Abstract:
:Evaluation of the outcome of evidence-based practice decisions in individual patients or patient groups is step five in the evidence-based practice approach. Outcome measures are any measures that reflect patient status. Status or outcome measures can be used to detect change over time (eg, treatment effects), to discriminate among clinical groups, or to predict future outcomes (eg, return to work). A variety of reliable and valid physical impairment and disability measures are available to assess treatment outcomes in hand surgery and therapy. Evidence from research studies that includes normative data, standard error of measurement, or comparative scores for important clinical subgroups can be used to set treatment goals, monitor recovery, and compare individual patient outcomes to those reported in the literature. Clinicians tend to rely on impairment measures, such as radiographic measures, grip strength, and range of motion, although self-report measures are known to be equally reliable and more related to global effects, such as return-to-work. The process of selecting and implementing outcome measures is crucial. This process works best when team members are involved and willing to trial new measures. In this way, the team can develop customized outcome assessment procedures that meet their needs for assessing individual patients and providing data for program evaluation.
journal_name
Hand Clinjournal_title
Hand clinicsauthors
MacDermid JC,Grewal R,MacIntyre NJdoi
10.1016/j.hcl.2008.11.001subject
Has Abstractpub_date
2009-02-01 00:00:00pages
97-111, viiissue
1eissn
0749-0712issn
1558-1969pii
S0749-0712(08)00101-7journal_volume
25pub_type
杂志文章相关文献
HAND CLINICS文献大全abstract::The purpose, as well as the value, of the two-stage system in the salvage situation is for the surgeon to perform all the reconstructive surgery needed at Stage 1. Nerves are repaired, vessels are repaired if necessary, the intrinsic system is inspected, a Swanson implant is added if needed, and pulleys are built. If ...
journal_title:Hand clinics
pub_type: 杂志文章
doi:
更新日期:1985-02-01 00:00:00
abstract::Free vascularized nerve transfer using microsurgical techniques for upper limb reconstruction should be considered as an alternative to conventional nonvascularized cable nerve grafts when the recipient bed is heavily scarred, as occurs in Volkmann's ischemia, when the nerve gap is exceptionally long, or when the free...
journal_title:Hand clinics
pub_type: 杂志文章
doi:
更新日期:1999-11-01 00:00:00
abstract::The role of the nurse is valuable in laying the groundwork for the assessment of the patient with numbness, tingling, and/or upper extremity pain. Through the initial history the nurse can establish rapport with the patient and provide a good chronology of the problem. This can assist the physician with the physical e...
journal_title:Hand clinics
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract::Rheumatoid arthritis commonly affects the distal radioulnar joint (DRUJ). This can result in pain, instability, or tendon rupture. The goals of surgical reconstruction of the DRUJ are to relieve pain, stabilize the joint, and prevent tendon rupture. We review many of the previously described procedures and report our ...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1989-05-01 00:00:00
abstract::Noninvasive studies, in general, and pulse volume recordings (PVRs), in particular, play important roles in diagnosis, planning, and monitoring of therapy for vascular disorders of the upper extremity. Essentially, PVR is a useful screening tool to show whether hemodynamically significant vascular disease has produced...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1993-02-01 00:00:00
abstract::In 1987, Dr. John Agee described a method of holding reduction in unstable proximal interphalangeal fracture dislocations while allowing early motion. This method significantly improved the outcome of joint motion. This article explains Dr. Agee's method and the mechanics and physics necessary to use it. The limitatio...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1994-05-01 00:00:00
abstract::Metacarpal and phalangeal fractures are common athletic injuries that can significantly affect the athlete's career when they occur during the season and affect the athlete's training when they occur in the off season. This situation is particularly relevant if there are complications or if fixation is not stable enou...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2009.05.005
更新日期:2009-08-01 00:00:00
abstract::A classification of distal radial articular fractures is described, based on observations of consistent patterns of fracture fragmentation and displacement. The classification categorizes articular fractures into four types, with the medial complex assuming a pivotal position as the cornerstone of both the radiocarpal...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1988-08-01 00:00:00
abstract::Release of the transverse carpal ligament is commonly performed and highly successful in the treatment of carpal tunnel syndrome; however, complications do occur and may be broadly classified as errors in diagnosis and surgical technique. Complications range from incomplete division of the transverse carpal ligament t...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1994-02-01 00:00:00
abstract::Cortical mapping and relearning are key factors in optimizing patient outcome following motor nerve transfers. To maximize function following nerve transfers, the rehabilitation program must include motor reeducation to initiate recruitment of the weak reinnervated muscles and to establish new motor patterns and corti...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2008.06.001
更新日期:2008-11-01 00:00:00
abstract::There are many nonsurgical treatment options for patients with upper limb spasticity. This article presents an algorithmic approach to management, encompassing evidence-based rehabilitation therapies, medications, and promising new orthotic and robotic innovations. ...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2018.06.003
更新日期:2018-11-01 00:00:00
abstract::This article describes the basic bony, ligamentous, and neurologic anatomy of the structures about the elbow. The surgical exposures of the elbow joint are described, providing details of the various posterior, lateral, and medial approaches to the articular segments. Clinical applications describing the potential ben...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2014.08.001
更新日期:2014-11-01 00:00:00
abstract::The anatomy of the ulnar nerve is described from its origin at the brachial plexus to its termination in the hand and digits. The critical anatomy surrounding the cubital tunnel and Guyon canal is emphasized, and clinically relevant anatomic variations, muscle anomalies, and peripheral nerve anastomoses are described....
