Use of two-point discrimination as a nerve repair assessment tool: preliminary report.

BACKGROUND

Two-point discrimination, static and dynamic, has long been used as an assessment tool for tactile gnosis, and to assess recovery after repair of a peripheral nerve. While use of a bent paperclip with a specified intertip distance as the assessment device has been described, no research has been performed on the accuracy of setting this distance by hand and eye alone. The aim of the present study was to demonstrate this accuracy.

METHODS

Five orthopaedic registrars, four residents and three clinic nurses performed static and dynamic two-point discrimination testing on each other. They set the tip distance by hand and eye by bending a paperclip such that the distance between the two ends was their best approximation of 5 mm and then 10 mm. The testing was repeated after 7 days, n = 264 for each tip distance.

RESULTS

Two-sample t-tests showed no significant difference (P > 0.53-0.93) between tip distance setting performed by registrars, nurses and residents; while single sample t-test showed a statistically significant difference (P < 0.0001) between the attempted tip distance and the overall mean tip distance achieved at 5 mm and 10 mm.

CONCLUSION

Statistical analysis showed that the single sample t-test could be discarded. Static and dynamic two-point discrimination testing with a paperclip set by hand and eye is therefore an accurate and reproducible test capable of being administered by both medical and non-medical staff, and is suitable for inclusion in a peripheral nerve repair testing protocol.