Klumpke paralysis

Diagnostic label and authority

Record the exact diagnostic wording, its author and whether it is provisional or established.

1. What clinical meaning does the diagnosing source assign to Klumpke paralysis? definition
2. Who applied the diagnosis, when, and on which examination or investigation evidence? provenance

Localisation and extent

Retain the demonstrated distribution and contradictory findings instead of forcing every deficit into C8-T1.

1. Which motor and sensory findings support lower plexus involvement, and which structures remain unlocalised? measurement
2. What evidence distinguishes this presentation from upper or total plexus palsy, a terminal neuropathy, or a cervical lesion? boundary

Causal evidence

Record birth or later onset and any documented traction event; upward arm traction is a described lower plexus mechanism. [Texas Children's Hospital](https://www.texaschildrens.org/sites/default/files/uploads/Chris%20Pederson.pdf).

1. When was weakness first observed, and was onset at birth, immediately after an event, or progressive? provenance
2. Which account supports the proposed mechanism, and what alternative explanation remains unresolved? boundary

Continuity and associated signs

Keep suspected stretch injury, rupture and root avulsion distinct, recording associated sympathetic findings separately.

1. What imaging, operative or specialist evidence establishes the affected structure and its continuity? provenance
2. Which sympathetic signs were assessed, on which side, and what interpretation did the clinician document? measurement

Mapped hand deficits

Record intrinsic hand and finger movement findings alongside sensory testing, including spared functions and examination limitations.

1. Which finger and intrinsic hand movements are weak, absent or preserved on an age-appropriate examination? measurement
2. Where is sensation altered, which modalities were tested, and how reliable was the examination? measurement

Usable hand function

Separate observed clawing, passive restriction and active weakness, then record their consequences for relevant tasks.

1. Is abnormal finger posture passively correctable, and which joints have restricted active or passive motion? measurement
2. Which age-relevant grasp, pinch or manipulation tasks can the person perform, and with what assistance? measurement

Time-anchored test evidence

Link imaging and electrodiagnostic reports to the clinical question, age and interval since onset.

1. When was each test performed relative to onset, and what question was it intended to resolve? provenance
2. Which conclusions about localisation or injury severity are explicit in the report, and which remain uncertain? boundary

Comparable recovery observations

Compare repeated assessments while retaining changes in method, assistance and compensatory movement.

1. How have the same tested muscles, sensory territories and hand tasks changed between dated assessments? measurement
2. Does improved task performance reflect documented motor recovery, compensation, assistance or an unresolved combination? boundary

Individual hand care plan

Record clinician-selected therapy, positioning, orthoses or sensory-protection measures with their functional targets.

1. Which documented hand deficit or activity goal does each prescribed measure address? action
2. What precautions, assistance needs and reassessment criteria accompany the plan? action

Review and escalation ownership

Store the responsible specialist, planned review date and explicit decision criteria without importing thresholds from other palsy patterns.

1. Which clinician owns the next decision, by when, and what evidence must be available? action
2. What age-, lesion- and recovery-specific criteria justify continued observation or assessment for an intervention? action

Check these first

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these check these first hold for the sense of Klumpke paralysis this model covers, and on what evidence? provenance

Kinds and varieties

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these kinds and varieties hold for the sense of Klumpke paralysis this model covers, and on what evidence? provenance

Identifiers and schemes

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these identifiers and schemes hold for the sense of Klumpke paralysis this model covers, and on what evidence? provenance

Real-world use

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these real-world use hold for the sense of Klumpke paralysis this model covers, and on what evidence? provenance

Failure modes and hazards

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these failure modes and hazards hold for the sense of Klumpke paralysis this model covers, and on what evidence? provenance

Neighbouring kinds and how to tell them apart

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these neighbouring kinds and how to tell them apart hold for the sense of Klumpke paralysis this model covers, and on what evidence? provenance