Hand and/or wrist injuries

Rationale

Hand and/or wrist injuries are common problems. The impact of the injury on function depends upon the severity of the original injury, the initial care, and rehabilitation.

Causal Conditions

(list not exhaustive)

1. Damage to tendons (e.g., laceration, tendonitis)
2. Damage to nerves (e.g., carpal tunnel syndrome)
3. Damage to bones and/or joints (e.g., fracture, dislocation)

Key Objectives

Given a patient with a hand and/or wrist injury, the candidate will diagnose the cause, severity, and complications, and initiate an appropriate management plan.

Enabling Objectives

Given a patient with a hand and/or wrist injury, the candidate will

1. list and interpret critical clinical findings, including
   1. if a history of trauma is present, a thorough exploration of the mechanism and timing of injury;
   2. appropriate physical examination, including neurovascular assessment;
   3. if appropriate screen for risk factors for repetitive strain injury;
   4. an occupational and recreational history;
2. list and interpret critical investigations, including
   1. radiograph(s) of the affected bone(s) and joint(s), if indicated;
3. construct an effective and relevant initial management plan, with particular attention to
   1. referral for specialist care, if appropriate;
   2. involvement of other health professionals as indicated;
   3. if splinting is required, demonstration of proper “position of safety”;
   4. appropriate analgesia;
   5. counselling regarding appropriate return to work or play;
   6. recognition of the potential for long-term impact on function.