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.