gms | German Medical Science

Objectives/Interrogation: This study aims to investigate the effect of both conservatively and surgically managed wrist trauma on the dart throwing motion (DTM) and to explore any relationship between DTM and patient-rated wrist evaluation (PRWE) scores.

Methods: For this study, 21 patients with unilateral wrist trauma were recruited during their first appointment to the hand therapy clinic. Patients were categorised in three groups based on their injury and type of treatment. Each patient was asked to perform DTM using a dart-like object, including object release, with both hands. Clinical measurements, including goniometric measurements of DTM range of motion and PRWE scores, were recorded by hand therapists at each appointment. Grip strength measurements were performed if it was considered appropriate by the therapist. Wrist kinematics were measured using a nine-camera optical motion capture system and a robust regression analysis was used to define the DTM plane orientation. All measurements were repeated on ten patients during a follow-up appointment, once they were discharged from the clinic. Wilcoxon signed-rank tests were used to assess all differences.

Results and Conclusions: Regardless of the type of the injury, all patients were able to perform DTM. Significant differences were found in the range of motion along DTM between the injured and the healthy hand at the start of the therapy (p=0.001). At the time of discharge, no differences were observed between the two hands (p>0.5). No significant differences were found in the DTM plane orientation between the injured and the healthy hand at early stages of the rehabilitation (p>0.8). The PRWE scores presented significant differences at the two stages of the therapy (p=0.008). A correlation was defined between the PRWE scores and the product of the range of motion along DTM and the grip strength measurements. These findings suggest that although wrist injury has a significant effect on the range of motion of the wrist, the orientation of the DTM plane is not affected equally. The correlation of patient-rated scores with objective functional measures, such as the range of motion along DTM and the grip strength, can further confirm their validity and improve our understanding of the underlying factors affecting these questionnaires.