Bruce et al developed criteria for evaluating outcome for a patient with a Monteggia fracture of the forearm.
Parameters:
(1) range of motion (derived from percent impairment of the upper extremity)
(2) activities of daily living and work status
(3) pain
(4) appearance (5 items)
(4a) cosmetic appearance
(4b) clinical angulation
(4c) clinical displacement
(4d) clinical carrying angle
(4e) union on radiographs
|
Parameter |
Finding |
Points |
|
activities of daily living |
function equal to opposite arm |
20 |
|
|
independent in activities of daily living; 0 to 2 work handicaps |
10 |
|
|
unable to do 1 - 3 activities of daily living; 3 or more work handicaps; occupational change required |
15 |
|
|
unable to do 4 or more activities of daily living; occupational disability |
5 |
|
pain |
none |
15 |
|
|
annoying without compromising activity |
13 |
|
|
interferes with activity |
10 |
|
|
prevents some activity |
5 |
|
|
causes outcries and/or prevents any activity |
0 |
|
cosmetic appearance |
acceptable |
1 |
|
|
not acceptable |
0 |
|
clinical angulation |
absent |
1 |
|
|
present |
0 |
|
clinical displacement |
absent |
1 |
|
|
present |
0 |
|
clinical carrying angle |
< 10 degrees |
1 |
|
|
>= 10 degrees |
0 |
|
union on X-ray |
present |
1 |
|
|
absent |
0 |
points for range of motion =
= 60 - (0.6 * (percent impairment of the upper extremity from 0 to 100))
total score =
= SUM(points for all parameters)
Interpretation:
• minimum score: 5
• maximum score: 100
• The higher the score the better the outcome.
|
Total Score |
Outcome |
|
96 - 100 |
excellent |
|
91 - 95 |
good |
|
81 - 90 |
fair |
|
<= 80 |
poor |
Specialty: Surgery, orthopedic
