Utility Of The Ten Test For Sensory Assessment In Traumatic Hand And Distal Forearm Nerve Injuries

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Main Authors: Jasmine Higgins, Erin Weber
Format: Recurso digital
Published: Zenodo 2026
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author Jasmine Higgins
Erin Weber
author_facet Jasmine Higgins
Erin Weber
contents PURPOSE: The ten test is a simplistic test for the assessment of digit sensation that does not require any specialized tools. It has been validated more rigorously for nontraumatic upper extremity nerve injuries. Alternative methods for sensory assessment either require expensive tools (Semmes-Weinstein) or are controversial in accuracy (two point discrimination, 2PD). We sought to evaluate the accuracy of the ten test, as compared to static 2PD, in the assessment of traumatic digital or distal median or ulnar nerve lacerations. METHODS: Patients greater than or equal to 18 years old who experienced a traumatic laceration to the digit, hand, or distal forearm with signs of sensory loss were included. Those with a history of carpal tunnel, neurologic or congenital upper extremity disorders, or prior nerve surgery or injury were excluded. A single examiner evaluated all digits of bilateral hands using the ten test and static 2PD either preoperatively or within two weeks postoperatively. A ten test 8 and 2PD 5 were considered indicative of decreased sensation and potential nerve injury. For distal median and ulnar nerve injuries, ring finger assessment was excluded, due to inconsistencies in innervation patterns. RESULTS: 30 patients were included. 25 were confirmed by surgical evaluation to have nerve lacerations (25 digital nerves, 1 common digital nerve, 4 median nerve, 3 ulnar nerve) while 5 with potential lacerations were found to have intact nerves (12 digital nerves). The sensitivity of 2PD was 96% and the specificity was 70%. The sensitivity of the ten test was 91% and the specificity was 86%. When comparing pre-op values for 5 patients found to have lacerated nerves with 5 patients found to have intact nerves, the positive predictive value of the ten test was 63% and the negative predictive value was 88% compared to 67% and 100% respectively, for 2PD. The positive likelihood ratio of the ten test was 6.50 and the negative likelihood ratio was .10 compared to 2 point-discrimination of 3.5 and .05, respectively. CONCLUSIONS: The ten test is a useful tool for assessing loss of sensation due to distal upper extremity nerve injury. Further studies will expand the sample size and evaluate the ability of the ten test to reflect recovery over time after nerve repair. *Source: https://ps-rc.org/meeting/Program/2026/EP73.cgi*
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spellingShingle Utility Of The Ten Test For Sensory Assessment In Traumatic Hand And Distal Forearm Nerve Injuries
Jasmine Higgins
Erin Weber
plastic surgery
reconstructive surgery
conference abstract
PSRC 2026
PURPOSE: The ten test is a simplistic test for the assessment of digit sensation that does not require any specialized tools. It has been validated more rigorously for nontraumatic upper extremity nerve injuries. Alternative methods for sensory assessment either require expensive tools (Semmes-Weinstein) or are controversial in accuracy (two point discrimination, 2PD). We sought to evaluate the accuracy of the ten test, as compared to static 2PD, in the assessment of traumatic digital or distal median or ulnar nerve lacerations. METHODS: Patients greater than or equal to 18 years old who experienced a traumatic laceration to the digit, hand, or distal forearm with signs of sensory loss were included. Those with a history of carpal tunnel, neurologic or congenital upper extremity disorders, or prior nerve surgery or injury were excluded. A single examiner evaluated all digits of bilateral hands using the ten test and static 2PD either preoperatively or within two weeks postoperatively. A ten test 8 and 2PD 5 were considered indicative of decreased sensation and potential nerve injury. For distal median and ulnar nerve injuries, ring finger assessment was excluded, due to inconsistencies in innervation patterns. RESULTS: 30 patients were included. 25 were confirmed by surgical evaluation to have nerve lacerations (25 digital nerves, 1 common digital nerve, 4 median nerve, 3 ulnar nerve) while 5 with potential lacerations were found to have intact nerves (12 digital nerves). The sensitivity of 2PD was 96% and the specificity was 70%. The sensitivity of the ten test was 91% and the specificity was 86%. When comparing pre-op values for 5 patients found to have lacerated nerves with 5 patients found to have intact nerves, the positive predictive value of the ten test was 63% and the negative predictive value was 88% compared to 67% and 100% respectively, for 2PD. The positive likelihood ratio of the ten test was 6.50 and the negative likelihood ratio was .10 compared to 2 point-discrimination of 3.5 and .05, respectively. CONCLUSIONS: The ten test is a useful tool for assessing loss of sensation due to distal upper extremity nerve injury. Further studies will expand the sample size and evaluate the ability of the ten test to reflect recovery over time after nerve repair. *Source: https://ps-rc.org/meeting/Program/2026/EP73.cgi*
title Utility Of The Ten Test For Sensory Assessment In Traumatic Hand And Distal Forearm Nerve Injuries
topic plastic surgery
reconstructive surgery
conference abstract
PSRC 2026
url https://doi.org/10.5281/zenodo.20064585