gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

A Modern Adaptation to the Ten Test for the Assessment of Digital Nerves

Meeting Abstract

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  • presenting/speaker Sunil Parthiban - Queen Elizabeth Hospital, Birmingham, United Kingdom
  • Mark Foster - Queen Elizabeth Hospital, Birmingham, United Kingdom
  • Dalia Ghalli - Queen Elizabeth Hospital, Birmingham, United Kingdom

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1027

doi: 10.3205/19ifssh0930, urn:nbn:de:0183-19ifssh09303

Veröffentlicht: 6. Februar 2020

© 2020 Parthiban et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objectives/Interrogation: Digital nerve injuries are common injuries of the hand with variable sensory recovery. These injuries have a significant burden of care and to the wider economy due to delayed return to work. Early, accurate diagnosis of nerve injury allows appropriate planning for surgery and informs the patient early of likely prognosis. There are several methods to assess a digital nerve injury. However, there is yet to be a method that can correctly predict nerve division and is easy to use. The aim of this study was to review the assessment of nerve injury and in particular the use of the Ten Test, and evaluate these in our own patient cohort.

Methods: Our study included patients who had a sensory deficit along the distribution of the digital nerves. We assessed 744 nerves in 370 patients during screening in an investigator led trial for nerve repair (Conduit Nerve approximation versus Neurorrhaphy Evaluation of Clinical outcome Trial). Data was collected prospectively and included the mode of injury, sensory score from 0-10, and operative findings. Patients were excluded if they did not have the Ten Test Score on assessment or if they did not have an operation which confirmed the diagnosis of nerve injury. Statistical modelling was applied to our data.

Results and Conclusions: 159 patients had a complete nerve injury, 484 patients did not have any nerve injury, 46 patients had a bruised or contused nerve and 55 patients had a partial nerve injury. The mean Ten Test score of a patient with a complete nerve injury was 3.13 with a standard deviation (SD) of 0.181. Statistical analysis showed a significant difference in the Ten Test scores between complete digital nerve injury and partial, intact or bruised nerves. Scores of 5 or more showed a negative predictive value of 81.1%. An interesting relationship was noted between the mode of injury and the reliability of the Ten Test score in predicting the severity of the injury which has led to our adaptation of the Ten Test.

The Ten Test can be considered a reliable examination tool in the assessment of digital nerve injuries. Accuracy in nerve injury assessment can be improved when combined with the mode of injury. Further data is required to ascertain whether the Ten Test can be used to rule out nerve injuries in a pre-operative setting.