Adducted thumb deformity
Introduction
Introduction Clinical manifestations of sacral nerve injury in exercise: When the upper arm sacral nerve is injured, each extensor muscle is extensively sacral, triceps, diaphragm, iliac crest, extensor muscle, supinator, extension finger, ulnar wrist The extensor muscles and the index finger and the small finger intrinsic extensors are uniform. Therefore, the wrist is drooping, the thumb and each finger are drooping, and the knuckles cannot be extended. The forearm has a pronation deformity, can not be rotated, and the thumb is deformed.
Cause
Cause
(1) Causes of the disease
Radial nerve injury is more common. The reasons are as follows:
1. Because the phrenic nerve is close to the tibia in the upper arm, it is also closer to the tibia in the forearm, so the fracture is often injured at the same time; it is often buried in the epiphysis during the fracture healing process.
2. Pull or compress to injure them. For example, the upper limbs are abducted for too long or the upper head of the head pillow falls asleep.
3. Gunshot wounds, cut injuries. Injury directly during wartime or in the corner.
4. Surgical injury: for example, a humeral head resection or a tibial surgery.
5. Excessive growth of the epiphysis or dislocation of the humeral head can also compress the phrenic nerve.
Examine
an examination
Related inspection
Cerebrospinal fluid neurotensin peptide electromyography thumb versus palm muscle strength test
First, the disease mainly has the following two aspects of clinical manifestations:
(1) Exercise: When the upper arm sacral nerve is injured, each extensor muscle is extensively sacral, triceps, diaphragm, iliac crest, extensor muscle, supinator, total finger muscle, ulnar wrist extensor and index finger The small intrinsic extensor muscles are uniform. Therefore, the wrist is drooping, the thumb and each finger are drooping, and the knuckles cannot be extended. The forearm has a pronation deformity, can not be rotated, and the thumb is deformed.
When examining the triceps and the wrist muscles, they should be performed in the direction of anti-gravity. The thumb loses its abduction, it does not stabilize the metacarpophalangeal joint, and the thumb function is severely impaired. Due to the ulnar wrist extensor and the temporal extension of the wrist, the wrist is difficult to move to the sides. The dorsal muscles of the forearm are atrophied. In the dorsal forearm of the forearm, most of the sacral nerve injury is the injury of the interosseous nerve. The sensation and triceps muscles are not affected. The longissimus dorsi muscle is good. Other extensors are even.
(2) Feeling: After the sacral nerve injury, the left and right sides of the back of the hand, the two half fingers of the temporal side, the upper arm and the posterior arm of the forearm are sensory.
Second, the basis of diagnosis
1. Have a history of trauma.
2. Those who have complete injuries above the elbow, can not stretch the wrist, stretch the thumb, stretch the fingers and abduct the thumb, showing a deformed wrist. Feeling handicap at the back of the tiger's mouth.
3. Those who have complete injuries below the elbow, have no effect, can not stretch the thumb, abduction of the thumb and extension of the fingers, no vertical wrist deformity.
4. EMG examination is helpful for diagnosis.
Diagnosis
Differential diagnosis
The thumb has only soft tissue and no bones: skeletal deformities can affect both upper limbs and are heavier on the left side. The variation or lack of forearm, wrist and temporal bone is the most common. The temporal carpal bone can make the base of the first metacarpal close to the midline due to delayed ossification. It is juxtaposed with other metacarpals. The fish can disappear, because the thumb is at the same level as other limbs. Therefore, the function of the palm is lost, and the variation of the thumb is a characteristic change of the disease. It is usually a subluxation, a finger, a three-point thumb, a distal curve to the ulnar side, a bifurcation, a short or absent or a thumb with only soft tissue and no bone.
Cardiac-limb syndrome, also known as Holt-Oram syndrome, atrio-digital syndrome, upper extremity cardiovascular syndrome, familial heart and Upper limb defects, atrial dysplasia, and atrio-digital dysplasia syndrome. The disease is an autosomal dominant hereditary disease characterized by cardiovascular malformations and skeletal malformations.
Can not stretch the thumb: flexor tendon sheath inflammation occurs mostly in the thumb and middle finger. The flexion and extension dysfunction of the affected finger is particularly obvious when waking up in the morning, and can be alleviated or disappeared after the activity. Pain sometimes radiates to the wrist. The flexion of the metacarpophalangeal joint can be tender, sometimes with a thickened tendon sheath and a pea-sized nodule. When bending the affected finger, suddenly staying in the semi-bend position, the finger can neither straighten nor bend, as if it is suddenly "snapped", the pain is unbearable, and with the other hand assisted to move, the finger can move again, resulting in Like the action of the trigger machine and the sound, it also has the name of trigger finger or snap finger.
