Three-dimensional assessment of hand outcome

Abstract

Introduction Patient reported outcome measures are central to National Health Service quality of care assessments. This study investigated the benefit of elective hand surgery by the simultaneous analysis of pain, function and appearance, using a three-dimensional (3D) graphical model for evaluating and presenting outcome. Methods A total of 188 patients scheduled for surgery completed pre- and postoperative questionnaires grading the severity of their pain, dysfunction and deformity of their hand(s). Scores were plotted on a 3D graph to demonstrate the degree of ‘normalisation’ following surgery. Results Surgical groups included: nerve compression (n=53), Dupuytren’s disease (n=51), trigger finger (n=20), ganglion (n=17) or other lump (n=21), trapeziometacarpal joint osteoarthritis (n=10), rheumatoid disease (n=5) and other pathology (n=13). A significant improvement towards normality was seen after surgery in each group except for patients with rheumatoid disease. Conclusions This study provides a simple, visual representation of hand surgery outcome by plotting patient scores for pain, function and appearance simultaneously on a 3D graph.

The Importance of Hand Appearance as a Patient-Reported Outcome in Hand Surgery

“… 10 – 14 Assessing aesthetics can be a powerful method of demonstrating the patients’ perspective on surgical interventions. 15 – 17 For example, Chung et al 16 found that hand appearance is a valued outcome for rheumatoid arthritis patients with severe hand deformity undergoing silicone metacarpophalangeal arthroplasty. In fact, aesthetic consideration was the most important outcomes domain over function.…”