Carpal tunnel syndrome.
I. Wrist flexion test: flex the wrist palm, ! Division when compressing the median nerve I – 2min o If the numbness on the palmar side of the hand increases, the pain pain increases and radiates to the index finger and middle finger, that is a positive test, suggesting carpal tunnel syndrome.
2. Percussion palpation test: also known as Tlnel’s sign. If the midpoint of the proximal margin of the transverse carpal ligament on the palmar side of the wrist is tapped or pressed, and if the irritation and numbness of the affected finger increase, the test is positive, indicating carpal tunnel syndrome.
3.Lift one hand test: The patient lies on his back and holds the affected limb straight and high, if the above two manifestations appear, the test is positive, suggesting carpal tunnel syndrome.
4.Pulse band test: Similar to the method of measuring blood pressure, only the blood pressure needs to be raised above the systolic pressure. If the above-mentioned manifestations appear, the test is positive, suggesting carpal tunnel syndrome.
5.Middle finger test: Ask the patient to straighten the elbow, wrist and interphalangeal joints with the palm down. Make the metacarpophalangeal joint of the middle finger do dorsal extension activities, and the examiner apply resistance. If there is pain at the two transverse fingers below the elbow flexor (i.e., at the medial edge of the flexor carpi radialis), the test is positive, suggesting carpal tunnel syndrome.
(Wrist) rheumatoid arthritis.
Bracelet test: when the lower end of the ulnar flexor is held in the hand, it can cause pain and is positive, as in rheumatoid arthritis.
Aseptic necrosis of the lunar bone.
Finstever’s sign: When the lunar bone is aseptically necrotic, the third metacarpal bone does not bulge when the fist is clenched.
Stenosing tenosynovitis of the flexural tuberosity.
Finkelstein’s sign: Also known as the clenched fist test. The thumb is first flexed, then the fist is clenched and the thumb is held in the palm while the wrist is tilted to the ulnar side, causing sharp pain in the flexor styloid process, suggesting stenosing tenosynovitis of the flexor styloid process.
Rupture of the thumb tendon.
Examination of thumb tendon rupture: When the thumb long flexor muscle is ruptured, the terminal segment of the thumb cannot be flexed automatically. When the long thumb extensor tendon is ruptured, the end joint of the thumb cannot be straightened automatically. During the examination, fix the proximal segment of the thumb and ask the patient to extend and flex the end joint automatically.
In thumb short extensor tendon rupture, the end segment is straightened and the affected finger cannot actively straighten the carpometacarpal joint of the thumb. When the short thumb flexor tendon is ruptured, the end joint cannot be automatically flexed proximally in the straightened state.
If the long and short thumb tendons are completely ruptured, active extension and flexion of the proximal and terminal segments of the thumb are completely lost.
Flexor rupture of the index, middle, ring, and little fingers.
Examination of rupture of the deep flexor tendon and superficial flexor tendon of the index, middle, ring, and little fingers: rupture of the deep flexor tendon of the finger, the end segment cannot be actively flexed. When the superficial flexor tendon is ruptured alone, the end phalanx cannot actively flex the middle phalanx in the extended position. If the proximal phalanx of the injured finger is fixed, and if the proximal and distal interphalangeal joints cannot be actively flexed, it means that the deep flexor tendon and the superficial flexor tendon of the finger are ruptured: and the extensor digitorum superficialis is ruptured in the index, middle, ring and little finger.
Examination of finger extensor tendon rupture: when the metacarpal region is ruptured, the interphalangeal joint can be actively straightened, but the metacarpophalangeal joint cannot be actively straightened. Rupture of the central tendon bundle of the proximal phalangeal region: the proximal interphalangeal joint cannot be actively straightened. Rupture or tear or avulsion fracture of the middle phalangeal area or near the stop of the extensor tendon: the end phalangeal joint of the finger cannot be actively straightened and the affected finger develops a hammer finger deformity.
Injury to the groin muscle: If the tensor fasciae or deep finger flexor tendon is ruptured proximal to the start point of the groin muscle, the metacarpophalangeal joint of the finger cannot be actively flexed. If the metacarpophalangeal joint is in flexion, the interphalangeal joint cannot be actively straightened’. If the interphalangeal joint is in extension, the metacarpophalangeal joint cannot be actively flexed.
Intrinsic hand muscle paralysis.
Beuil’s sign: Simple paralysis of the intrinsic hand muscles can cause claw-shaped hand deformity. When the examiner applies resistance to hyperextension with the finger at the dorsal base of the proximal phalanx of the clawed finger, the distal and proximal interphalangeal joints are then straightened and the deformity disappears. The test is negative when there is muscle paralysis in the hand with contracture of the skin, muscle keys, joint capsule and other compound claw-shaped hand.