Article

Ulnar nerve injuries can cause deficient hand movement patterns. Their assessment
is important for diagnosis and rehabilitation in hand surgery cases. The purpose
of this study was to quantify the changes in temporal coordination of the finger
joints during different power grips with an ulnar nerve block by means of a
sensor glove. In 21 healthy subjects, the onset and end of the active flexion of
the 14 finger joints when gripping objects of different diameters was recorded by
a sensor glove. The measurement was repeated after an ulnar nerve block was
applied in a standardized setting. The change in the temporal coordination of the
metacarpophalangeal (MCP), proximal interphalangeal (PIP) and distal
interphalangeal (DIP) joints with and without the nerve block was calculated
within the same subject. In healthy subjects, the MCP joints started their
movement prior to the PIP joints in the middle and ring finger, whereas this
occurred in the reverse order at the index and little finger. The DIP joint onset
was significantly delayed (P<0.01). With the ulnar nerve block, this coordination
shifted towards simultaneous onset of all joints, independent of the grip
diameter. The thumb and index finger were affected the least. With an ulnar nerve
block, the PIP joints completed their movement prior to the MCP joints when
gripping small objects (G1 and G2), whereas the order was reversed with larger
objects (G3 and G4). The alterations with ulnar nerve block affected mainly the
little finger when gripping small objects. With larger diameter objects, all
fingers had a significant delay at the end of the PIP joint movement relative to
the MCP and DIP joints, and the PIP and DIP joint sequence was reversed (P<0.01).
Based on the significant changes in temporal coordination of finger flexion
during different power grips, there are biomechanical effects of loss of function
of the intrinsic muscles caused by an ulnar nerve block on the fine motor skills
of the hand. This can be important for the diagnosis and rehabilitation of ulnar
nerve lesions of the hand.
CI - Copyright (c) 2017 SFCM. Published by Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS