Assessment Following Distal Radius Fractures: A Comparison of 4 Scoring Systems, Visual Numerical Scales, and Objective Measurements

Scott L. Barker, Haroon Rehman*, Anna L. McCullough, Shona Fielding, Alan J Johnstone

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Purpose To compare 4 recognized upper-limb scoring systems that are regularly used to assess wrist function after injury.

Methods We reviewed 116 patients 6 months after volar locking plate fixation for distal radius fractures. Two purely subjective and 2 composite scoring systems composed of both subjective and objective components were compared along with visual numerical scores for pain and function and objective measures of function. Each score was standardized into a scale from 0 to 100.

Results The distribution of the standardized total scores was statistically significantly different and indicated marked variability between scoring systems and therefore the information provided. Overall, the subjective scoring systems correlated well with each other and with both visual numerical scores for pain and function. However, the composite scores and objective measures of function correlated poorly with the subjective scores including the visual numerical scores.

Conclusions Results from wrist scoring systems should be interpreted with caution. It is important to ensure that the component parts of each score are taken into consideration separately because total scores may be misleading.

Clinical relevance Composite scores may be outdated and should be avoided. (Copyright (C) 2016 by the American Society for Surgery of the Hand. All rights reserved.)

Original languageEnglish
Pages (from-to)219-224
Number of pages6
JournalThe Journal of hand surgery
Issue number2
Early online date10 Dec 2015
Publication statusPublished - Feb 2016


  • wrist
  • fracture
  • outcome score
  • volar plate
  • fixation
  • disability
  • shoulder
  • quality
  • pain

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