Home   Package List   Routine Alphabetical List   Global Alphabetical List   FileMan Files List   FileMan Sub-Files List   Package Component Lists   Package-Namespace Mapping  
Routine: DVBCWHT2

DVBCWHT2.m

Go to the documentation of this file. 
DVBCWHT2 ;ALB/JER HAND, THUMB, FINGERS WKS TEXT ; 31 JULY 2003

 ;;2.7;AMIE;**58**;JULY 31, 2003

 ;

TXT ;

 ;;A. Review of Medical Records:

 ;;

 ;;B. Medical History (Subjective Complaints):

 ;;Are there flair ups of joint disease affecting hand, thumb or fingers?

 ;;   If so:

 ;;     1.  State severity, frequency and duration of flair ups.

 ;;     2.  Name precipitating and alleviating factors.

 ;;     3.  Estimate to what extent, if any, flair ups result in additional 

 ;;         limitation of motion or functional impairment.

 ;;

 ;;C. Physical Examination (Objective Findings):

 ;;Designate fingers as: thumb, index, long, ring, and little.  Provide a detailed 

 ;;assessment of each affected joint. State whether the individual is right 

 ;;or left hand dominant. Use a goniometer for measuring joint angles. Refer to

 ;;Residuals of Amputations worksheet, if applicable.

 ;;

 ;;    1. Evaluation of Ankylosis      

 ;;For each anklyosed joint, include angle of anklyosis. Describe any rotation or 

 ;;any angulation of bone.

 ;;Zero degrees of flexion represents the fingers fully extended, making a  

 ;;straight line with the rest of the hand.

 ;;    The "position of function" of the hand is:

 ;;        Wrist dorsiflexion: 20 to 30 degrees

 ;;        Metacarpophalangeal flexion: 30 degrees 

 ;;        Proximal interphalangeal joint flexion: 30 degrees 

 ;;        Thumb abduction and rotation: thumb pad faces the finger pads.

 ;;

 ;;    2. Evaluation of Limitation of Motion of Single or Multiple Digits of the  

 ;;       Hand

 ;;Provide range of motion for each digit of the hand. 

 ;;Normal Ranges of Motion for wrist, index, long, ring and little fingers:

 ;;  Metacarpophalangeal joint (wrist): zero to 90 degrees of flexion

 ;;  Proximal interphalangeal joint: zero to 100 degrees of flexion

 ;;  Distal (terminal) interphalangeal joint: zero to 70 or 80 degrees of flexion

 ;;

 ;;    3. Evaluation of Hand as a unit 

 ;;Measure the gap, in inches:

 ;; Between the tip of the thumb and the fingers 

 ;; Between the tips of the fingers and the proximal transverse crease of the palm

 ;; Between the thumb pad and the fingers with the thumb attempting to oppose

 ;; the fingers

 ;; Describe strength for pushing, pulling and twisting. Describe dexterity for 

 ;; twisting, probing, writing, touching and expression. Comment on whether and

 ;; how (e.g. decreased range of motion, in degrees) the flexion deformity 

 ;; interferes with the function of the other fingers.

 ;;

 ;;       4. Additional detailed measurements and consideration of other factors

 ;;          affecting function

 ;;Measure the active and passive range of motion of each affected joint. Include

 ;;movement against gravity and against strong resistance.

 ;;State whether and to what extent the range of motion (in degrees) or joint

 ;;function is additionally limited by pain, fatigue, weakness, or lack of 

 ;;endurance following repetitive use or during flair-ups. If more than one 

 ;;of these is present, state, if possible, which has the major functional  

 ;;impact. Include rationale for conclusions.

 ;;

 ;;  D. Diagnostic and Clinical Tests:

 ;;Include results of all diagnostic and clinical tests upon which examiner is

 ;;basing the diagnosis.

 ;;

 ;;  E.  Diagnosis:

 ;;

 ;;

 ;;

 ;;

 ;;Signature:                                                Date:

 ;;END