A Sign of Ulnar Palsy

Wartenberg, Robert

doi:10.1001/jama.1939.62800170002011a

Cited by 59 publications

(20 citation statements)

References 1 publication

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“…Diagnostic signs of the motor deficit were also noted preoperatively and postoperatively: atrophy of the first dorsal interosseous and hypothenar muscles, clawing of the small finger, the inability to cross the index and the long fingers, a positive Froment test, 20 and the Wartenberg sign. 21 The authors looked for specific complications after ulnar nerve transposition: pain and dysesthesia of the scar as well as subcutaneous adherence, neuroma of the medial antebrachial cutaneous nerve, wound complications, and hematoma.…”

Section: Clinical Evaluationmentioning

confidence: 99%

Comparative Clinical Outcomes of Submuscular and Subcutaneous Transposition of the Ulnar Nerve for Cubital Tunnel Syndrome

Charles

Coulet

Rouzaud

et al. 2009

The Journal of Hand Surgery

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Section: Clinical Evaluationmentioning

confidence: 99%

Comparative Clinical Outcomes of Submuscular and Subcutaneous Transposition of the Ulnar Nerve for Cubital Tunnel Syndrome

Charles

Coulet

Rouzaud

et al. 2009

The Journal of Hand Surgery

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“…Duchenne 38 highlighted this clinical observation in his book, originally published in 1867, noting that ''the impossibility to adduct the extended fingers represents the first step of paralysis of the interossei.'' In 1939, Wartenberg published a sign of ulnar neuropathy 53 that has since been coined ''Wartenberg's Sign.'' He described case studies whereby the small finger assumed a ''position of abduction,'' especially when the fingers are held extension.…”

Section: Wartenberg's Signmentioning

confidence: 99%

“…Wartenberg emphasized that this sign represents a late manifestation of ulnar nerve palsy. 53 Procedures to assess for the presence of a Wartenberg's sign involve asking the patient to first fully pronate and maintain the wrist in a neutral position. Then, the examiner asks the patient to first fully abduct and fully adduct the fingers.…”

Section: Wartenberg's Signmentioning

confidence: 99%

A Review of Clinical Tests and Signs for the Assessment of Ulnar Neuropathy

Goldman

Brininger

Schrader

et al. 2009

Journal of Hand Therapy

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ABSTRACT:Narrative Review: As part of a comprehensive assessment for suspected ulnar neuropathy, clinical testing plays an important role in the initial identification of a lesion and determining subsequent changes from baseline. The purpose of this article was to review ulnar nerve provocative testing and the substantial collection of diagnostic signs and tests. Administration procedures for each maneuver are described as well as the resulting positive and negative outcomes. The clinical tests described constitute only one aspect of the examination and should not substitute for other key components, such as taking a thorough medical and occupational history. Empirical research studies are indicated to further quantify the relationship between the testing outcomes and the severity of a lesion as well as to determine the most robust motor signs seen in the early stages of the disease.Level of Evidence: 5. J HAND THER. 2009;22:209-20. Clinical testing is an essential component in identifying and determining the extent of pathology for many upper extremity conditions; however, it can be particularly useful for evaluating patients with ulnar neuropathy. Injury to the ulnar nerve often results in a predictable set of upper extremity sensory and motor impairments. Sensory disturbances typically involve the small and ring fingers and can also involve the dorsal-ulnar aspect of the hand if the lesion is proximal to the wrist.1 Sensory changes can contribute to motor control difficulties or even manifest as a safety issue with severe compression to afferent axons transmitting pain and temperature information. Ulnar nerve motor involvement affects most of the intrinsic hand muscles, excluding three muscles in the thenar eminence and the lumbrical muscles to the index and ring fingers. If the entrapment is at the level of the elbow, the flexor digitorum profundus (FDP) to the ring and small fingers and the flexor carpi ulnaris (the strongest wrist flexor) may become weakened.

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“…A well-known pattern involves greater weakness of the adductor digiti minimi (i.e., third palmar interosseous muscle) relative to the abductor digiti minimi. Consequently, in such cases, the small finger stays abducted, giving rise to the well-known Wartenberg's sign [2]. Selective clawing of the ulnar two digits is also a common finding.…”

Section: Introductionmentioning

confidence: 99%

Focal Hand Dystonia in a Patient with Ulnar Nerve Neuropathy at the Elbow

Iyer

Thirkannad

2010

Hand (New York, N,Y.)

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We describe a patient who presented with dystonia of her small finger secondary to entrapment neuropathy of the ulnar nerve at the elbow. Pre operative electrophysiological studies suggested that the locus of entrapment was located proximal to the medial epicondyle. This was confirmed intraoperatively by the presence of a thickened and prominent arcade of Struthers. Surgical decompression resulted in a rapid and dramatic improvement of the dystonic pattern as well as an improvement in nerve conduction. A review of literature has not revealed any other reports of such a clear cut association between ulnar nerve entrapment and non task-specific focal hand dystonia.

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A Sign of Ulnar Palsy

Cited by 59 publications

References 1 publication

Comparative Clinical Outcomes of Submuscular and Subcutaneous Transposition of the Ulnar Nerve for Cubital Tunnel Syndrome

Comparative Clinical Outcomes of Submuscular and Subcutaneous Transposition of the Ulnar Nerve for Cubital Tunnel Syndrome

A Review of Clinical Tests and Signs for the Assessment of Ulnar Neuropathy

Focal Hand Dystonia in a Patient with Ulnar Nerve Neuropathy at the Elbow

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