The Cascade Sign is used to assess rotational deformity of the fingers due to the presence of metacarpal and phalangeal fractures. Overlapping or askew fingers could be due to internal derangement of the bones of the fingers due to trauma.
Patient should be awake and cooperative to perform the Cascade Sign test.
- Patient should be seated with elbow flexed at 90 degrees and the forearm supinated.
- Tell patient to close his hand without making a fist. The patient should close all his fingers and let the thumb remain open.
- Examine the hand. Normally, the fingers will come together over the hypothenar muscles and scaphoid bone.
- After the examination, let the patient open his hand.
Positive Cascade Sign Test
A positive Cascade Sign ia when fingers overlap or are askewed. This could indicate that there is carpal internal derangement due to trauma.
Patients that have faulty cascading fingers could have problems with gripping or holding objects. This could affect their daily way of living. It is therefore a must to assess the grip strength of the patient as well.