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New tool to measure outcomes could help improve arm surgery for devastating nerve injury
Date:5/19/2011

asured sensation and only 8 percent recorded assessments of pain. No article reported all five outcome measurements: strength, range of motion, functional scores, sensibility, and pain. The maximum number of outcomes a paper reported was three (14 percent of papers), and the remaining articles reported only one or two outcomes.

In a second study, the same investigators describe a first draft of a tool that they hope clinicians can use so that the reporting of outcomes is standardized. "What we are doing is presenting this to the international community to get buy in on the concept," said Scott W. Wolfe, M.D., hand and upper extremity surgeon and director of the soon-to-open Hospital for Special Surgery Center for Brachial Plexus and Complex Nerve Injury. "This is a first iteration and we hope the group will respond favorably, but we'd like to get researchers and plexus surgeons from the Far East, Europe, the States and South America to work together to design a system that we all feel will function effectively for our patients."

Dr. Wolfe said they had looked at different tools that doctors were using to see if they could come up with one that would work for brachial plexus surgery, but none of them were adequate and inclusive. "We had to take elements of different instruments as well as elements that we designed to derive a complete system," Dr. Wolfe said. "We're studying an injury of several critical nerves, an injury that affects the arm in a way that is very different from that of a fracture or degenerative disease. We needed to design an innovative way to analyze and report outcomes, because we're simultaneously assessing nerve, muscle and joint recovery. By way of example, although a patient's nerves could recover beautifully in a particular case, if their shoulder is frozen or their hand atrophied, the patient may not have a functional recovery; unless all elements are assessed, the analysis is incomplete."

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Contact: Phyllis Fisher
phyllis.fisher@gmail.com
212-606-1197
Hospital for Special Surgery
Source:Eurekalert

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