Telemedicine Evaluation and Techniques in Hand Surgery

Abstract

The demand for telemedicine has been increasing over the past several years with the growth of technology and digital connectivity in our daily lives. With the impact of the global coronavirus disease 2019 pandemic, telemedicine implementation has become a necessity for many specialties because social distancing measures have greatly affected access to routine medical care. This article presents a detailed and systematic approach to conducting a hand physical examination during a video telemedicine encounter. Although the telemedicine physical examination has limitations, most components of the normal physical examination can be completed remotely with a systematic approach. We enumerate modifications to maximize examination remotely and present considerations for improved delivery of telemedicine care. These methods may be beneficial to providers incorporating telemedicine into their practice.

The Hand and Wrist Examination for Video Telehealth Encounters

“…The comprehensive exam of the hand and wrist begins with the same steps as an in-person exam, leading with inspection and palpation (Supplemental Table 1). The patient should be positioned so that the clinician can easily view the patient's hands and wrists, resting comfortably on an even surface when possible [36]. Observing the position of the hands and wrists at rest may demonstrate certain pathology, including but not limited to neurologic palsies [3,19].…”

The Telemedicine-Based Pediatric Examination of the Neck and Upper Limbs: A Narrative Review

“…In the context of cubital tunnel syndrome, the Tinel test has been suggested to have poor feasibility, while the elbow flexion test has good feasibility and can serve as a viable alternative. 77 Modified tests for medial and lateral epicondylitis were also shown to have good feasibility.…”

“…Overall, inspection can be accomplished over telemedicine with minimal limitation, as are most aspects of the motor examination aside from strength against resistance. 77 Palpation can be substituted with guided self-palpation but peripheral pulses, temperature and a formal sensory examination with two-point discrimination cannot be conducted remotely. 77,78 Lastly, certain special tests can be performed consistently when incorporating the modifications highlighted below.…”

“…77 Palpation can be substituted with guided self-palpation but peripheral pulses, temperature and a formal sensory examination with two-point discrimination cannot be conducted remotely. 77,78 Lastly, certain special tests can be performed consistently when incorporating the modifications highlighted below. No With the unaffected elbow in flexion, patient is asked to "hook" its biceps tendon with their index finger and compare this to the contralateral side.…”

The Health Situation of Elderly People in Poland: Three Models for Analysing the Needs and Expectations of Polish Senior Citizens: NIA, Design Thinking and GROW in the Context of the Potential Use of Medical Technologies

“…Prior to the Covid-19 pandemic, it was estimated that the telemedicine market would reach over $130 billion by 2025 (Elliott, Yopes, 2019). However, the effects of the global pandemic required the implementation of telemedicine solutions in many fields (Van Nest, Ilyas, Rivlin, 2020). The epidemic situation meant that hospitals ceased to be perceived by society as safe places, becoming the source of an un�nown foreign 'plague', and doctors, nurses and medical staff, in a broad sense, began to be perceived as carriers of the virus.…”