Provider Prepared’s Weekly Pearl of Wound Wisdom #20 Getting on my nerves!
Sensory and motor functions of the hand arise from innervation by the median, radius and ulnar nerves. Examination of the hand should always include checking motor function as well as pin prick, light touch and two-point discrimination. Normal two-point discrimination will increase with age and neuropathic disease, but is considered approximately 4-5 mm.
Bassett, RE et al. Finger and thumb anatomy. UpToDate, July 2016.
On examination of this patient’s left hand, he is found to have decreased sensation in the 5th digit, ulnar aspect of the 4th digit and weakness with extension of the digits and wrist. This raises the concern for injury to the ulnar nerve associated with the forearm laceration.
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Nathan Whittaker, MD
- Brandon Durfee