Froment sign: Difference between revisions

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Clinical sign of ulnar nerve dysfunction

Froment's sign is a clinical test used to assess the function of the ulnar nerve, particularly its innervation to the adductor pollicis muscle. This sign is named after the French neurologist Jules Froment.

Clinical Significance

Froment's sign is primarily used to detect ulnar nerve palsy, which can result from various conditions such as cubital tunnel syndrome, Guyon's canal syndrome, or trauma to the elbow or wrist. The ulnar nerve is responsible for innervating several muscles in the hand, including the adductor pollicis, which is crucial for thumb adduction.

Test Procedure

To perform the test, the patient is asked to hold a piece of paper between the thumb and index finger, using a lateral pinch grip. The examiner then attempts to pull the paper away. In a normal response, the patient will maintain the grip using the adductor pollicis muscle, which is innervated by the ulnar nerve.

Positive Froment's Sign

A positive Froment's sign is indicated by the patient's inability to maintain the grip with the thumb flat against the index finger. Instead, the patient compensates by flexing the thumb's interphalangeal joint, using the flexor pollicis longus muscle, which is innervated by the median nerve. This compensatory action is due to weakness or paralysis of the adductor pollicis muscle.

Associated Conditions

Froment's sign is often associated with conditions that affect the ulnar nerve, including:

Differential Diagnosis

While Froment's sign is indicative of ulnar nerve dysfunction, it is important to differentiate it from other conditions that may affect hand function, such as:

Management

Management of a positive Froment's sign involves addressing the underlying cause of ulnar nerve dysfunction. Treatment options may include:

Physical therapy
Occupational therapy
Surgical intervention for nerve decompression
Splinting to prevent further nerve damage

Related Pages

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 {{Short description|Clinical sign of ulnar nerve dysfunction}}
-'''Froment's sign''' is a clinical test used to assess the function of the [[ulnar nerve]], particularly its innervation to the [[adductor pollicis]] muscle. This sign is often used in the diagnosis of [[ulnar nerve palsy]] and can indicate weakness or dysfunction in the muscles innervated by the ulnar nerve.
+'''Froment's sign''' is a clinical test used to assess the function of the [[ulnar nerve]], particularly its innervation to the [[adductor pollicis]] muscle. This sign is named after the French neurologist Jules Froment.
-==Clinical Presentation==
+==Clinical Significance==
-Froment's sign is elicited by asking the patient to hold a piece of paper between the thumb and index finger, using a lateral pinch grip. The examiner then attempts to pull the paper away. In a positive Froment's sign, the patient compensates for weakness of the adductor pollicis by flexing the [[interphalangeal joint]] of the thumb, using the [[flexor pollicis longus]] muscle, which is innervated by the [[median nerve]]. This compensatory action indicates weakness in the ulnar nerve-innervated muscles.
+Froment's sign is primarily used to detect [[ulnar nerve palsy]], which can result from various conditions such as [[cubital tunnel syndrome]], [[Guyon's canal syndrome]], or trauma to the elbow or wrist. The ulnar nerve is responsible for innervating several muscles in the hand, including the adductor pollicis, which is crucial for thumb adduction.
-[[File:Froment's_sign.jpg|Froment's sign being demonstrated|thumb|right]]
+==Test Procedure==
+To perform the test, the patient is asked to hold a piece of paper between the thumb and index finger, using a lateral pinch grip. The examiner then attempts to pull the paper away. In a normal response, the patient will maintain the grip using the adductor pollicis muscle, which is innervated by the ulnar nerve.
-==Pathophysiology==
+[[File:Froment's_sign.jpg|Froment's sign test|thumb|right]]
-The ulnar nerve is responsible for innervating several muscles in the hand, including the adductor pollicis, which is crucial for the adduction of the thumb. When the ulnar nerve is compromised, as in cases of [[cubital tunnel syndrome]] or [[ulnar nerve entrapment]], the adductor pollicis may become weak or paralyzed. As a result, the patient may rely on the flexor pollicis longus, a muscle innervated by the median nerve, to maintain grip strength, leading to the characteristic thumb flexion seen in Froment's sign.
-==Clinical Significance==
+==Positive Froment's Sign==
-Froment's sign is a valuable diagnostic tool for clinicians assessing patients with suspected ulnar nerve dysfunction. It helps differentiate between ulnar nerve palsy and other conditions affecting hand function. A positive Froment's sign suggests ulnar nerve involvement, which may require further investigation and management, such as nerve conduction studies or imaging.
+A positive Froment's sign is indicated by the patient's inability to maintain the grip with the thumb flat against the index finger. Instead, the patient compensates by flexing the thumb's interphalangeal joint, using the [[flexor pollicis longus]] muscle, which is innervated by the [[median nerve]]. This compensatory action is due to weakness or paralysis of the adductor pollicis muscle.
+==Associated Conditions==
+Froment's sign is often associated with conditions that affect the ulnar nerve, including:
+* [[Cubital tunnel syndrome]]
+* [[Guyon's canal syndrome]]
+* [[Ulnar nerve entrapment]]
+* [[Trauma]] to the elbow or wrist
+==Differential Diagnosis==
+While Froment's sign is indicative of ulnar nerve dysfunction, it is important to differentiate it from other conditions that may affect hand function, such as:
-==Related Tests==
+* [[Carpal tunnel syndrome]]
-In addition to Froment's sign, other tests can be used to evaluate ulnar nerve function, including:
+* [[Radial nerve palsy]]
-* [[Tinel's sign]]
+* [[Cervical radiculopathy]]
-* [[Phalen's test]]
-* [[Wartenberg's sign]]
 ==Management==
 Management of a positive Froment's sign involves addressing the underlying cause of ulnar nerve dysfunction. Treatment options may include:
-* Conservative measures such as splinting and physical therapy
-* Surgical intervention in cases of severe nerve compression or entrapment
+* [[Physical therapy]]
+* [[Occupational therapy]]
+* [[Surgical intervention]] for nerve decompression
+* [[Splinting]] to prevent further nerve damage
 ==Related Pages==
 * [[Ulnar nerve]]
 * [[Cubital tunnel syndrome]]
-* [[Ulnar nerve entrapment]]
+* [[Guyon's canal syndrome]]
-* [[Adductor pollicis]]
+* [[Nerve conduction study]]
 [[Category:Medical signs]]
 [[Category:Neurology]]