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Special Tests

Wrist and Hand Special Tests

Special TestMethod of Test and Indications
Tinel's Tap over carpal tunnel at wrist. (+ = tingling in thumb & index; indicative of CTS))
Phalen Flex wrists max & hold for 1 min. (+ = Numbness and tinglinig; indicative of CTS)
Reverse Phalen Wrists and hands in prayer position (+ = numbness & tingling; indicative of pathology other than CTS)
Finkelstein With thumb inside fingers, make fist & ulnarly deviate (+ = pain over abductor pollicis longus & extensor pollicis brevis; indicative of peritonitus of these 2 tendons, also tests for de Quervain's or Hoffmann's disease)
Froment's Sign Examiner attempts to pull a piece of paper from pt's thumb and index finger. (+ = terminal phalanx of thumb flexes b/c of paralysis of adductor pollicis; indicative of ulnar nerve paralysis.
Collateral Ligament (MCPs, DIPs, & PIPs) Stabilize finger proximal to the joint being tested and then grasp the finger distal to the joint being tested and apply a varus or valgus stres to the joint. (+ = more laxity of one compared to the other; indicative of compromised integrity of collateral
Pinch Grip Test Compare one hand vs. the other using a pinch meter. Use pulp-to-pulp pinch and lateral prehension.
Allen Test Open & close hand serveral times quickly. Examiner compresses radial and ulnar arteries, hand is opened and one artery is released. The hand should flush. Test is repeated with the other artery. (Indicatice of patency of radial & ulnar arteries & deter
Digit Blood Flow Compress nail bed and note time taken for color to return. Normal color return is 3 seconds. (+ = longer color return time; indicative of arterial insufficiency to fingers)
Hand Volume Test Using a volumeter, submerge one hand and compare the water displacement with the submergal of the other hand. (+ = differences of 30-50mL; indicative of swelling)
Created by: 138 Rechow