Assessment following Hand Trauma: A Review of some Commonly Employed Methods

2002 ◽  
Vol 7 (3) ◽  
pp. 79-84 ◽  
Author(s):  
Catherine BÜCher ◽  
Kenneth I Hume

Accurate assessment strategies underpin appropriate implementation and review of surgical and therapeutic intervention. This paper explores some of the commonly described assessment methods used following hand injury, including measures of range of motion (ROM), strength, sensation, hand function and patient self-evaluation. The strengths and limitations of some methods are discussed. It is suggested that accurate assessment tools and standardised approaches to assessment will promote effective evaluation of intervention. In addition long-term review and comparative studies may be facilitated by such an approach.

1970 ◽  
Vol 7 (1) ◽  
pp. 15-19
Author(s):  
Md Shamsuzzaman ◽  
SK Borhan Uddin ◽  
Md Masoom ◽  
Md Anowarul Islam ◽  
Azizul Haque

Fifty cases of hand trauma of different aetiology with soft tissue loss with exposed tendons and bones were treated in NITOR and DMCH, Dhaka between January '97 and December '02 with groin flap. Eighty three percent (83%) cases have good results with excellent flap adhesion and no flap loss. Seventeen percent (17%) cases have some degree of flap loss which were taken to be acceptable. Overall result in terms of restoring the hand function was encouraging which was approximately eighty eight percent (88%).   DOI = 10.3329/jom.v7i1.1357 J MEDICINE 2006; 7 : 15-19


2020 ◽  
Vol 16 (2) ◽  
pp. 23-28
Author(s):  
A.K. Rushai ◽  
L.V. Bogdanova ◽  
F.V. Klymovytskyy ◽  
S.V. Lisunov

Relevance. Fractures of the distal metaepiphysis of the radial bone among all fractures range from 11% to 30%. Unsatisfactory results of treatment in patients over 70 years old are found in 44% of cases. Timely and adequate rehabilitation treatment is important for obtaining good results in the treatment of such patients. Objective: to improve the results of the treatment of patients with fractures of the distal metaepiphysis of the radial bone based on early comprehensive individual rehabilitation treatment. Materials and methods. 97 patients with displaced fractures of the distal metaepiphysis of the radius were observed. Among them, 67 are women (69.1%), over 50 years old – 64 (66%). Used conservative treatment with a sparing technique of one-stage reduction. Upon completion of the correction, according to the indications, measures were prescribed for the prevention of neurodystrophic syndrome, depending on the likelihood of its development (according to the temperature gradient of the fingers of the extremities) in the form of drug therapy. Massage, kinesiotherapy, and physiotherapy began on the second day. The pain intensity was determined using a visual analog scale. The nature of pain was determined by the DN4 questionnaire (questionnaire for the diagnosis of neuropathic pain). For subjective unified assessment of hand function in the long term after a hand injury, I used a specific questionnaire DASH (Disability of the Arm, Shoulder and Hand Outcome Measure) – a questionnaire of outcomes and disability of the hand and hand. Results. Rehabilitation treatment at admission and at the early outpatient stage was complex, individual, taking into account the periods of illness. The debris correction was painless, low-traumatic, rational fixing bandages were used. The volume of drug therapy was determined by the value of the temperature gradient of the fingers. Conclusion. The proposed method for the rehabilitation of patients with fractures of the distal metaepiphysis of the radius is highly effective: good and satisfactory (according to the DASH scale) results were obtained in 97.8% of cases, unsatisfactory – in 2.2%.


