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The Kapandji score is a tool useful for assessing the opposition of the thumb, based on where on their hand the patient is able to touch with the tip of their thumb. [1]
This specific action cups the palm. Many texts, for simplicity, use the term opposition to represent this component of true apposition. In order to truly appose the thumb, the actions of a number of other muscles are needed at the thumb's metacarpophalangeal joint. Note that the two opponens muscles (opponens pollicis and opponens digiti minimi ...
If patients do have median nerve palsy, occupational therapy or wearing a splint can help reduce the pain and further damage. Wearing a dynamic splint, which pulls the thumb into opposition, will help prevent an excess in deformity. This splint can also assist in function and help the fingers flex towards the thumb.
The muscles of the thumb are nine skeletal muscles located in the hand and forearm. The muscles allow for flexion , extension , adduction , abduction and opposition of the thumb . The muscles acting on the thumb can be divided into two groups: The extrinsic hand muscles, with their muscle bellies located in the forearm, and the intrinsic hand ...
Other researchers use another definition, [4] referring to opposition-apposition as the transition between flexion-abduction and extension-adduction; the side of the distal thumb phalanx thus approximated to the palm or the hand's radial side (side of index finger) during apposition and the pulp or "palmar" side of the distal thumb phalanx ...
The main symptom is pain, particularly with gripping and pinching. [7] [8] This pain is often described as weakness, but true weakness is not a part of this disease. People may also note a change in shape of the thumb. [7] [8] Some people choose surgery, but most people find they can accommodate trapeziometacarpal arthritis. [9] [10] [11]
The examiner passively restricts the flexion of the fingers while the examinee attempts to actively flex the thumb. [10] A positive test is marked by restricted active thumb flexion with pain or cramping discomfort in the palmar and radial sides of the distal (lower) forearm or wrist. [10]
Finkelstein's test was described by Harry Finkelstein (1865–1939), an American surgeon, in 1930. [5]A similar test was previously described by Eichhoff, in which the thumb is placed in the palm of the hand and held with the fingers, and the hand is then ulnar deviated (see images), causing intense pain over the radial styloid which disappears if the thumb is released.