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Wrist Hand Evaluation

Special Tests. Compression testFlick/tap testPercussion testCollateral stress (wrist)Collateral stress (fingers)Watson ClunkTinel's signDigital Allen test. PhalenReverse PhalenMurphy's signDeQuervain's/FinkelsteinLong Finger Flexion testPaper/Froment signBunnell-Littler test. Compres

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Wrist Hand Evaluation

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    1. Wrist & Hand Evaluation Part Three

    2. Special Tests Compression test Flick/tap test Percussion test Collateral stress (wrist) Collateral stress (fingers) Watson Clunk Tinels sign Digital Allen test Phalen Reverse Phalen Murphys sign DeQuervains/Finkelstein Long Finger Flexion test Paper/Froment sign Bunnell-Littler test

    3. Compression Test (fracture): Examiner begins by grasping pts hand and compressing each digit along the long axis Complete on all digits Pain indicates a positive test for possible phalangeal fracture Do not perform if an obvious deformity is present

    4. Flick/Tap Test (fracture) Stabilize pts finger with one hand and flick or tap the tip of pts finger with the index finger of the other hand Repeat on all digits Pain indicates a positive test for possible fracture

    5. Percussion Test (fracture) Stabilize pts hand with one hand and percuss pts fingers independently with the index finger of the other hand Repeat on all digits Pain indicates a positive test for possible fracture

    6. Collateral Stress Test (wrist) (capsular laxity): The examiner stabilizes the pts distal forearm with one hand while grasping the pts hand with the other While holding the pts forearm in a neutral position, the examiner then applies valgus and varus forces to the pts wrist to test the integrity of the pts medial and collateral wrist ligaments, respectively

    7. Collateral Stress Test (fingers) (laxity): The examiner stabilizes the pts finger with the thumb and index finger of one hand and applies mild varus and valgus force to each of the interphalangeal joints with the thumb and index finger of the other hand, looking for laxity or abnormal joint opening that may be indicative of lateral and/or medial collateral ligament sprain Repeat on all phalangeal articulations of all fingers

    8. Watson Clunk Test (instability): The examiner stabilizes pts distal radius and ulna with one hand and grasps the pts scaphoid bone with the thumb and index finger of the other The examiner then attempts to translate the pts scaphoid anteriorly and posteriorly Dislocation and/or subluxation indicates a positive test for scaphoid instability

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