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Hypermobile metacarpo-phalangeal joints Hyperextension of the thumb Hyperextension of the hand. Hypermobility syndrome is generally considered to comprise hypermobility together with other symptoms, such as myalgia and arthralgia. It is relatively common among children and affects more females than males.
The primary function of the extensors is to straighten out the digits. The thumb has two extensors in the forearm; the tendons of these form the anatomical snuff box. Also, the index finger and the little finger have an extra extensor, used, for instance, for pointing. The extensors are situated within 6 separate compartments.
During hyperextension the accessory ligaments are lengthened while the proper ligaments are shortened. [3] As a result, the joint is stable during full flexion while the relaxed collateral ligaments allows lateral and rotation movements during extension. [4] The tendons of interosseous and lumbricales add to the lateral stability of the joint. [1]
On the back of the hand, the ED tendons diverge to follow the fingers and the EI tendon joins the ulnar side of one of the ED tendons along the back of the index finger. The EDM takes a similar course as the EI except it follows the ED tendon along the little finger. The ECU crosses from the lateral to the medial side of the forearm.
The palmar plate is supported by a ligament on either side of the joint called the collateral ligaments, which prevent deviation of the joint from side to side. The ligaments can partially or fully tear and can avulse with a small fracture fragment when the finger is forced backwards into hyperextension.
In contrast to the volar plates of the MCP joints of the fingers, the volar plate of the thumb MCP joint is a thick structure firmly attached to the base of the proximal phalanx. It forms the bottom of a two-sided box, the sides of which are made up of the collateral ligaments. [8]
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.
Swan neck deformity has many of possible causes arising from the DIP, PIP, or even the MCP joints. In all cases, there is a stretching of the volar plate at the PIP joint to allow hyperextension, plus some damage to the attachment of the extensor tendon to the base of the distal phalanx that produces a hyperflexed mallet finger.