The use of Disabilities of the Arm, Shoulder, and Hand Questionnaire in rehabilitation after acute traumatic hand injuries.

This longitudinal observational prospective study evaluates the use of a self-reported measure Disabilities of the Arm, Shoulder, and Hand (DASH) in assessing traumatic hand injury patients. A total of 146 subjects were invited to fill out a validated questionnaire (DASH) during their first consultation and at discharge from therapy. The findings revealed a significant improvement in DASH scores upon discharge from therapy. The use of Quick DASH, an 11-question shortened version of the full 30-question DASH, also generated similar results with the psychometric properties maintained. Despite the low correlation between DASH and the therapists' measures of recovery of power grip, the results of this study confirmed the effectiveness of using the DASH in assessing traumatic hand injury patients. Clinical implications suggest that the DASH can be used to assess the improvement in the functional status of traumatic hand injury subjects, as well as to enhance therapists' understanding of the subjects' perspective regarding their disability, and to assist in effective treatment planning. Further study on the application of the Quick DASH in larger population, and its association with functional status is suggested.

Splinting for peripheral nerve injury in upper limb.

The prognosis and speed of peripheral nerve recovery depend very much on the level of injury, severity of injury, the surgical intervention and the subsequent rehabilitative process. Many high level injuries may take years or months for the affected peripheral nerve to recover. Prolonged muscle imbalance causes joint contractures and over-stretching of denervated muscles. Without proper care, hand function recovery may be limited even the nerve regenerated afterwards. During the nerve regeneration period, splinting is one of the most useful modality to minimise deformities, prevent joint contractures and substitute loss motor control. Proper splinting encourages early use of the injured hand in daily activities. There are different types of splinting design for median nerve palsy, ulnar nerve palsy and radial nerve palsy. Dynamic splinting techniques are frequently employed to allow early prehension activities. Other therapeutic techniques, including pressure garment and sensory re-education are useful to enhance better functional return after nerve repair.