Froment's sign

Froment's sign
Deep palmar nerves
Differential diagnosispalsy of the ulnar nerve

Froment's sign is a special test of the wrist for palsy of the ulnar nerve, specifically, the action of adductor pollicis.[1] Froment's maneuver can also refer to the cogwheel effect from contralateral arm movements seen in Parkinson's disease.

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 the thumb and index finger (pinch grip). The examiner then attempts to pull the object out of the subject's hands.[2]

  • 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 flexor pollicis longus of the thumb to maintain grip pressure causing a pinching effect.[3]
  • Clinically, this compensation manifests as flexion of the interphalangeal joint of the thumb (rather than adduction, 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.[3]
  • Note that the flexor pollicis longus 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.[2]

Eponym

It is named after French neurologist Jules Froment.[4][5]

References

  1. ↑ "Ulnar Nerve - Wheeless' Textbook of Orthopaedics". Retrieved 2008-01-26.
  2. 1 2 Jeff G. Konin et al. Special Tests for Orthopedic Examination: Third Edition. Thorofare, NJ. SLACK Incorporated, 2006.
  3. 1 2 Richardson, Craig and Fabre, Gerd. '"Froment's Sign." Journal of Audiovisual Media in Medicine. Vol. 26, No. 1 (2003):34.
  4. ↑ synd/1970 at Who Named It?
  5. ↑ Froment, J. (1915). "La préhension dans les paralysies du nerf cubital et le signe du pouce". La Presse Médicale. Paris. 23: 409.
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