2019 ◽  
Author(s):  
ADIL FATHELRAHMAN

<p>This paper investigates application of holistic approach to teaching and assessment and applies selected strategies to measure the effectiveness of such approach using results from teaching <strong>a Decision Support Systems (DSS) Course. Assessment is an integral part of the learning cycle and for any teaching strategy to succeed, teaching should be aligned with assessment strategies.</strong><strong></strong></p> <p><br></p><p>The strategies used in this paper for measurement of <strong>the effectiveness of the holistic approach </strong>are student ratings, self-evaluation, and learning outcome measures.<strong></strong></p>


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Westley ◽  
H Creasy ◽  
R Mistry

Abstract Introduction The Queen Victoria Hospital (QVH) was designated a cancer and trauma hub during the COVID-19 pandemic. With this, a new virtual hand trauma clinic was set up. We assess accuracy of assessment within this virtual set-up with comparison to pre COVID-19 face-to-face assessment. Method Two weeks of clinic sessions during and pre lockdown were analysed. Initial assessment was compared with the patient's operation note. Results In the pre COVID-19 two-week period 129 face-to-face appointments were analysed. Of 99 patients that required surgery 77 (78%) had an accurate assessment. 6 were overestimated, 12 were underestimated. 189 patients were seen over two weeks during lockdown via telephone or video call. Accuracy of assessment increased with seniority of the clinician. Of 126 patients that required an operation 109 (87%) had an accurate assessment; all structures injured were correctly predicted. 12 were overestimated, 5 had their injury underestimated. Conclusions The new virtual clinic allowed patients to be remotely assessed during lockdown, reducing footfall and unnecessary journeys. We found that virtual clinic assessments are accurate, and no patient underwent an unnecessary procedure. Using a telephone call plus photo gave similar accuracy as a video call. Virtual assessment was more accurate than face-to-face assessment.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Michał Waszczykowski ◽  
Bożena Dziankowska-Bartkowiak ◽  
Michał Podgórski ◽  
Jarosław Fabiś ◽  
Arleta Waszczykowska

AbstractThe aim of this study was to estimate the long-term results of complex and supervised rehabilitation of the hands in systemic sclerosis (SSc) patients. Fifty-one patients were enrolled in this study: 27 patients (study group) were treated with a 4-week complex, supervised rehabilitation protocol. The control group of 24 patients was prescribed a home exercise program alone. Both groups were evaluated at baseline and after 1-, 3-, 6-, and 12-months of follow-up with the Disability of the Arm, Shoulder and Hand Questionnaire (DAHS) as the primary outcome, pain (VAS—visual analog scale), Cochin Hand Function Scale (CHFS), Health Assessment Questionnaire Disability Index (HAQ-DI), Scleroderma-HAQ (SHAQ), range of motion (d-FTP—delta finger to palm, Kapandji finger opposition test) and hand grip and pinch as the secondary outcomes. Only the study group showed significant improvements in the DASH, VAS, CHFS and SHAQ after 1, 3 and 6 months of follow-up (P = 0.0001). Additionally, moderate correlations between the DASH, CHFS and SHAQ (R = 0.7203; R = 0.6788; P = 0.0001) were found. Complex, supervised rehabilitation improves hand and overall function in SSc patients up to 6 months after the treatment but not in the long term. The regular repetition of this rehabilitation program should be recommended every 3–6 months to maintain better hand and overall function.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 602-602
Author(s):  
Rachael Spalding ◽  
Peter Lichtenberg

Abstract Despite surrounding social stigma and stereotypes of the “asexual older adult,” older adults, including those residing in long-term care facilities, indicate that expressing their sexuality continues to be important to them (Doll, 2013). This presentation will feature presentations regarding recent research and perspectives relevant to late-life sexuality with a focus on how issues of sexual expression may particularly emerge in long-term care settings. Dr. Maggie Syme will present findings from mixed-methods, consumer-based approaches that elucidate how current and future long-term care residents view late-life sexuality, with a focus on the practical applications of these findings to inform facility administration and policies. Ethical and legal issues surrounding sexuality in long-term care will be discussed by Dr. Pamela Teaster, who will present ethical models that can translate into potential best-practice recommendations and strategies. Rachael Spalding will discuss the paucity of psychometrically sound assessment tools for measuring attitudes towards late-life sexuality and discuss their development of such a measure. Finally, Dr. Lilanta Bradley and Dr. Pamela Payne-Foster will present a framework for sexual agency in late-life and identify relevant gaps in the literature regarding gender, ethnicity/race, and geographical differences. Ultimately, this presentation will offer a forum for lively discussion among attendees regarding these pertinent topics.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
R Mistry

