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In medicine, split hand syndrome is a neurological syndrome in which the hand muscles on the side of the thumb (lateral, thenar eminence) appear wasted, whereas the muscles on the side of the little finger (medial, hypothenar eminence) are spared.
Hypothenar hammer syndrome (HHS) is a vascular occlusion in humans in the region of the ulna. It is caused by repetitive trauma to the hand or wrist (such as that caused by the use of a hammer) [ 2 ] by the vulnerable portion of the ulnar artery as it passes over the hamate bone , which may result in thrombosis , irregularity or aneurysm formation.
Carpal tunnel syndrome can result in thenar muscle paralysis which can then lead to ape hand deformity if left untreated. [11] Ape hand deformity can also be seen in the hand of benediction deformity. [citation needed]
A person with idiopathic carpal tunnel syndrome will not have any sensory loss over the thenar eminence (bulge of muscles in the palm of hand and at the base of the thumb). This is because the palmar branch of the median nerve, which innervates that area of the palm, separates from the median nerve and passes over the carpal tunnel.
In the thenar eminence, the recurrent branch of the median nerve provides motor innervation to: [4] opponens pollicis muscle; abductor pollicis brevis muscle; superficial part of flexor pollicis brevis muscle; A separate, more proximal branch of the median nerve additionally provides motor innervation to the 1st and 2nd lumbricals of the hand.
Nevertheless, an ape hand deformity is not a requirement for a carpal tunnel syndrome diagnosis. Presence of a benediction sign when attempting to form a fist, due to weakness in flexion of radial half of digits. Sensory deficit: loss of sensation in lateral 3 + 1 ⁄ 2 digits including their nail beds, and the thenar area.
A hand imitating an ulnar claw. The metacarpophalangeal joints of the 4th and 5th fingers are extended and the Interphalangeal joints of the same fingers are flexed.. An ulnar claw, also known as claw hand or Spinster’s Claw, is a deformity or an abnormal attitude of the hand that develops due to ulnar nerve damage causing paralysis of the lumbricals.
The muscles of hypothenar eminence are from medial to lateral: Opponens digiti minimi; Flexor digiti minimi brevis; Abductor digiti minimi; The intrinsic muscles of hand can be remembered using the mnemonic, "A OF A OF A" for, Abductor pollicis brevis, Opponens pollicis, Flexor pollicis brevis (the three thenar muscles), Adductor pollicis, and the three hypothenar muscles, Opponens digiti ...