Accuracy of the preoperative examination in Zone 5 wrist lacerations

Fifty patients were studied to determine the accuracy of the preoperative p hysical examination in flexor tendon Zone 5 wrist lacerations, Initially, a retrospective review of the charts of 33 patients who were examined by a s econd- or third-year postgraduate physician was done, An average of three e rrors per examination was found. Then a prospective study of 17 patients wa s performed to see if an examiner's level of training in hand surgery influ enced the accuracy of the examination. Error rates improved slightly with e xperience. Ninety-seven examinations were performed in the combined prospec tive and retrospective studies, and only 13 were completely correct, Nearly 1/2 of all examinations had three or more errors, If a structure had been lacerated, the injury was not detected 33% of the time on the preoperative examination, The size and mechanism of injury of the skin laceration did no t correlate with the number of structures that were cut.