Serial Kinematic and Functional Assessments for Hand Motion Impairment: A Case Report with Hand Rehabilitation for a Comminuted Proximal Phalangeal Fracture

Kinematical representation of joint motion can objectively provide spatial and temporal assessment rather than static indication using conventional goniometric measurements. From clinical perspectives, serial kinematic assessments are reliable methods of quantifying treatment outcomes. Although this technique has already been adopted over a span of years, limited literatures and actual clinical practices regarding this conception can be found. In this study, serial functional evaluations based on kinematic analysis in this study were performed as an example to confirm the effectiveness of dynamic traction splint and hand rehabilitation for a comminuted phalangeal fracture. We reported a case with comminuted spiral proximal phalangeal fracture of the right middle finger, which was treated using a dynamic traction splint with an out-trigger and an elastic band to pull the K-wire for periosteotaxis based on Schenck's method in order to avoid bony shortening and instability. A designed rehabilitation protocol was applied to this case. Follow-up motor function assessments were measured using an electromagnetic tracking system and strength measurement tools. Serial assessments of maximal fingertip workspace and joint range of motion of the injured finger were improved after intervention. Angular kinematics of the finger showed evidence of joint motion smoothness. The sequential movement performance was also improved. Follow-up assessments of both grasp and pinch power showed satisfactory improvement. This method allows clinicians to determine impairments of injured sites or movement deficiencies using dynamically temporal and spatial kinematics, whether in real-time or off-line movement examinations. This work establishes a consulting room measurement system conveniently providing clinicians to objectively assess patients' conditions for each visit.