title: Evaluation of the Patient-Specific Functional Scale in hand fractures and dislocations.
abstract: BACKGROUND
  Generic upper extremity disability questionnaires utilize standardized items. The Patient-Specific Functional Scale (PSFS) allows the patient to identify specific self-reported items. This study evaluated the validity of the PSFS to assess outcome in patients with hand fractures or dislocations.
  
  
  METHODS
  Adults with hand fractures or dislocations, who completed hand therapy between January 2012 and January 2013, were eligible for inclusion. At the initial and final assessment, each patient was asked to complete the PSFS. Each patient identified three items that were difficult or they were unable to perform, and the degree of difficulty was ranked from 0 to 10 (able to perform at pre-injury level). We excluded patients with an incomplete PSFS. Statistical analyses evaluated the relationships between the PSFS and the independent variables.
  
  
  RESULTS
  There were 63 patients (37 men, 26 women); 21 of the 63 patients underwent surgery for fracture fixation. The mean duration of hand therapy treatment was 2.2 ± 1.4 months. The mean PSFS scores were as follows: initial 3.2 ± 2.2; final 8.1 ± 2.2. There was a significant improvement in PSFS scores from initial to final assessment (p < 0.001) and a moderate correlation (r = 0.3, p = 0.02). There was no statistical difference in PSFS scores between men and women or surgery and no surgery.
  
  
  CONCLUSIONS
  In these patients with hand fractures or dislocations, the PSFS indicated significant improvement in function. Using items identified by the patient, the PSFS provides a valuable perspective of outcome and may be used in conjunction with generic disease-specific questionnaire for assessment of the upper extremity.
authors.affiliation: Toronto Western Hospital Hand Program, Division of Plastic & Reconstructive Surgery, University of Toronto, Toronto, ON Canada ; Toronto Western Hospital Hand Program, 399 Bathurst Street, 2EW-422, Toronto, ON M5T 2S8 Canada.
authors.forename: Christine B
authors.initials: CB
authors.lastname: Novak
authors.affiliation: Toronto Western Hospital Hand Program, Division of Plastic & Reconstructive Surgery, University of Toronto, Toronto, ON Canada.
authors.forename: Marianne M
authors.initials: MM
authors.lastname: Williams
authors.affiliation: Toronto Western Hospital Hand Program, Division of Plastic & Reconstructive Surgery, University of Toronto, Toronto, ON Canada.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Conaty
keywords: Assessment; Function; Hand injury; Outcome measure; Patient specific; Validity