Comparison of Compliance, Time Required for Diagnosis and Pain of Patients with Finger Tendon Injury Between Gross and Ultrasonographic Confirmation

Lee, Seo Woo; Park, Hyun Jae; Lee, Jung Won; Park, Sae Hoon; Kim, Jae Woo

Abstract

PURPOSE
It is not always easy to determine the existence of tendon injuries when it comes to patients with finger lacerations. Thus, we tried to find the difference in effectiveness and in compliance of patients when we employed two different types of diagnosis, conventional gross confirmation and ultrasonographic confirmation.
METHODS
From December 2009 to March 2010, we enrolled 14 patients with finger tendon injury at Soonchunhyang University Cheonan Hospital. The median age of the patients was 35.9+/-14.4, and the ratio of females to males was 1:2.5 We evaluated the compliance of each patient by measuring four different categories (level of cooperativeness in showing their wound and in following the instructions, level of movement of their fingers during the diagnosis and total number of attempts to diagnose) by using a score from 1 to 3 for each category, for a total possible score of 12 for each patient. We also measured the painfulness of each patient by using a score of 1 to 10 and the time required for each diagnosis.
RESULTS
The levels of patients' compliance was 8.9+/-2.1 when diagnosed with gross confirmation and 9.8+/-2.1 when diagnosed with ultrasonographic confirmation (p value=0.042). The pain score of the patients was 3.7+/-1.7 with gross confirmation and 2.9+/-1.2 with ultrasonographic confirmation (p value=0.020). The median duration of time in each test was 6.7+/-4.8 minutes with gross confirmation and 10.5+/-4.2 minutes with ultrasonography (p value=0.006).
CONCLUSION
Comparing gross confirmation and ultrasonographic confirmation, gross confirmation is a better method than ultrasonography because of time efficiency. However, ultrasonographic confirmation has advantages over gross confirmation in pain scale and better compliance of patients. Emergency physicians generally employ gross confirmation rather than ultrasonography in determining the existence of tendon injury in patients. In patients with finger lacerations without bone injury, ultrasonography can be considered as a secondary diagnostic tool, especially when patients have much pain.