A model instrument for the documentation of outcome after nerve repair.

Abstract

We present a new model for documentation and quantification of the functional outcome after nerve repair at the wrist or distal forearm level and a protocol that includes a numerical scoring system. The model, presented here along with validation and reliability test results, supports our hypothesis that the summarized test results reflecting specific functional limitations correlates well with the patient's opinion of the impact of the nerve injury on activities of daily living. Seventy patients with nerve repair were examined using the protocol. Analysis included 3 factors: sensory domain (sensory innervation, tactile agnosis, and finger dexterity), motor domain (motor innervation and grip strength), and pain/discomfort domain (hyperaesthesia and cold intolerance). The analysis explained 73% of the variances of the variables and the variables had a logical distribution between the factors. Analysis of internal consistency demonstrated good homogeneity. A calculated total score correlated strongly with the patients' global estimation of the impact of the injury on activities of daily living and the summary of sensory and pain/discomfort domains correlated significantly with the Medical Research Council S0-S4 scale. The presented model represents a useful new tool for evaluation of the functional outcome after nerve injury and repair.