title: The utility of using a hand clerking sheet for initial assessment of hand-related injuries.
abstract: Our study aims to develop and evaluate the practicality, clinical merit, and usefulness of a hand clerking sheet for use in a clinical orthopedic surgical unit. We hypothesize that the cause and extent of damage to anatomical structures will be more accurately documented in concordance with intraoperative findings when evaluated with the clerking sheet.
  
  
  
  All patients admitted to a tertiary care institute for hand-related injuries requiring acute surgical intervention within a 1-year period were evaluated. Assessments made preoperatively without the clerking sheet were evaluated retrospectively. Data concerning cause and extent of damage to anatomical structures were recorded using the hand clerking sheet for all newly admitted cases. The number of injuries documented prior to surgery and intraoperatively was compared.
  
  
  
  Patients who were assessed without the use of a clerking sheet had their injuries diagnosed with 61% accuracy (96/157), while patients who were assessed with the use of a clerking sheet were diagnosed with 91% accuracy (146/160). Overall, injuries evaluated with the clerking sheet were more accurate than without the aid of the clerking sheet 91% versus 61% ( p < 0.05).
  
  
  
  The high level of concurrence supports the view that patients admitted for hand-related injuries that were assessed with the aid of a hand clerking sheet or hand chart were diagnosed more accurately.
authors.affiliation: Department of Orthopaedic Surgery, Khoo Teck Puat Hospital, Singapore.
authors.forename: Benjamin T K
authors.initials: BT
authors.lastname: Ding
authors.affiliation: Department of Orthopaedic Surgery, Khoo Teck Puat Hospital, Singapore.
authors.forename: Vaikunthan
authors.initials: V
authors.lastname: Rajaratnam
mesh_terms: D005260:Female; D006230:Hand Injuries / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D012189:Retrospective Studies
keywords: assessment aids; hand chart; hand evaluation; hand injuries; junior doctors