Assessment of the rheumatoid hand
Dickson, R. A.
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Present methods of assessing the function of the hand are reviewed and found to be inadequate. Two new concepts are introduced; the concept of assessing the function of the hand at the digital level, and the concept that hand function and bone density are closely related in both the hypodynamic state of disuse and the hyperdynamic state of improved function following corrective surgery.To investigate hands in this manner, the design and use of two biomechanical instruments, the 'Cybernometer' and the 'Torquemeter', invented by the author, are described. The use of Colour Television Image Analysis as a new method of measuring bone density, developed by the author, is also described.With this equipment a biomechanical study has been performed on normal hands and a positive relationship has been shown between function and bone density in both normal and rheumatoid hands.A statistical analysis has been performed on 51 rheumatoid patients before and after a variety of types of corrective hand surgery in terms of function and bone density. Not only is disuse osteoporosis accompanied by a reduction in hand function but also by surgically improving function osteoporosis in the rheumatoid hand is reversed.