MCP hyperextension and IP joint flexion. Previous Next. QID: L 2 Question Complexity. Question Importance. Sort by. All Videos 0 Podcasts 1. Listen Now min. If the curvature of your fingers is due to an injury, resting your hand may be the only treatment you need. Your healthcare provider may also suggest that you wear a brace that keeps your wrist straight to prevent further injury. You may need surgery to repair damaged nerves, ligaments , or muscles that are causing your symptoms.
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The ulnar claw hand deformity occurs more with a lower ulnar nerve lesion below the elbow and typically causes flexion and clawing of the fourth and fifth fingers due to the unopposed action of the medial part ulnar part of the flexor digitorum profundus muscle. Clawing is determined when the patient is asked to extend the fingers.
A hand in the ulnar claw position will have the fourth and fifth fingers extended at the metacarpophalangeal MCP joints and flexed at the interphalangeal IP joints.
When you ask the patient to extend the fingers, the patient will not be able to extend the interphalangeal IP joints at the fourth and fifth fingers Figure 1. This happens when the ulnar nerve innervates the ulnar half of the flexor digitorum profundus muscle. The ulnar nerve also innervates the third and fourth lumbrical muscles, all of the interosseous muscles, the adductor pollicis muscle.
And the deep head of the flexor pollicis brevis. When there is an injury to the ulnar never at the wrist, there will be loss of function for all the interosseous muscles and the ulnar two lumbricals. The second and third digits are mainly unaffected by this injury except in adduction and abduction of the fingers, while the fourth and fifth digits are largely affected by injury to the ulnar nerve.
With dysfuntion of these muscles, the extensor digitorum is unopposed, causing hyperextension of the fourth and fifth digits at the metacarpophalangeal MCP joints. The extensor digitorum is very affective in extending the MCP joint. The extensor digitorum gets help from the interossei and the lumbricals to extend the IP joints through the extensor hood or the extensor expansion.
At the interphalangeal IP joints, the extensor digitorum has to overcome and counteract the flexion force that is exerted by the functional flexor digitorum profundus.
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