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Date of completion
Mayo Wrist Score    
Clinician's name (or ref) Patient's name (or ref)
 
Please answer the following 12 multiple choice questions.  
During the past 4 weeks......  
Section 1 - Pain Intensity   Section 2 - Functional Status
No pain   Returned to regular employment
Mild Occasional   Restricted employment
Moderate, tolerable   Able to work, but unemployed
Severe to intolerable   Unable to work because of pain
     
Section 3 (choose either 3a or 3b)
3a - Range of Motion (% of normal side)   3b - If only injured hand examined
100%    Greater than 120 degrees
75-99%    90-120 degrees
50-74%    60-90 degrees
25-49%    30-60 degrees
0-24%   less than 30 degrees
     
Section 4 - Grip strength % of normal  
The Mayo Wrist Score is
100%  
75-100%    
50-75%    
25-50%  

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0-25%  
   

Interpreting the Wrist Mayo Score

90-100

Excellent
80-90
 Good
60-80
 Satisfactory
Below 60
 Poor

Reference for Score: Amadio PC, Berquist TH, Smith DK, Ilstrup DM, Cooney WP 3rd, Linscheid RL. Scaphoid malunion. J Hand Surg [Am]. 1989 Jul;14(4):679-87. Link to pubmed