the proximal and distal interphalangeal joints and the grip strength were used for objective assessment. The mean follow-up was 34 months (12 to 49). The mean normalised Michigan hand outcome score was 84. The mean AROM of the proximal interphalangeal joint was 85 degrees and that of the distal interphalangeal joint 48 degrees. The mean grip strength was 92% of the uninvolved hand. Twelve patients have returned to their original occupations. There has been no radiological osteolysis or clinical osteomyelitis. This modified traction system has given acceptable results with a low rate of complications. It is light, cheap, effective and easy to apply.

We have reviewed prospectively 44 cases of chronic scapholunate dissociation treated by Blatt's dorsal capsulodesis. The diagnosis was based on clinical and arthroscopic criteria. The minimum follow-up was 2 years. The results were analysed clinically and radiologically. Postoperatively statistically significant reductions in wrist movements and grip strengths were noted. Delay in surgery and presence of compensation claims were also statistically significant factors. Patients with a high column/row index had higher overall good and excellent results. The scapholunate gap, scapholunate angle, carpal height and the type of instability as diagnosed on arthroscopy and cineradiography did not affect the outcome significantly. The scapholunate gap, scapholunate angle and the carpal height did not change significantly after operation.

The purpose of this study was to evaluate the relationship between radiological and functional results in patients with extra-articular fractures of the distal radius. We conducted a prospective study of radiological and functional assessment in 95 consecutively selected extraarticular distal radius fractures. There were two patient groups: more than 60 and less than 60 years of age. The final fracture union radiographs were analysed for their functional outcome using the Michigan Hand Outcomes Questionnaire (MHQ) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. In patients with acceptable radiological results, 62% (MHQ group) and 72% (DASH group) of patients had satisfactory functional outcome. Analysing patients with satisfactory functional results, 56% (MHQ group) and 59% (DASH group) had satisfactory radiological results. There was a higher proportion of patients with better functional results, despite poor radiological results, in both of the age groups. There was a statistically significant correlation between satisfactory radial tilt and functional outcome in the younger patients. In the older age group, patients with satisfactory radiological results had satisfactory functional outcome (p<0.05). However, in the older age group, satisfactory functional results were achieved, despite unsatisfactory radiological results.Résumé Le propos de cette étude est d'évaluer les relations entre les résultats radiologiques et fonctionnels des patients ayant présenté une fracture extra articulaire de l'extrémité distale du radius. Une étude prospective et radiologique a été menée chez 95 patients consécutifs présentant ce type de fractures. Ils ont été divisés en deux groupes, le groupe de plus de 60 ans et le groupe de moins de 60 ans. La consolidation finale, radiographique, a été analysée de même que le résultat fonctionnel en utilisant le score de Michigan et le questionnaire DASH. Si l'on prend les patients présentant un résultat radiologique acceptable, 62% selon le score Michigan et 72% selon le score DASH, ceuxci ont un résultat fonctionnel satisfaisant. Si l'on analyse les patients à partir du score fonctionnel : 56% ayant un score Michigan satisfaisant et 59% un score DASH satisfaisant ceux-ci ont une consolidation radiologique également satisfaisante. Les résultats montrent qu'il existe une proportion élevée de patients ayant un score fonctionnel satisfaisant en dépit d'un résultat radiologique peu satisfaisant dans chaque groupe d'âge. De même il existe une relation statistiquement significative entre la bascule de l'extrémité distale du radius et le résultat fonctionnel chez les patients jeunes. Dans le groupe des patients âgés de plus de 60 ans ceux qui ont un résultat radiologique satisfaisant ont également un résultat cliniquement satisfaisant (p<0.05). Cependant dans le groupe des patients les plus âgés les résultats fonctionnels satisfaisants sont observés malgré des résultats radiologiques peu satisfaisants.