Clinical scoring systems became more and more popular in evaluating the efficacy of treatment procedures in wrist disorders [
1,
2]. Numerous physician-based as well as patient-reported clinical measurement tools have been developed. However the physician-based clinical examination does not necessarily correlate with the patient’s satisfaction [
3] and does not inevitably take into account further aspects related to an analysis of outcome such as the patient’s ability to perform activities of daily living and the ability to return to previous occupations [
1]. Therefore the additional use of self-assessment questionnaires to clinical assessed parameters may result in a higher transparency of the patient’s wrist function and restrictions. A systematic review of the literature was performed to identify valid and commonly used scoring systems regarding follow-up examination in the field of wrist disorders. PubMed.gov was searched for wrist-specific terms (wrist, surgery, joint, upper extremity) combined with psychometric (validity, reliability, responsiveness, follow-up) and instrument specific terms (self-evaluation, patient-based, measurement tool, outcome measure, questionnaire). The Disabilities of the Arm, Shoulder and Hand (DASH) [
4], the Patient-Rated Wrist Evaluation Score (PRWE) [
5], the Cooney and Bussey Score (CBS) [
6] and the Mayo Wrist Score (MWS) [
7] were identified as frequently used and valid assessment measurement tools in wrist disorders. However the validation studies most commonly focus specific patient groups or diagnosis (e.g. fractures of the distal radius in the validation of the Patient-Rated Wrist Evaluation Score (PRWE)) and we are still far from a single outcome evaluation system which is reliable, valid and sensitive to clinically relevant change [
4‐
8]. In addition the available self-assessment questionnaires focus on subjective parameters such as pain, usual and specific activities but the range of motion (ROM) as an essential objective parameter in wrist disorders is rarely considered. The Patient-Rated Wrist Evaluation Score (PRWE), for example, presents a wrist specific outcome instrument but it does not depict photographs to allow for a patient-based evaluation of the range of motion. The Disabilities of the Arm, Shoulder and Hand (DASH) score presents a frequently used and established self-assessment score for the general upper limb function but it does not constitute a wrist-specific rating instrument.
Therefore the purpose of this prospective study was to develop and validate an all-purpose Munich Wrist Questionnaire (MWQ) without limitations in the applicability regarding diagnosis or specific disorders for a patient-based follow-up examination considering subjective (pain, work and activities of daily living) as well as objective parameters (range of motion) in a heterogeneous patient collective.
The study protocol was approved by the local ethics committee (Ethics Committee of the medical faculty, Klinikum rechts der Isar, Technical University of Munich, Germany; study number 5316/12).