The authors administered a hand anatomy test to 26 emergency room physicians in training in London, England. The results of the test were compared to the results of the same test administered 16 years earlier to 40 emergency room physicians in training in Oxford, England (Arch Emerg Med 1992). The later group of physicians performed worse in response to every question. For example, 85 % of physicians in the early group correctly defined the anatomy of a mallet finger, whereas only 35% of physicians in the later group correctly defined the pathology of this injury. In the early group, 83% of physicians knew how to assess the motor function of the ulnar nerve, whereas only 35% of physicians in the later group were familiar with clinical tests for ulnar nerve motor function.
The findings from this study suggest that there are deficiencies in hand anatomy knowledge among doctors in training in emergency medicine. A lack of hand anatomy knowledge may lead to missed diagnoses and an inability to recognize significant or serious hand injuries at the initial presentation. The results are most likely applicable to the United States and education in this regard clearly needs to improve.