Emerg Med J 23:883-886 doi:10.1136/emj.2005.031377
  • Emergency casebook

Case of the month: The skin wrinkle test: a simple nerve injury test for paediatric and uncooperative patients

  1. A Tindall,
  2. R Dawood,
  3. B Povlsen
  1. Guy’s & St Thomas’ Hospitals, London, UK
  1. Correspondence to:
 A Tindall
 12 Farington House 22 Gloucester Street Pimlico London SW1V 2DN, UK; alistair_tindall{at}
  • Accepted 17 July 2006


Assessment of the distal neurological status after injuries to the hand and fingers is one of the most frequent parts of standard trauma practice. Two-point discrimination as clinical examination is often sufficient to identify such lesions, but difficulties occur in the comatose, young or otherwise uncooperative patient. This article describes a simple pain-free alternative method of assessing digital nerve integrity by submerging the finger tip in water and observing if wrinkles develop on the skin.


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    Among patients with minor TBI (GCS 13-15) getting CT scans ≥ 24 hours after injury, what proportion have a traumatic finding?


    0.5% - 43% response rate
    3% - 41% response rate
    10% - 16% response rate

    Related original article: PCT head imaging in patients with head injury who present after 24 h of injury: a retrospective cohort study

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