Jnl Wrist Surg 2018; 07(03): 211-218
DOI: 10.1055/s-0037-1612594
Scientific Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Long-Term Functional Results of a Wrist Exercise Program for Patients with Palmar Midcarpal Instability

M. A. M. Mulders
Department of Plastic, Reconstructive, and Hand Surgery, Academic Medical Center, Amsterdam, The Netherlands
,
G. S. I. Sulkers
Department of Plastic, Reconstructive, and Hand Surgery, Academic Medical Center, Amsterdam, The Netherlands
,
A. J. Videler
Hand and Wrist Center Amsterdam, Amsterdam, The Netherlands
,
S. D. Strackee
Department of Plastic, Reconstructive, and Hand Surgery, Academic Medical Center, Amsterdam, The Netherlands
,
M. J. C. Smeulders
Department of Plastic, Reconstructive, and Hand Surgery, Academic Medical Center, Amsterdam, The Netherlands
› Author Affiliations
Further Information

Publication History

27 July 2017

07 November 2017

Publication Date:
21 December 2017 (eFirst)

Abstract

Background Patients with palmar midcarpal instability have symptoms of pain, combined with clinical signs of abnormal mobility on stressing the joint, an unpredictable blockade feeling, and a noticeable clunk, in the absence of an underlying trauma. No data are available on the effect of conservative treatment for these patients.

Purpose The purpose of this study was to evaluate the effect and the long-term functional outcomes of a wrist exercise program in patients with palmar midcarpal instability.

Patients and Methods All patients diagnosed with palmar midcarpal instability between 2005 and 2011 were included. Patients completed the Patient-Rated Wrist and Hand Evaluation (PRWHE) and the Short Form-36 health (SF-36) questionnaires, scaled their perceived pain before and after treatment, and indicated the effect of the received treatment.

Results A total of 119 patients diagnosed with palmar midcarpal instability were included. The median follow-up time was 6 years (IQR 4.5–7.0). The median PRWHE score after hand therapy was 35.5 and the median mental component of the SF-36 score was 53.9 and the physical component was 45.2. The median perceived pain reduced from eight to four and the median therapeutic effect of the wrist exercise program was five.

Conclusion Although palmar midcarpal instability remains to be a chronic disease, the effectiveness of our wrist exercise program is promising with acceptable long-term functional results and a good quality of life.

Level of Evidence Level IV, retrospective cohort study.

Note

Ethical approval was obtained from the Institutional Review Board of our Hospital before start of this study, without the need for informed consent. This study was conducted at the Department of Plastic, Reconstructive, and Hand Surgery of the Academic Medical Center in Amsterdam, the Netherlands.