Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not .
Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population .
A Comparative Study of Clinical and Radiologic Outcomes of Unstable Colles Type Distal Radius Fractures in Patients Older Than 70 Years: Nonoperative Treatment Versus Volar Locking Plating
Objectives : To compare final functional and radiographic outcomes of closed reduction and casting ( CAST ) with open reduction and internal fixation ( ORIF ) with palmar locking plate for unstable Colles type distal radius fractures ( DRFs ) in low-dem and patients older than 70 years . Design : Retrospective , clinical study . Setting : Level 1 university trauma center . Patients : Over a mean period of 4 years and 7 months , 130 consecutive patients older than 70 years were treated for an unstable dorsally displaced DRF of which 114 or 87 % were followed for 1 year or longer . Intervention : ORIF ( n = 53 ) using volar locking plate or closed reduction and casting ( n = 61 ) . Main Outcome Measurements : Objective and subjective functional results ( active range of motion ; grip strength ; disabilities of the arm , shoulder and h and ( DASH ) score ; patient-rated wrist evaluation ( PRWE ) score ; visual analog scale ; and Green and O'Brien score ) and radiographic assessment ( dorsal tilt , radial inclination , radial shortening , fracture union , and posttraumatic arthritis ) were assessed . Results : At final follow-up , there was no significant difference between the 2 groups for mean ranges of motion , grip strength , DASH score , PRWE score , and Green and O'Brien score . Pain level was significantly less for the patients in the CAST group . An obvious clinical deformity was present in 77 % of cast group and none in the ORIF group . At final follow-up , in the ORIF group , there was a mean loss of dorsal tilt of 1.3 degrees , radial inclination of 0.3 degrees , and radial length of 0.5 mm compared with the postoperative measurements . No primary acceptable reduction was achieved in 44 % of the CAST group . At final follow-up , in the CAST group , dorsal tilt , radial inclination , and radial shortening averaged −24.4 ± 12 degrees , 19.2 ± 6.5 degrees , and + 3.9 ± 2.7 mm , respectively . Malunion occurred in 89 % primarily reduced fractures . Dorsal tilt , radial inclination , and radial shortening were significantly better in the ORIF group . Conclusions : Radiographic results ( dorsal tilt , radial inclination , and radial shortening ) after unstable dorsally displaced DRFs are significantly better in patients treated by ORIF using a volar fixed-angle plate rather than those treated by cast immobilization ( P < 0.05 ) . At a mean follow-up time of 4 years and 7 months , the clinical outcomes of active range of motion , the PRWE , DASH , and Green and O'Brien scores do not differ between the 2 methods of treatment . The pain level was significantly less in the CAST group ( P < 0.05 ) , and this group experienced no complications . There was no difference between the subjective and functional outcomes for the surgical and the nonsurgical treatments in a cohort of patients older than 70 years .  Unsatisfactory radiographic outcome in older patients does not necessarily translate into unsatisfactory functional outcome . Nonoperative treatment may be the preferred method of treatment in this age group
Only the DASH and PRWE have evidence of reliability , validity , and responsiveness in patients with traumatic injuries to the h and and wrist ; other measures either have incomplete evidence or evidence gathered in a nontraumatic population .
Conclusions : The DASH and PRWE both have evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
Other PROMs used to assess h and and wrist trauma patients do not .
Background : Patient-reported outcome measures ( PROMs ) are important tools for assessing outcomes following injuries to the h and and wrist .
Many commonly used PROMs have no evidence of reliability , validity , and responsiveness in a h and and wrist trauma population .
This systematic review examines the PROMs used in the assessment of h and and wrist trauma patients , and the evidence for reliability , validity , and responsiveness of each measure in this population .