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New outcome measurement tool could improve arm surgery for devastating nerve injury
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Investigators with the Hospital for Special Surgery in New York have developed a novel tool to measure outcomes in brachial plexus surgery, according to a Hospital for Special Surgery press release. The study was presented at the 2011 International Symposium on Brachial Plexus Surgery in Lisbon, Portugal.
“What we are doing is presenting this to the international community to get buy-in on the concept,” Scott W. Wolfe, MD, lead author on the study, stated in the release. “This is a first iteration, and we hope the group will respond favorably, but we’d like to get researchers and plexus surgeons from the far east, Europe, the [Untied] States and South America to work together to design a system that we all feel will function effectively for our patients.”
An international audience
Following a study that revealed little in terms of standardization among the reported outcomes of traumatic nerve injury — and thus significant difficulty in the comparison of efficacy of different surgical treatments — Wolfe’s group set out to design a tool capable of facilitating this standardization and present it to an international audience.
The key elements of the first draft of the instrument, as noted in the release, are measurements of motion, strength and function for seven critical domains of the upper extremity: shoulder elevation, shoulder external rotation, elbow flexion, elbow extension, wrist extension, finger flexion and intrinsics. The tool also assesses tasks such as touching the back of your head, touching your mouth, and holding a utensil.
“We had to take elements of different instruments as well as elements that we designed to derive a complete system,” Wolfe stated. “We’re studying an injury of several critical nerves, an injury that affects the arm in a way that is very different from a fracture or degenerative disease. We need to design an innovative way to analyze and report outcomes, because we’re simultaneously assessing nerve, muscle, and joint recovery.”
Reference:
- Wolfe SW, Lee SK, Garg R. Proposed universal outcomes instrument for the assessment of adult brachial plexus injuries. Presented at the 2011 International Symposium on Brachial Plexus Surgery. May 19-21. Lisbon, Portugal.
- Disclosure: The authors have reported no relevant financial disclosures.
- www.hss.edu
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