Review of Systems Questions for Finger Laceration Assessment
A thorough review of systems for a patient with a finger laceration should focus on identifying potential complications that could affect wound healing, tendon function, and long-term outcomes.
Key ROS Questions to Ask
Injury-Specific Assessment
- Ask about the mechanism of injury (what caused the laceration, when it occurred, and how) 1
- Inquire about the position of the finger at the time of injury (important for assessing potential tendon involvement) 1
- Ask if there was any crushing component to the injury 1
- Determine if there is any foreign body sensation or known foreign material in the wound 1
Functional Assessment
- Ask about ability to move the finger through full range of motion 1
- Inquire about any catching, locking, or triggering sensation when moving the finger (could indicate partial tendon laceration) 2
- Ask about any numbness or tingling in the affected finger (to assess nerve involvement) 1
Pain Assessment
- Determine pain level and characteristics (sharp, dull, throbbing) 3
- Ask if pain changes with movement of the finger 1
Medical History Relevant to Wound Healing
- Ask about history of diabetes, peripheral vascular disease, or other conditions affecting circulation 1, 4
- Inquire about immunocompromising conditions or medications that may impair wound healing 3
- Ask about tetanus immunization status 3
- Determine if patient is on anticoagulants or has bleeding disorders 3
Allergies
- Ask about allergies to local anesthetics, adhesives, antibiotics, or other medications that might be used in treatment 3
Occupational and Functional Concerns
- Ask about patient's occupation and hand dominance (to assess functional impact) 5
- Determine if the injury will affect work, daily activities, or hobbies 6
Social History
- Ask about alcohol use at time of injury (as this may affect wound healing and compliance) 5
- Inquire about smoking status (affects wound healing) 4
Special Considerations
For Suspected Tendon Injury
- Ask specifically about ability to flex and extend all joints of the affected finger 1
- Inquire about any popping or snapping sensations during movement 2
For Suspected Foreign Body
- Ask about the material that caused the injury (glass, wood, metal) 1
- Inquire about sensation of something still in the wound 1
For Suspected Vascular Compromise
- Ask about color changes in the fingertip (pallor, cyanosis) 1
- Inquire about temperature changes in the affected finger 4
A systematic review of systems approach for finger lacerations helps ensure proper assessment and management, reducing the risk of missed injuries and complications that could lead to increased morbidity or functional impairment 1.