- See:
- Intrinsic Plus Finger
- Lumbical Plus Finger
- Phalangeal Injury
- Discussion:
- lumbical plus finger should be distinguished from intrinsic plus finger;
- Clinical Presentation:
- gripping medium-sized objects such as hammer handle is done primarily through IP joint flexion because handle effectively blocks MP joint from achieving full flexion;
- pts w/ intrinsic tightness will become symptomatic when repetitively using this grip configuration against resistance;
- Technique:
- intrinsic tightness is demonstrated by comparing passive PIP joint flexion w/ MP joint held in extension and then flexion;
- test for intrinsic tightness is performed by passively holding pt's MCP joints extended & either actively or passively flexing PIP joints;
- since intrinsics are put on stretch by MCP extension, if they are tight, IP joints will have limited flexion;
- if PIP joint flexion is restricted when MP joint is held in extension but not when MP joint is held in flexion, pt has positive intrinsic tightness test;
- attempts at active digital extension characterized by hyperextension of MP joint w/ simultaneous flexion of the PIP joint;
- when MP joint are held in flexion, active extension of IP joint is normal