Analysis of the two-point discrimination test in daily routine practice

Abstract

Background

Finger nerve lesions lead to a sensory deficit with para-anesthesia or anesthesia and impair hand functions. In daily clinical practice, the diagnosis of an injured finger nerve can be challenging. This study aims at evaluating if the two-point discrimination (2PD) test is a good predictor of nerve lesions to indicate operative treatments in hand trauma patients.

Methods

Based on the record of patients with an acute hand and finger injury, it was evaluated whether a pathological 2PD test in the clinical examination corresponds to the intraoperative findings of a severed nerve. From 2008 and 2014, patients with isolated finger nerve lesions were included, while patients with concomitant bone or tendon injuries were excluded.

Results

As many as 113 patients with a total of 131 nerve injuries of the hand and fingers were suitable for this study. The statistical analysis revealed a sensitivity of 98% among them for the 2PD test. Further, a positive predictive value of 96% was demonstrated.

Conclusions

The results of our study showed that the 2PD test is a valuable examination to diagnose nerve injuries of fingers in hand trauma patients. It is a simple, reliable, and available examination tool and therefore can be suggested in daily clinical practice.

Level of Evidence: Level III, diagnostic study.

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