gms | German Medical Science

Objective: Measuring outcome following surgery is important for evaluating and comparing surgery and rehabilitation results. In the upper extremity, sensorimotor testing should address dominant side differences, since hand dominance may cause a bias in evaluations. Our purpose was to evaluate the effect of hand-dominance on sensorimotor testing following surgery for distal radius fractures (DRF).

Materials and Methods: Database: patients treated surgically with volar plating for DRF. Patients underwent postoperative hand therapy according to standard of care. Evaluation was performed immediately post-surgery, at 6 weeks, and 3 months post-surgery. Information collected: age, gender, hand-dominance, injured hand, background disease, fracture characteristics, complications, motion, grip-strength. Testing included: blinded Semmes Weinstein monofilaments, two-point discrimination, Moberg and stereognosis testing.

Results: Sixty patients (76.6% females) aged 62.1(16.9) years were included, 54 were right-handed. There were differences in injured hand-dominance performing Semmes Weinstein and Moberg testing with eyes closed at initial evaluation (p<0.001) and thumb sensation at 3 months (p=0.003). All patients improved between initial and final evaluation. No differences were found in amount of change.

Conclusions:

1.

This study does not support correction for hand-dominance when evaluating outcomes following surgery for DRF, though some differences in sensorimotor testing were found.

2.

It is possible that the tests evaluated are not sensitive enough to discover the effect of hand dominance on function following injury.

3.

Further study to evaluate the effect of hand dominance in "normal" patient function may aid in improved understanding of this effect on outcomes testing.