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2007.05.001
更新日期:2007-08-01 00:00:00
abstract::Treatment of recurrent Dupuytren disease is challenging. Multiple options exist, each having relative benefits and weaknesses. Choice for optimal treatment is made on a case-by-case basis, with shared decision making with the patient. Percutaneous and enzymatic techniques are best reserved for patients with well-defin...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2018.03.009
更新日期:2018-08-01 00:00:00
abstract::Upper extremity burn contractures are a major challenge to the reconstructive surgeon. Despite increasing sophistication in the overall management of acute thermal injuries, contractures still occur and are the most common cause of skin contracture in the hand. Reconstructive options for axillary, antecubital, wrist, ...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1990-05-01 00:00:00
abstract::There are myriad factors that affect patient satisfaction following a distal radius fracture, including anatomic alignment, age, motion, pain,and hand dominance to name a few. The seeming contradictions in the literature serve to illustrate that individual outcomes are not entirely predict-able because of the differen...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2005.03.001
更新日期:2005-08-01 00:00:00
abstract::Most sports are associated with specific patterns of hand injury. In some cases, these are unavoidable due to the nature of hand involvement dictated by the rules or environment of the sport. In other cases, such injuries point out the need for better protective gear or training. ...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1990-08-01 00:00:00
abstract::Elbow arthroscopy is, to a degree, technically demanding. A complete knowledge of the regional anatomy of the elbow is essential. The technical expertise of the arthroscopist continues to improve, and sophistication of equipment continues to increase. These clear the way for new indications of elbow arthroscopy. It is...
journal_title:Hand clinics
pub_type: 杂志文章
doi:
更新日期:1994-08-01 00:00:00
abstract::To reduce ischemic time and yet achieve a high-quality repair, the replantation team should be well organized. The team should be conversant with microvascular techniques and employ efficient methods of tendon repair and bone fixation. Developments in instrumentation and technique in recent years have improved success...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:2001-08-01 00:00:00
abstract::The term "failure of differentiation" describes the phenotypes of a large number of otherwise unrelated conditions. The six conditions described here (arthrogryposis, camptodactyly, clinodactyly, Madelung deformity, trigger finger, and trigger thumb) are believed to occur because various structures failed to different...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2008.12.003
更新日期:2009-05-01 00:00:00
abstract::The surgical return of sensibility in the injured upper extremity remains a major goal for the reconstructive surgeon. Free flaps have created the opportunity for successful reconstruction in those patients in whom irreplaceable sensory end organs have been destroyed. In addition, well-vascularized composite tissues m...
journal_title:Hand clinics
pub_type: 杂志文章
doi:
更新日期:1985-05-01 00:00:00
abstract::The Z-plasty is a useful procedure in surgery of the upper limb for lengthening skin along a selected axis, for breaking up a straight line, and for obliterating webs. At least six geometric variables are considered in designing a conventional Z-plasty, and several modified designs must be considered. Geometrical mode...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1985-11-01 00:00:00
abstract::In summary, the authors believe that traumatic bone defects of the diaphyseal forearm, fewer than 6 cm in length, can be well managed with corticocancellous bone grafting, provided the patient has an adequate soft-tissue envelope. In cases of soft-tissue compromise, primary bone grafting is still the treatment of choi...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1999-05-01 00:00:00
abstract::Power and tip pinch are an integral part of intrinsic hand function that can be significantly compromised with dysfunction of the ulnar nerve. Loss of power pinch is one component that can significantly affect an individual's ability to perform simple daily tasks. Tip pinch is less affected, as this task has significa...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2016.03.007
更新日期:2016-08-01 00:00:00
abstract::Injuries to the extensor mechanism create an imbalance in the precise flexion-extension system that regulates finger motion. This imbalance results in visible and functional deformities. Although these deformities are initially supple, they can become fixed and progress to joint degeneration. This article outlines ear...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:2000-08-01 00:00:00
abstract::Experience will show that proper management during the first 3 postoperative weeks will be the major determinant for the final result in extensor tendon injuries. In the simple injury, meticulous care in properly immobilizing each joint, combined with edema control, allows the patient to begin the mobilization phase w...
journal_title:Hand clinics
pub_type: 杂志文章
doi:
更新日期:1986-02-01 00:00:00
abstract::Distal radius fractures are common fractures that can cause significant disability. As techniques and implants have improved, better results can be expected from internal and external fixation of complex wrist fractures. With meticulous technique, articular alignment can be secured and small articular fragments can be...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:
更新日期:1997-11-01 00:00:00
abstract::Comparative effectiveness research (CER) is a concept initiated by the Institute of Medicine and financially supported by the federal government. The primary objective of CER is to improve decision making in medicine. This research is intended to evaluate the effectiveness, benefits, and harmful effects of alternative...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2014.04.001
更新日期:2014-08-01 00:00:00
abstract::Arthrodesis and arthroplasty are surgical options used for the management of pain, stiffness, deformity, and instability related to arthritis and traumatic injury of the small joints of the hand. Arthrodesis and arthroplasty come with a risk of postoperative infection. Superficial soft tissue infections can often be m...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2015.01.002
更新日期:2015-05-01 00:00:00
abstract::A dysvascular digit is defined as a threatened circulatory condition of a digit caused owing to multiple reasons, such as medical illness or trauma. A dysvascular digit always needs surgical manipulation of the vessel in trauma cases. The revascularization of the digit is a priority in such conditions, after which rec...
journal_title:Hand clinics
pub_type: 杂志文章,评审
doi:10.1016/j.hcl.2019.01.001
更新日期:2019-05-01 00:00:00