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Routine: DVBCWHT2

DVBCWHT2.m

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  1. DVBCWHT2 ;ALB/JER HAND, THUMB, FINGERS WKS TEXT ; 31 JULY 2003
  1.  ;;2.7;AMIE;**58**;JULY 31, 2003
  1.  ;
  1. TXT ;
  1.  ;;A. Review of Medical Records:
  1.  ;;
  1.  ;;B. Medical History (Subjective Complaints):
  1.  ;;Are there flair ups of joint disease affecting hand, thumb or fingers?
  1.  ;;   If so:
  1.  ;;     1.  State severity, frequency and duration of flair ups.
  1.  ;;     2.  Name precipitating and alleviating factors.
  1.  ;;     3.  Estimate to what extent, if any, flair ups result in additional 
  1.  ;;         limitation of motion or functional impairment.
  1.  ;;
  1.  ;;C. Physical Examination (Objective Findings):
  1.  ;;Designate fingers as: thumb, index, long, ring, and little.  Provide a detailed 
  1.  ;;assessment of each affected joint. State whether the individual is right 
  1.  ;;or left hand dominant. Use a goniometer for measuring joint angles. Refer to
  1.  ;;Residuals of Amputations worksheet, if applicable.
  1.  ;;
  1.  ;;    1. Evaluation of Ankylosis      
  1.  ;;For each anklyosed joint, include angle of anklyosis. Describe any rotation or 
  1.  ;;any angulation of bone.
  1.  ;;Zero degrees of flexion represents the fingers fully extended, making a  
  1.  ;;straight line with the rest of the hand.
  1.  ;;    The "position of function" of the hand is:
  1.  ;;        Wrist dorsiflexion: 20 to 30 degrees
  1.  ;;        Metacarpophalangeal flexion: 30 degrees 
  1.  ;;        Proximal interphalangeal joint flexion: 30 degrees 
  1.  ;;        Thumb abduction and rotation: thumb pad faces the finger pads.
  1.  ;;
  1.  ;;    2. Evaluation of Limitation of Motion of Single or Multiple Digits of the  
  1.  ;;       Hand
  1.  ;;Provide range of motion for each digit of the hand. 
  1.  ;;Normal Ranges of Motion for wrist, index, long, ring and little fingers:
  1.  ;;  Metacarpophalangeal joint (wrist): zero to 90 degrees of flexion
  1.  ;;  Proximal interphalangeal joint: zero to 100 degrees of flexion
  1.  ;;  Distal (terminal) interphalangeal joint: zero to 70 or 80 degrees of flexion
  1.  ;;
  1.  ;;    3. Evaluation of Hand as a unit 
  1.  ;;Measure the gap, in inches:
  1.  ;; Between the tip of the thumb and the fingers 
  1.  ;; Between the tips of the fingers and the proximal transverse crease of the palm
  1.  ;; Between the thumb pad and the fingers with the thumb attempting to oppose
  1.  ;; the fingers
  1.  ;; Describe strength for pushing, pulling and twisting. Describe dexterity for 
  1.  ;; twisting, probing, writing, touching and expression. Comment on whether and
  1.  ;; how (e.g. decreased range of motion, in degrees) the flexion deformity 
  1.  ;; interferes with the function of the other fingers.
  1.  ;;
  1.  ;;       4. Additional detailed measurements and consideration of other factors
  1.  ;;          affecting function
  1.  ;;Measure the active and passive range of motion of each affected joint. Include
  1.  ;;movement against gravity and against strong resistance.
  1.  ;;State whether and to what extent the range of motion (in degrees) or joint
  1.  ;;function is additionally limited by pain, fatigue, weakness, or lack of 
  1.  ;;endurance following repetitive use or during flair-ups. If more than one 
  1.  ;;of these is present, state, if possible, which has the major functional  
  1.  ;;impact. Include rationale for conclusions.
  1.  ;;
  1.  ;;  D. Diagnostic and Clinical Tests:
  1.  ;;Include results of all diagnostic and clinical tests upon which examiner is
  1.  ;;basing the diagnosis.
  1.  ;;
  1.  ;;  E.  Diagnosis:
  1.  ;;
  1.  ;;
  1.  ;;
  1.  ;;
  1.  ;;Signature:                                                Date:
  1.  ;;END