Abstract Introduction Scarring is the final common pathway for healing within the skin. Scars can be itchy, painful, tight, and disfiguring. Despite advances in surgery there is currently no reliably effective treatment for reducing or preventing scarring. The primary aim of this research is to assess the currently available models for scarring and evaluate/further develop the utility of current assessment tools, in an effort to design a pilot randomised control trial (RCT) for silicone gel treatment of scars. Method A systematic review of scar models in humans and animals. Examination of currently used subjective and objective scar assessment tools in a plastic surgery scar clinic. A retrospective cohort study assessing long-term scar outcomes in paediatric burn patients. Results Limitations and drawbacks of many existing methods to assess scar treatments were found. No statistically significant difference in long-term scarring outcomes was found between paediatric burns patients treated surgically versus conservatively. A RCT for silicone gel sheeting in the treatment of scars was set up and successful in recruitment. Conclusions Here, we have demonstrated difficulties in establishing a scientific scar treatment model; and created a pilot study that will help to provide high-quality evidence for the efficacy of silicone gel sheeting as a treatment for scars.


2021 ◽  
pp. 030802262110080
Author(s):  
Ilkem Ceren Sigirtmac ◽  
Cigdem Oksuz

Introduction The Purdue Pegboard Test (PPT) is crucial for assessing fine dexterity of patients with hand injury. Determining the PPT cutoff value is needed to distinguish patients with impaired hand dexterity from those with unimpaired hand dexterity. The aim of this article is to examine the construct validity of PPT and to determine its cutoff values for patients with hand injuries. Method The PPT and Disabilities of Arm Shoulder and Hand Questionnaire Turkish version (DASH-T) were used to measure hand dexterity. To examine construct validity, we measured the correlation between PPT and DASH-T. The cutoff values were determined using the receiver operating characteristic (ROC) curve generated with sensitivity and 1-specificity. We recruited 101 patients with hand injury and 162 healthy participants. Results Correlation between all subtests of PPT and DASH-T were weak ( r = −0.282; −0.473: p<0.05). The cutoff value for the assembly subtest of PPT was 24.5. The range of area under the curve (AUC) values for PPT subtests was good to excellent (AUC: 0.82–0.92). Conclusion The current study demonstrates that PPT is a valid instrument for measuring hand dexterity in patients with hand injury. Results also suggest that PPT distinguished the patients with impaired hand function from those with unimpaired hand dexterity.


Author(s):  
Patrick Alexander Wachholz ◽  
Deborah Cristina De Oliveira ◽  
Kathryn Hinsliff-Smith ◽  
Reena Devi ◽  
Paulo José Fortes Villas Boas ◽  
...  

This scoping review aimed to explore the characteristics, strengths, and gaps in research conducted in Brazilian long-term care facilities (LTCFs) for older adults. Electronic searches investigating the residents (≥60 years old), their families, and the LTCF workforce in Brazil were conducted in Medline, EMBASE, LILACS, and Google Scholar, within the timescale of 1999 to 2018, limited to English, Portuguese, or Spanish. The reference lists were hand searched for additional papers. The Mixed Methods Appraisal Tool (MMAT) was used for critical appraisal of evidence. Data were reported descriptively considering the study design, using content analysis: 327 studies were included (n = 159 quantitative non-randomized, n = 82 quantitative descriptive, n = 67 qualitative, n = 11 mixed methods, n = 6 randomized controlled trials, and n = 2 translation of assessment tools). Regardless of the study design, most were conducted in a single LTCF (45.8%), in urban locations (84.3%), and in non-profit settings (38.7%). The randomized trials and descriptive studies presented the lowest methodological quality based on the MMAT. This is the first review to provide an overview of research on LTCFs for older people in Brazil. It illustrates an excess of small-scale, predominantly qualitative papers, many of which are reported in ways that do not allow the quality of the work to be assured.


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