ABSTRACT
If the fingers of the claw hand are stabilized in order to prevent over-extension of the metacarpophalangeal joints, the long extensors will fully extend both interphalangeal joints. Based on the proximal interphalangeal stiffness assessed by this test, a simple therapeutic plan is proposed for the choice of the appropriate techniques for palliative claw hand surgery.
Subject(s)
Humans , Metacarpophalangeal Joint/physiopathologyABSTRACT
Two tests are proposed for assessment of ulnar and median nerve function for use under field conditions: (i) "flap flexion" of fingers for ulnar nerve, and, (ii) tip-to-tip thumb opposition to the fourth finger for median nerve. These tests, which are a part of a series of simple clinical tests proposed for rapid neurological evaluation of the function of the nerves involved in leprosy, are simple, objective and easy to do. Because these tests depend on the strength of muscles tested, they might spare its direct assessment. In fact, it is difficult to assess and grade the strength of the little muscles of the hand and that is very much dependent on the examiner's own experience. Therefore, it is rather subjective. The tests described here may also be used for evaluating the results of corrective surgery of the hand. Whenever possible, making photographic records of these two tests, to be archived in the forms where everyone can see and compare them, seems to be easier and more objective than the subjective transcription of the feelings of an examiner assessing the strength of the small muscles of the hand. These two tests seem to be most objective for a scientific prospective study with a long term follow up. So, they could be used in assessing the results of leprosy neuritis by medical treatment, or, by medical treatment completed (when necessary only and not routinely) by surgical decompression of nerves and also of corrective surgery of claw hand, or, loss of opposition of the thumb.