gms | German Medical Science

Objectives/Interrogation: We use eHands as an assessment tool for all our hand trauma patients who present in our unit. It provides a structured way of assessing and documenting the clinical findings. The aim of this study was to investigate the accuracy of our clinical and operative findings and determine factors which may result in any potential discrepancies.

Methods: We conducted a retrospective study of 100 patients who were assessed and operated on between July and September 2018. Clinical examination findings were compared to the operation notes and categorised as completely correct, partially correct and completely incorrect. Grade of assessing doctor, time of assessment and senior review was also collected. A two-tailed T-test was used to assess statistical significance.

Results and Conclusions: Sixty-two percent of patients had a complete correlation between clinical and operative findings. Partially correct clinical diagnosis was found in 26 patients and 12 patients had a completely incorrect preoperative diagnosis. Digital nerve injury followed by flexor tendon was the most common overdiagnosed condition in both the partially and completely incorrect group. Digital nerve and flexor tendon injury was the most frequently missed of the patients who had a partially correct clinical diagnosis. No difference in clinical accuracy was found correlating with the grade of assessor.

The accuracy of clinical examination and operative findings is high using our eHands assessment tool. There is no significant difference in accuracy between grades of assessing doctors.