We have located links that may give you full text access.
The diagnostic accuracy of clinical examination in hand lacerations.
International Journal of Surgery 2007 April
INTRODUCTION: Hand injuries account for a significant proportion of emergency department attendance. We investigated the diagnostic accuracy of clinical examination in patients with simple hand lacerations undergoing surgical exploration at our unit.
METHODS: One hundred and sixty-five consecutive patients were identified as undergoing exploration of the hand. Case notes of these patients were reviewed. The clinical findings, made by emergency department doctors (ED) and hand surgeons (HS), were compared with the operative findings.
RESULTS: A total of 101 patients were included following exclusion criteria. Both ED and HS correctly identified 68.2% of flexor tendon injuries. Overall, the ED diagnosed accurately significantly fewer extensor tendon injuries (ED 65.6% vs HS 75.0%, p<0.001). Similarly, HS diagnosed nerve injuries more accurately than ED (ED 54.5% vs HS 78.8%, p<0.005).
DISCUSSION: Clinical examination forms an important part of the patient assessment, provides the surgeon with an idea of which structures are potentially injured, and its value should never be underestimated. Formal exploration, however, should be undertaken since both ED and HS missed about 30% injuries.
METHODS: One hundred and sixty-five consecutive patients were identified as undergoing exploration of the hand. Case notes of these patients were reviewed. The clinical findings, made by emergency department doctors (ED) and hand surgeons (HS), were compared with the operative findings.
RESULTS: A total of 101 patients were included following exclusion criteria. Both ED and HS correctly identified 68.2% of flexor tendon injuries. Overall, the ED diagnosed accurately significantly fewer extensor tendon injuries (ED 65.6% vs HS 75.0%, p<0.001). Similarly, HS diagnosed nerve injuries more accurately than ED (ED 54.5% vs HS 78.8%, p<0.005).
DISCUSSION: Clinical examination forms an important part of the patient assessment, provides the surgeon with an idea of which structures are potentially injured, and its value should never be underestimated. Formal exploration, however, should be undertaken since both ED and HS missed about 30% injuries.
Full text links
Related Resources
Trending Papers
Proximal versus distal diuretics in congestive heart failure.Nephrology, Dialysis, Transplantation 2024 Februrary 30
World Health Organization and International Consensus Classification of eosinophilic disorders: 2024 update on diagnosis, risk stratification, and management.American Journal of Hematology 2024 March 30
Heart failure with preserved ejection fraction: diagnosis, risk assessment, and treatment.Clinical Research in Cardiology : Official Journal of the German Cardiac Society 2024 April 12
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app