TemplateHand painTap a choice or type a Repertoire Line to see how the note changes. Defaults are what the template inserts on its own.Try a Repertoire Linehand painfinger injury: right, finger, jammed, xr negativewrist injury: left, wrist, scaphoidhand injury: mallet fingerhand injury: xr fracturewrist injury: gymnast wrist, defer xrPractice wording only: leave out patient details. Nothing typed here is saved or sent. Practice a case insteadLateralityChoose oneFirst lineRightLeftLocationChoose oneFirst linehandfingerthumbwristExamChoose oneNeurovascularly intact, with full finger motion and no rotational deformityDefaultRotational deformity or angulation of a fingerUnable to bend or straighten a finger joint, concerning for a tendon injuryNumbness in a finger, concerning for a nerve injuryLikely causeChoose oneLikely jammed finger (ligament sprain without fracture)Likely contusionLikely wrist sprainConcern for a scaphoid fracture given snuffbox tendernessConcern for mallet finger given inability to straighten the fingertipLikely gymnast's wrist (distal radius growth plate stress injury)ImagingChoose oneX-ray ordered given bony tendernessDefaultExam reassuring; x-ray deferred after shared decision makingX-ray without fractureX-ray with fracture; splinted and referred to orthopedicsSupportChoose oneBuddy taping until pain-freeFinger splintFingertip extension splint worn at all timesWrist splintThumb spica splintSplintPlanChoose anyRest, ice, and elevationDefaultGentle range of motion exercises once pain allowsDefaultWrist weight bearingChoose anyRest from weight bearing on the wrists, such as tumbling and handstands, for at least 6 weeks and until pain-freePhysical therapyChoose anyPhysical therapy referralReferralChoose oneOrthopedics referralHand surgery referralFollow-upChoose oneafter the x-ray resultDefaultas neededin 1-2 weeks to repeat the x-rayin 1-2 weeksafter the specialist visitCounseling paragraphChoose oneParagraphMost hand and finger injuries in children are sprains or bruises that improve over 1-2 weeks. Recommended supportive care with tylenol or motrin as needed, with an emphasis on ice, elevation, and gentle motion as pain allows. Return precautions given including swelling that keeps getting worse, numbness or tingling, a finger that looks crooked or will not straighten, pain that is not improving, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.DefaultA scaphoid fracture may not show on the first x-ray, so the wrist stays in the splint until a repeat x-ray. Recommended supportive care with tylenol or motrin as needed, with an emphasis on wearing the splint at all times, ice, and elevation. Return precautions given including pain or swelling that keeps getting worse, numbness or tingling, a cold, pale, or blue hand or fingers, a splint that feels too tight, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.Mallet finger heals when the fingertip is kept straight in the splint without any breaks, because bending it even once can restart healing. Recommended supportive care with tylenol or motrin as needed, with an emphasis on keeping the splint on at all times, including when washing. Return precautions given including a fingertip that will not stay straight, numbness, skin breakdown under the splint, pain that keeps getting worse, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.Children's hand bones heal quickly, and orthopedics will guide the splint or cast and return to activity. Recommended supportive care with tylenol or motrin as needed, with an emphasis on elevation for the first few days, ice, and keeping the splint dry. Return precautions given including pain or swelling that keeps getting worse, numbness or tingling, a cold, pale, or blue hand or fingers, a splint that feels too tight, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.The hand specialist will examine the finger and guide treatment, since tendon and nerve injuries heal best when treated early. Recommended supportive care with tylenol or motrin as needed, with an emphasis on protecting the finger and elevation until the visit. Return precautions given including numbness that spreads, a cold or pale finger, swelling that keeps getting worse, pain that keeps getting worse, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.What the sources coverLaterality, location (hand, finger, thumb, wrist)Neurovascular status, motion, rotational deformity; tendon and nerve concernJammed finger, contusion, wrist sprain, scaphoid, mallet finger, gymnast's wristX-ray given exam; defer; negative; fractureBuddy tape, finger, mallet, wrist, thumb spica, splintRest, ice, elevation; range of motion exercisesRest from wrist weight bearingPT, orthopedics, hand surgeryReturn precautions in the templateswelling that keeps getting worsenumbness or tinglinga finger that looks crooked or will not straightenpain that is not improvingSourcesHealthyChildren.org: Common Finger Injuries in AthletesThe Cribsiders #86: , #94 Overuse InjuriesFew formal guidelines cover this topic, so the template also leans on expert opinion.