24 Years old M complaining of gradually progressive deformity of left hand after 1.5 years of surgical operation of left hand due to trauma by rulling machine. Trauma is healed by secondary intention. Operation was done 4 years ago.
Today, patient presents left hand deformity with loss of sensation of the medial part of the palm and fingers (ring and little ) is marked by black ink in the picture.
- On cardboard test: fingers of left hand can not grasp a paper sheet due to paralysis of interossei as a result lost of adduction and abduction of fingers.
- Ulnar claw hand due to paralysis of medial two lumbricals due to ulnar nerve injured due to trauma
- Paralysis of adductor pollicis longus; if pinched a paper Between thumb and ring finger , thumb is flexed as froment sign.
- marked atrophy of theinner muscle; muscle wasting. Picture of Claw hand...
Investigation: X-ray is done.
Treatment: conservative treatment and nerve suture as usual.
This patient also have recurrent umbilical hernia.
In this ulnar claw hand case, you need to know the innervation of hand muscles by ulnar nerve and its root.
Muscles are innervated by ulner nerve below.
1. flexor carpi ulnaris**
2. flexor digitorum profundis***
3. lumbrical muscles***
4. opponens digiti minimi
5. flexor digiti minimi
6. abductor digiti minimi
6. interossei** and
7. adductor pollicis**
Root of ulnar nerve: C8 and T1. Shown below
Information will be updated with time.
Today, patient presents left hand deformity with loss of sensation of the medial part of the palm and fingers (ring and little ) is marked by black ink in the picture.
- On cardboard test: fingers of left hand can not grasp a paper sheet due to paralysis of interossei as a result lost of adduction and abduction of fingers.
- Ulnar claw hand due to paralysis of medial two lumbricals due to ulnar nerve injured due to trauma
- Paralysis of adductor pollicis longus; if pinched a paper Between thumb and ring finger , thumb is flexed as froment sign.
- marked atrophy of theinner muscle; muscle wasting. Picture of Claw hand...
Investigation: X-ray is done.
Treatment: conservative treatment and nerve suture as usual.
This patient also have recurrent umbilical hernia.
In this ulnar claw hand case, you need to know the innervation of hand muscles by ulnar nerve and its root.
Muscles are innervated by ulner nerve below.
1. flexor carpi ulnaris**
2. flexor digitorum profundis***
3. lumbrical muscles***
4. opponens digiti minimi
5. flexor digiti minimi
6. abductor digiti minimi
6. interossei** and
7. adductor pollicis**
Root of ulnar nerve: C8 and T1. Shown below
Information will be updated with time.
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| Ulnar Nerve |
2 comments
Very informative. Thanx for posting it
ReplyThank you too for your Good Comment,
ReplyWemedical post the clinical cases as much as possible.
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