Wrinkling Test

Original Editor - Ehtisham Panhwar
Top Contributors - Ehtisham Panhwar and Kirenga Bamurange Liliane

Purpose

Wrinkle or Wrinkling or Shivel test is a special test for hands. The Wrinkle test is used to check the nerve integrity of the hand by assessing the proper nervous response to an environmental stimulus which is water immersion for a sustained period of time. A Wrinkle test is used to diagnose a nerve injury or a limb's digit denervation.

Technique

• The patient should be in a sitting position
• Take warm water in a bowel
• Immerse patients affected or testing hand in the bucket
• Keep it immersed for around 10-30 minutes
  

  Negative sign on test.
• Take the hand out and look for wrinkles in hand
• A positive sign is not having wrinkles in any hand digit and a negative sign is having wrinkles on the finger as shown in the figure.

Evidence

In a study conducted by Rubin et al, they mention that wrinkle tests have a sensitivity of 69.5%, a specificity of 62.5% with a confidence interval of 95% in diagnosing the digital nerve injury.

The journal of hand therapy explains the significance that it is quite helpful to denervation in an infant or a young child who has not yet developed enough skills to be able to understand the instructions of other examinations. Wrinkle test do not require much cognitive understanding.

Resources

Many videos demonstrate the wrinkling test available on the internet, from which this video exactly shows how to do the special test and clearly show positive and negative signs of the tests.