Author Topic: Hand Surgery Forum - Standard Hand Pictures  (Read 2984 times)

Offline DrBermant

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Hand Surgery Forum - Standard Hand Pictures
« on: February 01, 2013, 06:40:01 PM »
This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

How To Evaluate Before and After Pictures is region dependent. Just what should comprise a standard set of hand pictures? This depends on the problem being documented, but should include both views showing the hand from multiple positions and function. Videos are a much more critical method to demonstrate hand problems and function revealing so much more than photos alone.

While the limited views shown in this Snowblower Hand Injury show a little, they were not the complete set taken. But at the date I was doing hand, my photos were slides, before the digital revolution. So it will mean going back to the slide collections and converting sets I took then to demonstrate the views I was doing way back then vs. what I have learned over the years about the power of dynamic documentation and the power of video. Vascular video hand exams are powerful statements that are so difficult to show with still photos.

Hand Standard Pictures
Whole hand with fingers in relaxed extended position.
Palmer View
Dorsal View
Radial View
Ulnar View

Whole hand with fingers fully extended position finders adducted
Palmer View
Dorsal View

Whole hand with fingers fully extended position finders abducted
Palmer View
Dorsal View

Whole hand with fingers flexed into fist.
Palmer View
Dorsal View
Radial View
Ulnar View

Whole hand with thumb to each of fingers (one photo for each finger)
Palmer View

Close up of lesion, wound details.

Vascular sensation issues additional.

Wrist Standard Pictures Would be additional

Basic Hand Video Ballet:
Palmer, then Dorsal, then Radial, and Ulnar views.
Start with hand with fingers extended relaxed in natural curve.
Hyper extend all fingers and leave extended to watch for vascular changes.
Relax hand
Flex fingers into fist.
Extend one finger at a time until all fingers extended. Then flex one finger at a time until all flexed.
Hand fully extended fingers together. Abduct and then adduct fingers and thumb.
Thumb to finger sequentially and then repeat.
Video also can then demonstrate specific hand function issues of concern, problem, or progress.

Hope this helps,

Michael Bermant, MD
Retired Plastic Surgeon
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Michael Bermant, MD
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