Wartenberg's Sign

Purpose
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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.[1] A positive test indicates ulnar nerve neuropathy but does not determine site of compression (Guyon’s canal, cubital tunnel, arcade of Struthers).

Technique
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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.[2]


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References[edit | edit source]

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  1. Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.
  2. 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.