(i) Clinical assessment of peripheral nerve injuries

Clinical assessment of a peripheral nerve lesion requires 1) the knowledge of the unique sensory territory and motor functions of the particular nerve, 2) the availability of a few examination tools, such as a tuning fork, a Disk-Criminator or paper clip, and, occasionally, 3) a local anesthetic. The clinical assessment should permit the diagnosis of a nerve division, a nerve compression, and a painful neuroma. Clinical situations common to orthopedic surgery, such as carpal and tarsal tunnel syndrome, as well as neuromas of cutaneous nerves encountered in these nerve compression sites are reviewed. Also discussed are commonly missed nerve compressions, such as the Morton's 'neuroma', cubital tunnel syndrome, and common peroneal entrapment at the knee. Use of nerve blocks is indicated prior to treatment of painful neuromas and prior to a partial dorsal or volar wrist denervation for the treatment. of wrist pain. This concept may be extended to the lower extremity, for example to the treatment of knee pain. Suite 104, 3901 Greenspring Avenue, Baltimore, Maryland 21211, USA.