Wrist Hand Special Tests Flashcards
(12 cards)
Detection of Scaphoid Fracture
Tenderness in snuffbox
Tenderness over scaphoid tubercle
Longitudinal compression of thumb pain
Thumb ROM
Combination of all 4
Scaphoid Fracture CPR for imaging/ immobilization
male sex
snuffbox swelling
snuffbox tenderness
painful unlar deviation
painful axial thumb compression
Scaphoid Fracture S/S
Logistic regression model identified these findings as independent predictors of fracture
male sex; injured in sports
anatomical snuff box pain on ulnar deviation of the wrist >3 days post-injury
scaphoid tubercle tenderness at two weeks
Vascular
Allen’s Test
Vascular
Volumetric Displacement
Carpal Tunnel Special Tests
Phalen’s
Reverse Phalen’s
Modified Phalen’s
Carpal Compression
Tinel’s
Carpal Tunnel Syndrome Special Testing
At least 15 different special tests describes in the literature in addition to the common physical and subjective history findings associated with the syndrome
difficult to assess accuracy secondary to lack of a gold standard
majority of studies have significant design flaws and/or bias confounders
Tetro Provocation Test
Elbow extended, forearm supinated, and wrist flexed to 60*
Single thumb pressure over median nerve at carpal tunnel for 20 seconds
Carpal Tunnel CPR
- hand shaking improves symptoms
- wrist ratio index >.67
- symptom severity scale
- diminished sensation in thumb area of median distribution
- > 45 years old
Neurological
two-point discrimination
Functional discriminative touch test that correlates well with hand use and ability specific but not sensitive for CTS
Sensory Abilities
2-4 mm fingertips is normal
6-10 mm is fair
11-15 is poor
complex regional pain syndrome
trauma that triggers a sympathetically mediated (and exaggerated) vascular inflammatory reaction
