- See:
-
Intrinsic Plus Finger
-
Lumbical Plus Finger:
-
Phalangeal Injury
- Discussion:
-
lumbical plus finger should be distinguished from
intrinsic plus finger;
- Clinical Presentation:
- gripping medium-sized objects such as hammer handle is done primarily thru IP joint
flexion because handle effectively blocks MP joint from achieving full flexion;
- pts w/ intrinsic tightness will become symptomatic when repetitively
using this grip configuration against resistance;
- Technique:
- intrinsic tightness is demonstrated by comparing passive PIP joint
flexion w/ MP joint held in extension and then flexion;
- test for intrinsic tightness is performed by passively holding pt's MCP joints
extended & either actively or passively flexing PIP joints;
- since
intrinsics are put on stretch by MCP extension, if they are tight,
IP joints will have limited flexion;
- if PIP joint flexion is restricted when MP joint is held in extension but not when
MP joint is held in flexion, pt has positive intrinsic tightness test;
- attempts at active digital extension characterized by hyperextension
of MP joint w/ simultaneous flexion of the PIP joint;
- when MP joint are held in flexion, active extension of IP joint is normal;
