Cumulative Incidence of Carpal Instability in the Second Year after a Fall onto Outstretched Hand

Lisa J. O'Brien, Luke Robinson, Hayley O'Sullivan

Research output: Contribution to journalMeeting Abstractpeer-review

Abstract

Purpose: Using established clinical and radiological measures, we aimed to establish the cumulative incidence of carpal instability in people who have fallen onto an outstretched hand in the second year post injury. We also sought to describe its relationship with functional impairment. Methods: We used emergency department records of an innerurban tertiary hospital to contact all patients who presented with wrist pain following fall onto outstretched hand who were now between one and two years post injury. Carpal instability was defined by blinded radiological evaluations and provocative clinical tests, including Scaphoid Shift (Watson’s) test, Ballottement, and mid-carpal shift test. Wrist-related pain and disability was measured using the Patient-Rated Wrist and Hand Evaluation. Results: Fifty (28 male, 22 female; mean age of 47.8 years) of 146 eligible patients attended for assessment. We found a cumulative incidence of 44% of carpal instability within the second year post injury. Of these, 12 (24%) cases had SL dissociation, 12 (24%) had luno-triquetral instability and 7 (14%) had midcarpal instability. There were no significant correlations between clinically confirmed carpal instability and pain, function, or work participation. Conclusion: This study found a higher than anticipated cumulative incidence of carpal instability in the second year post injury. Patients should be advised to monitor symptoms in the year post injury and seek a review if symptoms of pain, clicking or clunking arise.
Original languageEnglish
Pages (from-to)149-149
Number of pages1
JournalJournal of Hand Therapy
Volume31
Issue number1
DOIs
Publication statusPublished - 2018
EventAmerican Society of Hand Therapists Annual Meeting 2017 - Anaheim Marriott, Anaheim , United States of America
Duration: 12 Oct 201715 Oct 2017
Conference number: 40
https://www.asht.org/about/blog/are-you-ready-ashts-40th-annual-meeting

Keywords

  • Wrist
  • Instability
  • Screening-outcome

Cite this