Tinel's Sign

Purpose

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The purpose of this test is to determine whether or not there is any compromise of the ulnar nerve causing a loss of sensation or tingling.

Procedure

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Patient Position

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Sitting on the edge of the exam table with the injured elbow in slight flexion.

Position of Examiner

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Standing in front of the athlete holding the athlete's wrist with the distal hand.

Evaluative Procedure

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The examiner taps the ulnar nerve, located in the ulnar notch, with the index finger while stabilizing the wrist. The ulnar notch is between the olecranon process and medial epicondyle.

Mechanism

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The nerve innervates the little and ring finger but also the palm of the hand.

Results

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Tingling along the medial side of the forearm, hand and fingers. Special Considerations: Can be from traction of the nerve from a valgus force, or a type of compression , which can be seen with inflammation. Comparing bilaterally in order to compare results.

Adverse Effects

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A positive finding can be caused by traction from a valgus force or nerve compression so it is recommeneded that a bilateral comparison be done to find more reliability.

History

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Tinel's sign was named after Jules Tinel even though he was not the first one to come up with the idea of testing for nerve compressions.

Implications

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Compromise of the ulnar nerve

References

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"Special Tests." Minnesota State University Mankato. 22 Feb. 2010. Web. 11 Mar. 2011. <http://ahn.mnsu.edu/athletictraining/spata/elbowmodule/specialtests.html>.

Konin, Jeff G. "Section 4." Special Tests for Orthopedic Examination. Thorofare, NY: SLACK, 2006. Print.

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http://www.youtube.com/watch?v=T1oFeckmaGQ