International Orthopaedics

, Volume 32, Issue 1, pp 1–6 | Cite as

Outcome evaluation measures for wrist and hand – which one to choose?

  • Manish ChangulaniEmail author
  • Ugochuku Okonkwo
  • Tulsi Keswani
  • Yegappan Kalairajah
Review Article


The aim of this study was to critically analyse the various outcome measures available for assessing wrist and hand function. To this end, an extensive literature search was performed on Medline, PubMed and the Science Citation Index, focusing on terms associated with the method of development of the outcome measures item generation, item reduction, validity, reliability, internal consistency and their strengths and weaknesses. The most commonly used outcome measures described in literature were the DASH score (disability of shoulder, arm and hand questionnaire), the PRWE score (patient-rated wrist evaluation questionnaire), the Brigham and Women's carpal tunnel questionnaire and the Gartland and Werley score. Our study provides very useful evidence to suggest that the PRWE score is the most responsive instrument for evaluating the outcome in patients with distal radius fractures, while the DASH score is the best instrument for evaluating patients with disorders involving multiple joints of the upper limb. The Brigham and Women's score is a disease-specific outcome instrument for carpal tunnel syndrome; it has been validated and demonstrated to show good responsiveness and reliability in evaluating outcome in patients with carpal tunnel release. The Gartland and Werley score, although the most commonly described instrument in the literature for evaluating outcome after wrist surgery, has not been validated so to date.


Grip Strength Carpal Tunnel Syndrome Carpal Tunnel Distal Radius Fracture Hand Function 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Le but de ce travail est d’analyser de façon critique les différents scores fonctions du poignet et de la main. Une analyse importante de la littérature a été réalisée sur Medline, PubMed et l’Index Science Citation. Cette analyse a été complète prenant en compte les différents scores. La méthode de mesure la plus habituelle a été le score DASH pour les lésions de l’ épaule, du bras et de la main, le score PRWE (pour le poignet), celui de Brigham pour le canal carpien et surtout le poignet, le score de Gartland et celui de Werley. Notre étude permet de mettre en évidence que le score le plus adapté pour les fractures de l’extrémité distale du radius est le score PRWE. Le score DASH est le meilleur instrument pour mesurer les atteintes multiples des articulations des membres supérieurs. Le score de Brigham est spécialement adapté au syndrome du canal carpien, le score de Gartland et Werley est le score le plus habituellement utilisé dans la littérature pour évaluer la chirurgie du poignet.


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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Manish Changulani
    • 1
    Email author
  • Ugochuku Okonkwo
    • 1
  • Tulsi Keswani
    • 2
  • Yegappan Kalairajah
    • 1
  1. 1.Orthopaedic Research UnitSouth West London Elective Orthopaedic Centre (SWLEOC)EpsomUK
  2. 2.Flat 2, Windsor HouseCarlisleUK

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