he fractured the fifth metacarpal and
also believed that he had injury to the whole hand. He
reported pain and loss of control in the right hand. After
examination, the impressions included osteoarthritis of the
hand secondary to the injury that the veteran suffered
during WWII and possible carpal tunnel syndrome.
On VA examination of May 1993, the veteran reported he had
frequent pains shooting up and down his right upper
extremity from his hand to his shoulder. The examiner noted
that physical examination was very difficult to perform as
the veteran could not relax to allow passive range of motion
testing and seemed to be resisting the examiner throughout
those efforts. The fifth metacarpal of the right hand had a
mild bow dorsally. An x-ray of the right hand showed an old
fracture of the fifth metacarpal and the middle phalanxof
the right little finger, but no other fractures or
malalignment. The radiological impression included no
change in the appearance in the hands since January 1991.
The examiner indicated that x-rays of the right hand
revealed evidence of an old fifth metacarpal fracture with
an angulation of 38 degrees of the distal metacarpal shaft,
otherwise, there was minimal interphalangeal joint
osteophyte formation with preservation of articular
cartilage. The examiner stated that it was extremely
difficult to evaluate the full residual effect of the remote
injury to the right hand due to lack of cooperation by the
veteran during the examination. The examiner concluded
that, based on the radiographs and history, it would not be
expected that the injuries described and visualized would be
as debilitating as they appeared to the veteran.
On VA neurologic examination in May 1993, the veteran
complained of right hand pain