The Ten Test and Sensory Evaluation of Hand and Finger Injuries in the Emergency Department

Background

Hand and finger injuries are a common presenting complaint to the emergency department (ED) and are associated with significant morbidity. Neurologic evaluation of these injuries is a crucial component of the patient assessment and can be done via a variety of testing methods.

Discussion

Although most taught and cited in the ED literature, the two-point discrimination test for sensation has several drawbacks, including limited reproducibility and reliability. Although often utilized by hand surgical specialists, the Semmes-Weinstein monofilament test and the Weinstein Enhanced Sensory Test are not practical for the emergency physician due to the need for specialized equipment and frequent calibration. The Ten Test, a relatively new sensory evaluation method, has been shown to be reliable, reproducible, and pragmatic in varying types of clinical environments.

Conclusion

The Ten Test is a pragmatic alternative method of evaluation to two-point that is utilized by specialists in hand surgery and injuries. The emergency physician should consider adding the Ten Test to their evaluation and reporting of hand and finger injuries in the ED.