Clinical calculator
Mayo Wrist Score Calculator
Mayo Wrist Score
The Mayo Wrist Score is a 100-point rating of the wrist made of four equal parts — pain, functional status, range of motion and grip strength, 25 points each — with the last two expressed as a percentage of the opposite wrist, and it is graded excellent at 90 or above through to poor below 60.
What the Mayo Wrist Score means
Mayo Wrist Score scores run from 0 to 100, where a higher score is better. The bands below are conventional reporting categories, not diagnostic cut-offs.
- Poor0–59
- Satisfactory60–79
- Good80–89
- Excellent90–100
How the score is calculated
Stated in full so the calculation can be independently checked, and reproduced by hand if needed.
Four components are added to a maximum of 100. Pain contributes 25 points (no pain 25, mild and occasional 20, moderate and tolerable 15, severe to intolerable 0). Functional status contributes 25 points (returned to regular employment 25, restricted employment 20, able to work but unemployed 15, unable to work because of pain 0). Range of motion contributes 25 points as a percentage of the opposite wrist (100% 25, 75% to 99% 15, 50% to 74% 10, 25% to 49% 5, 0% to 24% 0), and grip strength contributes 25 points on the same percentage bands. A higher total is better. Totals are graded excellent at 90 to 100, good at 80 to 89, satisfactory at 60 to 79 and poor below 60, though publications differ on where the boundaries fall.
Missing data
There is no imputation rule. Every component must be assessed for the total to be valid. Unanswered items contribute zero in the calculator above, which understates the score — a partial figure is shown only so the entry can be checked, and must not be graded.
Instrument profile
- Developer
- William P. Cooney, R. Bussey, James H. Dobyns and Ronald L. Linscheid
- Institution
- Mayo Clinic, Rochester, United States
- First published
- 1987
- Custodian
- No active custodian
- Items
- 4
- Response format
- Four graded items, two of them as a percentage of the opposite wrist
- Score range
- 0 to 100
- Direction
- Higher score = better
- Recall period
- Current status at the time of examination
- Completion time
- About 3 minutes
- Age range
- Adults
- Regions
- Wrist & Hand
- Conditions
- Distal radius fracture, Scaphoid nonunion, Perilunate injury, Scapholunate advanced collapse, Wrist osteoarthritis, Kienböck disease
- Procedures
- Distal radius fixation, Scaphoid fixation, Proximal row carpectomy, Four-corner fusion, Total wrist arthrodesis, Total wrist arthroplasty
- Languages
- English
- Observer agreement
- Not established by the developers.
- Validity
- The point values were assigned by consensus rather than derived from patient data, and the score was not developed with the item-generation and validation work that current standards require. Half of it is objective measurement and half is clinician-recorded history.
- Reliability
- Used to report change after wrist surgery, but with no established minimal clinically important difference a change of a given number of points cannot be called meaningful.
- Ceiling effect
- Present. The 100% band is the only one that scores 25 on motion and grip, so a good result with a small residual deficit loses 10 points on each — the steps between bands are uneven, which makes the total coarse.
- Floor effect
- Uncommon.
When to use the Mayo Wrist Score
Well suited to
- Reading and comparing wrist surgery series, particularly distal radius fracture, scaphoid and salvage-procedure literature, much of which reports a Mayo wrist score.
- Continuing a long-running series or registry that has collected the score from the start.
Limitations and poor fits
- Choosing a patient-reported primary outcome for a new study — use the Patient-Rated Wrist Evaluation or the QuickDASH, which measure what the patient experiences rather than what the examiner records.
- Bilateral wrist problems, or a patient whose opposite wrist is not normal: two of the four components are percentages of that side.
- Retired patients and students, for whom the employment-based functional status item has no sensible answer.
- Judging whether an individual patient has improved meaningfully, since no minimal clinically important difference has been established.
Mayo Wrist Score compared with other instruments
Instruments measuring a related construct, with the practical difference between them.
| Instrument | Items | Range | What it adds |
|---|---|---|---|
| QuickDASH | 11 | 0–100 | The QuickDASH is an 11-item shortened form of the DASH that measures physical function and symptoms across the whole upper limb on a single 0 to 100 scale, where a higher score means greater disability. |
| Frykman | 2 | 1–8 | The Frykman classification sorts distal radius fractures into eight types from two findings — whether the fracture enters the radiocarpal joint, the distal radioulnar joint, both or neither, and whether the ulnar styloid is fractured — with odd-numbered types having an intact styloid and even-numbered types a fractured one. |
| Mayo Elbow Score | 8 | 0–100 | The Mayo Elbow Performance Score is a 100-point examiner-completed rating of the elbow that combines 45 points for pain, 20 for arc of motion, 10 for stability and 25 for five daily tasks, graded excellent at 90 or above, good at 75 to 89, fair at 60 to 74 and poor below 60. |
Copyright and permitted use
Published openly because it is the question every clinician and researcher asks before using an instrument, and almost nobody answers it.
A rating table published in the peer-reviewed literature in 1987 and reproduced throughout the hand surgery literature, with no licensing programme known to us. We have not approached the Mayo Clinic, so we cannot say the table is free of copyright; if a rights holder objects, the page will be changed.
References
- Cooney WP, Bussey R, Dobyns JH, Linscheid RL. Difficult wrist fractures. Perilunate fracture-dislocations of the wrist. Clinical Orthopaedics and Related Research. 1987.
Editorial status
Not yet reviewedQueued for clinical review by Sam Tuffun, PT, DPT. Sign-off has not taken place — this is a placeholder assignment, not a completed review.