Rationale

Hand and/or wrist injuries are common problems. The impact of the injury on function depends on the severity of the original injury, initial care, and rehabilitation.

Causal Conditions

(list not exhaustive)

1. Damage to tendons (e.g., laceration, tendonitis)

2. Damage to nerves (e.g., carpal tunnel syndrome)

3. Damage to bones and/or joints (e.g., fracture, dislocation)

Key Objectives

Given a patient with a hand and/or wrist injury, the candidate will diagnose the cause, severity, and complications, and initiate an appropriate management plan.

Enabling Objectives

Given a patient with a hand and/or wrist injury, the candidate will

1. list and interpret critical clinical findings, including those based on

   1. a thorough exploration of the mechanism and timing of injury if a history of trauma is present,

   2. an appropriate physical examination, including a neurovascular assessment,

   3. screening for risk factors for repetitive strain injury if appropriate, and

   4. an occupational and recreational history;

2. list and interpret critical investigations, including

   1. if indicated, appropriate imaging of the affected bone(s) and/or joint(s), and

   2. electromyography;

3. construct an effective and relevant initial management plan, with particular attention to

   1. referral for specialist care if appropriate,

   2. involvement of other health care professionals as indicated,

   3. if splinting is required, demonstration of proper position of safe immobilization,

   4. appropriate analgesia,

   5. counselling regarding appropriate return to work or play, and

   6. recognition of the potential for long-term impact on function.