Examining the Hand in the Video Consultation

Author:

Welle Kristian1,Täger Stefan2,Hackenberg Roslind Karolina2,Markowetz Alexander3,Schildberg Frank Alexander1ORCID,Burger Christof1,Wirtz Dieter Christian1,Jansen Tom1,Kabir Koroush1ORCID

Affiliation:

1. Department of Orthopaedics and Trauma Surgery, Bonn University Medical Centre, Germany

2. Department of Orthopaedics and Trauma Surgery, Section of Hand and Plastic-Reconstructive Trauma Surgery, Bonn University Medical Centre, Germany

3. Department of Mathematics and Computer Science, Philipps University Marburg, Germany

Abstract

Abstract Background Video consultations could support patient care in hand surgery during social distancing in the COVID-19 era. According to the literature, images of hand and fingers can support telediagnosis in hand emergencies. We present this feasibility study on online video consultation in hand surgery. Methods A structured examination was designed to query the medical history and examine motor skills, sensitivity, strength and function tests of the hand. Thirty examinations on both hands were carried out by online video consultation, then in direct contact and compared with each other. Results With 4560 evaluated range of movement of the hand and finger joints, there was a high correlation between the measurement methods of R = 0.995 (p < 0.0001, confidence interval 0.9946 – 0.9954). In the video-based examination, 84.6% of the measured values showed a deviation of less than 5° compared to the direct examination, 92.8% less than 10° deviation. Good accordance was also found in the patientʼs medical history. An estimating examination of sensitivity, function and strength during video examination is feasible with simple auxiliary aids. Deficits are evident in the detection of scars, in function tests and the absence of haptic findings. Conclusion Online video consultation allows hand examination with sufficient documentation of hand and finger movements (range of motion) and proper evaluation of symptoms. It cannot replace direct examination but complement patient care in hand surgery even beyond the current COVID-19 pandemic.

Publisher

Georg Thieme Verlag KG

Subject

Orthopedics and Sports Medicine,Surgery

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