Examination of Hands what does it mean & what to do about it. by Don Hudson, D.O.
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Transcript of Examination of Hands what does it mean & what to do about it. by Don Hudson, D.O.
Examination of Handswhat does it mean & what to do about it.
byDon Hudson, D.O.
Before the Examination
What is the patients age and occupationWhich is the dominate handHas there been a prior hand impairment or
injuryWhen did it startWhat have you (the patient) done that
makes it better or worse
Traumatic InjuryInclude the following:When did the injury occurWhere and under what conditions did it
occurHow did the injury occurWhat was the exact position/posture of the
hand at the time of injuryWhat treatment has been given & what
was the effect
Non-Traumatic InjuriesWhen did the pain, sensory change,
swelling or contracture beginHow is function impaired in your
occupation, hobbies and activities of daily living
Are other joints or tendons involvedWhat activities make the pain better or
worseWhat time of the day or night is it worse
Terminology of Exam and Motions
Nerves of the Hands
Fracture Terminology
Testing
Testing
Testing
Testing
Testing
Testing
Testing
Use Pressure Not Clamps
Carpal Tunnel Injury
Trapping the Median Nerve at the wrist crease may cause paresthesias in the median nerve distribution.
Tinel’s sign- percussion over the Median Nerve.
Phalen’s sign- Volar flexion for one minuet will cause paresthesia of the hand
Carpal Tunnel Syndrome
Why are Exams on Hands so Important
The final out come of injured hands frequently rests in your hands.
The payment for injuries rests in your notes.
The long term complications rests in your hands & your documentation.
Documentation
Your notes make a major difference.Your exam makes a huge difference in
where and how the patient is treated.Describe what you see, describe it in
appropriate terms, and any exam or treatments be sure to document what happened as a result of that treatment or examination
When in doubt !!!!!!
Check your own hands.We have working copies of what we are
seeing, don’t be afraid to look at your working copy to see if you can figure out what it should be doing or not doing as the case may be.
Also never be afraid to consult
The idea that you can say;“ It not working, it looks bad & I do not
know what’s wrong” is OK.Just be sure you have completed an exam
or have a good reason why you have not.Unless not indicated most hand injuries
need to be exposed to get a good examination.
THE END