Purpose
Any loss of range of motion of the finger after flexor tendon repair is an impairment
of function, but to what extent it causes disability is not properly understood. The
aim of this study was to assess the correlation between perceived function (disability)
and objectively measured loss of function (impairment), to understand what impairments
are meaningful to patients.
Methods
We assessed 49 patients who underwent flexor tendon repair an average of 38 months
after repair. We measured the perceived function with the visual analog scale, the
4-step rating scale (poor, fair, good, or excellent), and the Disabilities of the
Arm, Shoulder, and Hand (DASH) score. The objective measurement of impairment included
active range of motion at each joint, total active motion, grip strength, and 2-point
discrimination. We also converted range of motion into 4 categories (poor, fair, good,
and excellent) following guidelines from 3 different classification systems (American
Society for Surgery of the Hand, Strickland–Glocovac, and revised Strickland). We
used Spearman ρ and linear regression to assess the correlation.
Results
Active range of motion at the distal interphalangeal joint had a strong correlation
and total active range of motion of the finger joints had a moderate correlation with
perceived function measured using the visual analog scale and DASH score. Other measured
impairments did not correlate with perceived function. Objective classification categories
also did not correlate with the patient’s own assessment.
Conclusions
Our results validate the use of range of motion and the DASH questionnaire in assessing
flexor tendon repairs. Classification of angular measurement according to the tested
systems does not reflect the patient’s perspective; it limits the precision of the
measurement and adds little value to the measurement itself.
Type of study/level of evidence
Prognostic IV.
Key words
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References
- Pain, impairment, and disability in the AMA guides.J Law Med Ethics. 2004; 32: 315-326
- Measuring outcomes in hand surgery.Clin Plast Surg. 2013; 40: 313-322
- Clinical outcomes associated with flexor tendon repair.Hand Clin. 2005; 21: 199-210
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Article Info
Publication History
Published online: August 13, 2018
Accepted:
May 29,
2018
Received:
November 12,
2017
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2019 by the American Society for Surgery of the Hand. All rights reserved.
