Froment sign
Froment's sign is a special test of the wrist. It tests for palsy of the ulnar nerve, specifically, the action of adductor pollicis. [1] Froment sign can also refer to cogwheel effect seen in essential tremor.
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.[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 FPL (flexor pollicis longus) of the thumb to maintain grip pressure causing a pinching effect.[3]
- Clinically, this compensation manifests as flexion of the IP 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.[4]
- 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.[5]
Eponym
It is named after Jules Froment.[6][7]
References
- ^ "Ulnar Nerve - Wheeless' Textbook of Orthopaedics". Retrieved 2008-01-26.
- ^ Jeff G. Konin et al. Special Tests for Orthopedic Examination: Third Edition. Thorofare, NJ. SLACK Incorporated, 2006.
- ^ Richardson, Craig and Fabre, Gerd. '"Froment's Sign." Journal of Audiovisual Media in Medicine. Vol. 26, No. 1 (2003):34.
- ^ Richardson, Craig and Fabre, Gerd. '"Froment's Sign." Journal of Audiovisual Media in Medicine. Vol. 26, No. 1 (2003):34.
- ^ Jeff G. Konin et al. Special Tests for Orthopedic Examination: Third Edition. Thorofare, NJ. SLACK Incorporated, 2006.
- ^ synd/1970 at Who Named It?
- ^ Froment, J. (1915). "La préhension dans les paralysies du nerf cubital et le signe du pouce". La presse médicale. 23. Paris: 409.
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