Wrist & Hand
Vascular
Evidence: confirmed
Capillary Refill Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Assessing peripheral perfusion.
How to Perform
- Action: Squeeze the fingernail until it turns white (blanches). Hold for 5 seconds and release.
Interpretation of Results
- Normal: Color returns in < 3 seconds.
- Positive: Delayed return (>3s) suggests arterial insufficiency or shock.
Clinical Context & Limitations
The Capillary Refill Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Wrist & Hand region, combining the Capillary Refill Test with complementary examination tests significantly improves overall diagnostic confidence.
