Responsiveness of the Michigan Hand Outcomes Questionnaire and physical measurements in outcome studies of distal radius fracture treatment.

PURPOSE: Outcomes study of distal radius fracture (DRF) treatment has been hampered by an uncertainty regarding the most appropriate outcomes assessment tool to evaluate the effectiveness of treatment. This study aimed to measure the responsiveness of the Michigan Hand Outcomes Questionnaire (MHQ) and physical measurements to assess the value of these outcomes tools for DRF studies.

METHODS

Forty-seven patients prospectively completed the MHQ and physical testing at 3 months and 6 months (period 1) after open reduction and internal fixation of unstable DRFs. Thirty-seven patients prospectively completed the MHQ and physical testing at 6 months and 1 year after open reduction and internal fixation (period 2). Responsiveness to clinical change within each period was calculated with standardized response means (SRMs).

RESULTS

In period 1, all domains of the MHQ except aesthetics significantly improved. The SRMs were large for the overall score and for the work domain. The SRMs were medium for the pain, function, and activities of daily living domains. In period 1, the grip strength, pinch strength, and active wrist range of motion measurements significantly improved and had large SRMs. In period 2, the grip- and pinch-strength tests significantly improved and the SRMs were medium, whereas the active wrist range of motion had a small SRM.

CONCLUSIONS

Unlike other conditions such as carpal tunnel syndrome, for which the outcomes questionnaire is the most responsive measure, in DRF treatment both the MHQ and physical tests are responsive in measuring outcomes and should be reported for outcomes studies of DRFs. The MHQ and physical tests can be used for outcomes research related to DRF with the advantage of also being useful for assessing and comparing outcomes for other hand disorders.