Wartenberg's Sign
Original Editor - Peter Sheehy
Top Contributors - Sheik Abdul Khadir, Admin, Gertjan Pauwels, Scott Buxton, Rachael Lowe, Kim Jackson, Peter Sheehy, WikiSysop, Amanda Ager, 127.0.0.1, Evan Thomas and Naomi O'Reilly
Definition[edit | edit source]
Wartenberg's Sign refers to the slightly greater abduction of the fifth digit, due to paralysis of the abducting palmar interosseous muscle and unopposed action of the radial innervated extensor muscles (digiti minimi, digitorum communis ).[1]
Purpose
[edit | edit source]
Wartenburg’s sign is a test used for assessing integrity of the motor innervations of hand intrinsics in cases of suspected ulnar neuropathy. The inability to perform adducted digital extension is due to weakness in ulnar innervated intrinsic muscles, and the unopposed action of the slightly medially attached extensor digiti minimi results in extension and abduction of the 5th digit.[2] A positive test indicates ulnar nerve neuropathy but does not determine site of compression (Guyon’s canal, cubital tunnel, arcade of Struthers).
Technique
[edit | edit source]
A study by Goldman et al (2009) [3] adopted the technique to assess Wartenberg's Sign - The patient is placed with wrist in neutral position and forearm fully pronated and instructed to perform full extension of all the fingers. Once digits are extended patient is asked to fully abduct all fingers and then adduct all fingers. A positive sign is indicated with the observation of abduction of the 5th digit, with inability to adduct the 5th finger when extended.
David J Magee [4] propose another technique with minor variation - The patient sits with his or her hand resting on the table. The examiner passively spreads the finger apart and asks the patient to bring them together again. Inability to squeeze the little finger to the remainder of the hand indicates positive test for ulnar neuropathy.
Recent Related Research (from Pubmed)[edit | edit source]
Failed to load RSS feed from http://eutils.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1JcY43SP_RPRSMJttnbJOHbjkml9j3c3r6OuQvBywsz1o1Cwdt|charset=UTF-8|short|max=10: Error parsing XML for RSS
References[edit | edit source]
- ↑ A.J. Larner; A Dictionary of Neurological Signs; Springer Science & Business Media, 12-Nov-2010; page 369
- ↑ Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.
- ↑ Goldman SB, Brininger TL, Schrader JW, Curtis R, Koceja DM. Analysis of clinical motor testing for adult patients with diagnosed ulnar neuropathy at the elbow. Arch Phys Med Rehabil 2009;90:1846-52
- ↑ David J. Magee:Orthopedic Physical Assessment: chapter 6-elbow ;sixth edition;Elsevier Health Sciences, 2008
