DVBCWHT9 ;ALB/RLC HAND, THUMB, FINGERS WKS TEXT ; 16 JAN 2007
;;2.7;AMIE;**120**;FEB 17, 2004;Build 4
;
TXT ;
;;A. Review of Medical Records:
;;
;;B. Medical History (Subjective Complaints):
;;
;; Comment on;
;;
;; 1. History of hospitalizations or surgery (Date and location if known,
;; reason or type of surgery).
;; 2. History of trauma to hands or fingers.
;; 3. History of neoplasm:
;;
;; a. Date of diagnosis, diagnosis.
;; b. Benign or malignant.
;; c. Types and dates of treatment.
;; d. Date of last treatment.
;;
;; 4. Treatment-type, dose, frequency, response, and side effects.
;; 5. Dominant hand and how determined.
;; 6. Current symptoms-any decreased strength or dexterity.
;; 7. Effects on occupational functioning and activities of daily living.
;; 8. Are there flare-ups of joint disease affecting hand, thumb or fingers?
;; If so:
;;
;; a. State severity, frequency and duration of flare-ups.
;; b. Name precipitating and alleviating factors.
;; c. Estimate to what extent, if any, flare-ups result in additional
;; limitation of motion or functional impairment. (Per Veteran).
;;
;;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 index, long, ring and little fingers:
;;
;; Metacarpophalangeal joint: 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
;;
;; a. Measure the active range of motion of each affected joint.
;; b. Measure the range of motion of each affected joint after at least
;; three repetitive motions. State whether and to what extent the
;; range of motion (in degrees) is additionally limited by pain,
;; fatigue, weakness, or lack of endurance following repetitive use.
;; If more than one of these is present, state, if possible, which
;; has the major functional impact. Include rationale for all
;; conclusions. If unable to do repetitive motions, so state and
;; provide reason.
;;
;;D. Diagnostic and Clinical Tests:
;;
;; 1. Include results of all diagnostic and clinical tests conducted in
;; the examination report.
;;
;;E. Diagnosis:
;;
;;
;;
;;Signature: Date:
;;END
--- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCWHT9 4348 printed Oct 16, 2024@17:52:44 Page 2
DVBCWHT9 ;ALB/RLC HAND, THUMB, FINGERS WKS TEXT ; 16 JAN 2007
+1 ;;2.7;AMIE;**120**;FEB 17, 2004;Build 4
+2 ;
TXT ;
+1 ;;A. Review of Medical Records:
+2 ;;
+3 ;;B. Medical History (Subjective Complaints):
+4 ;;
+5 ;; Comment on;
+6 ;;
+7 ;; 1. History of hospitalizations or surgery (Date and location if known,
+8 ;; reason or type of surgery).
+9 ;; 2. History of trauma to hands or fingers.
+10 ;; 3. History of neoplasm:
+11 ;;
+12 ;; a. Date of diagnosis, diagnosis.
+13 ;; b. Benign or malignant.
+14 ;; c. Types and dates of treatment.
+15 ;; d. Date of last treatment.
+16 ;;
+17 ;; 4. Treatment-type, dose, frequency, response, and side effects.
+18 ;; 5. Dominant hand and how determined.
+19 ;; 6. Current symptoms-any decreased strength or dexterity.
+20 ;; 7. Effects on occupational functioning and activities of daily living.
+21 ;; 8. Are there flare-ups of joint disease affecting hand, thumb or fingers?
+22 ;; If so:
+23 ;;
+24 ;; a. State severity, frequency and duration of flare-ups.
+25 ;; b. Name precipitating and alleviating factors.
+26 ;; c. Estimate to what extent, if any, flare-ups result in additional
+27 ;; limitation of motion or functional impairment. (Per Veteran).
+28 ;;
+29 ;;C. Physical Examination (Objective Findings):
+30 ;;
+31 ;; Designate fingers as: thumb, index, long, ring, and little. Provide a detailed
+32 ;;assessment of each affected joint. State whether the individual is right
+33 ;;or left hand dominant. Use a goniometer for measuring joint angles. Refer to
+34 ;;Residuals of Amputations worksheet, if applicable.
+35 ;;
+36 ;; 1. Evaluation of Ankylosis
+37 ;;
+38 ;;For each anklyosed joint, include angle of anklyosis. Describe any
+39 ;;rotation or any angulation of bone.
+40 ;;
+41 ;;Zero degrees of flexion represents the fingers fully extended, making
+42 ;;a straight line with the rest of the hand. The "position of function"
+43 ;;of the hand is:
+44 ;;
+45 ;; Wrist dorsiflexion: 20 to 30 degrees
+46 ;; Metacarpophalangeal flexion: 30 degrees
+47 ;; Proximal interphalangeal joint flexion: 30 degrees
+48 ;; Thumb abduction and rotation: thumb pad faces the finger pads.
+49 ;;
+50 ;; 2. Evaluation of Limitation of Motion of Single or Multiple Digits of the
+51 ;; Hand
+52 ;;
+53 ;;Provide range of motion for each digit of the hand.
+54 ;;
+55 ;;Normal Ranges of Motion for index, long, ring and little fingers:
+56 ;;
+57 ;; Metacarpophalangeal joint: zero to 90 degrees of flexion
+58 ;; Proximal interphalangeal joint: zero to 100 degrees of flexion
+59 ;; Distal (terminal) interphalangeal joint: zero to 70 or 80 degrees
+60 ;; of flexion
+61 ;;
+62 ;; 3. Evaluation of Hand as a unit
+63 ;;
+64 ;;Measure the gap, in inches:
+65 ;;
+66 ;; Between the tip of the thumb and the fingers
+67 ;; Between the tips of the fingers and the proximal transverse crease
+68 ;; of the palm
+69 ;; Between the thumb pad and the fingers with the thumb attempting
+70 ;; to oppose the fingers
+71 ;;
+72 ;;Describe strength for pushing, pulling and twisting. Describe dexterity for
+73 ;;twisting, probing, writing, touching and expression. Comment on whether and
+74 ;;how (e.g. decreased range of motion, in degrees) the flexion deformity
+75 ;;interferes with the function of the other fingers.
+76 ;;
+77 ;; 4. Additional detailed measurements and consideration of other factors
+78 ;; affecting function
+79 ;;
+80 ;; a. Measure the active range of motion of each affected joint.
+81 ;; b. Measure the range of motion of each affected joint after at least
+82 ;; three repetitive motions. State whether and to what extent the
+83 ;; range of motion (in degrees) is additionally limited by pain,
+84 ;; fatigue, weakness, or lack of endurance following repetitive use.
+85 ;; If more than one of these is present, state, if possible, which
+86 ;; has the major functional impact. Include rationale for all
+87 ;; conclusions. If unable to do repetitive motions, so state and
+88 ;; provide reason.
+89 ;;
+90 ;;D. Diagnostic and Clinical Tests:
+91 ;;
+92 ;; 1. Include results of all diagnostic and clinical tests conducted in
+93 ;; the examination report.
+94 ;;
+95 ;;E. Diagnosis:
+96 ;;
+97 ;;
+98 ;;
+99 ;;Signature: Date:
+100 ;;END
