Soft Tissue Injuries of the Hand Case 1

1. Question

A male factory worker presents to the ED with a left hand injury sustained whilst manufacturing aluminium window frames. In your initial assessment of this patient, you start by taking a more thorough history from him.

See if you can list at least three important considerations in your history taking.

2. Question

Examination of the patient’s hand will help guide you with regards to further management of this patient. Match up the examination findings and the diagnoses.

Sort elements

Flexor tendon rupture
Nerve compression
Need for surgical exploration
Central slip extensor tendon injury
Radial nerve injury

Loss of fingers flexion cascade at rest
Proximal fracture with sensory loss
Open wound breaching palmar aponeurosis
Elson’s test positive
Sensory loss to the dorsum of the first web space

3. Question

When examining the injured hand, which of the following statements are true?

Select one or more options.

The presence of a normal finger flexion cascade excludes flexor tendon injury
When flexor tendons are intact wrist extension leads to extension of fingers
A tendon rupture does not occur without overlying skin laceration
Two-point discrimination is the most reliable test for sensory examination of the hand
In open hand injuries, careful clinical examination can exclude injuries of tendons or nerves