Froment’s Sign: Difference between revisions
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== | == Introduction == | ||
Froment's sign<ref>''Froment, J. “La prehension dans les paralysies, du nerf cubital et la signe du ponce.” Presse med.23 (1915): 409.''</ref><ref name=":0">Richardson J and Fabre G. [https://www.ncbi.nlm.nih.gov/pubmed/12916637 Froment's Sign]. [https://www.ncbi.nlm.nih.gov/pubmed/12916637 Audiov Media Med, 2003] </ref> is a physical examination of the hand to test for palsy of the [[Ulnar Nerve|ulnar nerve]] which results in reduced functionality and muscle weakness of the pinch grip. | |||
== Structure == | |||
It tests the strength of the [[adductor pollicis]] of the thumb, which is innervated by the ulnar nerve and is weakened in [[Ulnar Nerve Entrapment|ulnar nerve palsy]]. | |||
Froment's sign presents after damage to the ulnar nerve, which innervates the adductor pollicis and interossei muscles, which provide adduction of the thumb and extension of the interphalangeal joint. The flexor pollicis longus (innervated by the median nerve), will substitute for the adductor pollicis (innervated by the ulnar nerve) and cause the thumb to go into hyperflexion. [http://www.physio-pedia.com/Ulnar_Nerve_Entrapment Ulnar nerve palsy] can be as a result of dysfunction at the cervical spine, elbow ([[Cubital Tunnel Syndrome|cubital tunnel syndrome]]) or at the wrist ([[Cyclist's palsy|Guyons canal syndrome]]). | == Purpose == | ||
Froment's sign presents after damage to the ulnar nerve, which innervates the adductor pollicis and interossei muscles, which provide adduction of the thumb and extension of the interphalangeal joint. The flexor pollicis longus (innervated by the median nerve), will substitute for the adductor pollicis (innervated by the ulnar nerve) and cause the thumb to go into hyperflexion. [http://www.physio-pedia.com/Ulnar_Nerve_Entrapment Ulnar nerve palsy] can be as a result of dysfunction at the cervical spine, elbow ([[Cubital Tunnel Syndrome|cubital tunnel syndrome]]) or at the wrist ([[Cyclist's palsy|Guyons canal syndrome]]). | |||
== Position == | |||
=== Patient position === | |||
The patient is sitting. | |||
=== Therapist position === | |||
The therapist is either sitting or standing. | |||
== Application == | |||
A patient is asked to hold an object, usually a flat object such as a piece of paper, between their thumb and index finger (pinch grip). The examiner then attempts to pull the object out of the subject's hands<ref>Jeff G. Konin ''et al''. ''Special Tests for Orthopedic Examination: Third Edition.'' Thorofare, NJ. SLACK Incorporated, 2006.</ref> | |||
== Positive Sign == | |||
A normal individual will be able to maintain a hold on the object without difficulty. With ulnar nerve palsy, the patient will experience difficulty maintaining a hold and will compensate by flexing the FPL (flexor pollicis longus) of the thumb to maintain grip pressure causing a pinching effect.{{#ev:youtube|yJTIhm1VfSI|400}}<ref>CRTechnologies. Froment's Sign. Available from: http://www.youtube.com/watch?v=yJTIhm1VfSI [last accessed 24/10/2020]</ref> | |||
Similar to Froment’s sign, Jeanne’s sign<ref>''Jeanne M. “La deformation du ponce la paralysie cubitale.” Bul Mem Soc Chir Paris 41 (1915): 703-19.''</ref> indicates ulnar nerve palsy and is also seen in response to pinch forces. Instead of isolated thumb IP flexion, the IP flexion is accompanied by MP joint hyperextension. | Similar to Froment’s sign, Jeanne’s sign<ref>''Jeanne M. “La deformation du ponce la paralysie cubitale.” Bul Mem Soc Chir Paris 41 (1915): 703-19.''</ref> indicates ulnar nerve palsy and is also seen in response to pinch forces. Instead of isolated thumb IP flexion, the IP flexion is accompanied by MP joint hyperextension. | ||
Revision as of 11:07, 11 February 2024
Top Contributors - Harvey Manes, Admin, Rachael Lowe, Kim Jackson, Momina Khalid, Fasuba Ayobami, Claire Knott and Lucinda hampton
Introduction[edit | edit source]
Froment's sign[1][2] is a physical examination of the hand to test for palsy of the ulnar nerve which results in reduced functionality and muscle weakness of the pinch grip.
Structure[edit | edit source]
It tests the strength of the adductor pollicis of the thumb, which is innervated by the ulnar nerve and is weakened in ulnar nerve palsy.
Purpose[edit | edit source]
Froment's sign presents after damage to the ulnar nerve, which innervates the adductor pollicis and interossei muscles, which provide adduction of the thumb and extension of the interphalangeal joint. The flexor pollicis longus (innervated by the median nerve), will substitute for the adductor pollicis (innervated by the ulnar nerve) and cause the thumb to go into hyperflexion. Ulnar nerve palsy can be as a result of dysfunction at the cervical spine, elbow (cubital tunnel syndrome) or at the wrist (Guyons canal syndrome).
Position[edit | edit source]
Patient position[edit | edit source]
The patient is sitting.
Therapist position[edit | edit source]
The therapist is either sitting or standing.
Application[edit | edit source]
A patient is asked to hold an object, usually a flat object such as a piece of paper, between their thumb and index finger (pinch grip). The examiner then attempts to pull the object out of the subject's hands[3]
Positive Sign[edit | edit source]
A normal individual will be able to maintain a hold on the object without difficulty. With ulnar nerve palsy, the patient will experience difficulty maintaining a hold and will compensate by flexing the FPL (flexor pollicis longus) of the thumb to maintain grip pressure causing a pinching effect.
Similar to Froment’s sign, Jeanne’s sign[5] indicates ulnar nerve palsy and is also seen in response to pinch forces. Instead of isolated thumb IP flexion, the IP flexion is accompanied by MP joint hyperextension.
Evidence[edit | edit source]
This test has been described[2], but no studies were found that look at diagnostic properties
References[edit | edit source]
- ↑ Froment, J. “La prehension dans les paralysies, du nerf cubital et la signe du ponce.” Presse med.23 (1915): 409.
- ↑ 2.0 2.1 Richardson J and Fabre G. Froment's Sign. Audiov Media Med, 2003
- ↑ Jeff G. Konin et al. Special Tests for Orthopedic Examination: Third Edition. Thorofare, NJ. SLACK Incorporated, 2006.
- ↑ CRTechnologies. Froment's Sign. Available from: http://www.youtube.com/watch?v=yJTIhm1VfSI [last accessed 24/10/2020]
- ↑ Jeanne M. “La deformation du ponce la paralysie cubitale.” Bul Mem Soc Chir Paris 41 (1915): 703-19.
