Froment's Sign - Process of Examination

Process of Examination

To perform the test, 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.

  • A normal individual will be able to maintain a hold on the object without difficulty.
  • However, 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.
  • Clinically, this compensation manifests as flexion of the IP joint of the thumb (rather than extension, as would occur with correct use of the adductor pollicis).
  • The compensation of the affected hand results in a weak pinch grip with the tips of the thumb and index finger, therefore, with the thumb in obvious flexion.
  • Note that the FPL is normally innervated by the anterior interosseous branch of the median nerve.
  • Anterior interosseous branch comes off more proximally than the wrist, in evaluating lacerations near the wrist.
  • Simultaneous hyperextension of the thumb MCP joint is indicative of ulnar nerve compromise. This is also known as Jeanne's Sign.

Read more about this topic:  Froment's Sign

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