What is the intrinsic plus position?
The overall safe position of immobilization for the hand is called the intrinsic plus or clam digger position. In the intrinsic plus position, the MCP joints are positioned in flexion and the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints of the fingers are positioned in extension.
What is intrinsic plus and minus hand?
As the MCP joints extend, the flexor tension on the IP joints increases and the extensor tension decreases. This causes the PIP and DIP joints to flex. The resultant late deformity is the intrinsic negative (or minus) hand, consisting of MCP joint extension, IP joint flexion, thumb adduction, and wrist flexion.
What causes intrinsic plus hand?
Intrinsic plus hand describes a rare and painful contracture of the intrinsic hand muscles with excessive flexion at the metacarpophalangeal joints and extension at the interphalangeal joints. Resulting from many causes to include trauma and neurologic injury, intrinsic plus hand can involve any number of fingers.
What is intrinsic minus or claw hand?
Intrinsic Minus Hand is a hand deformity characterized by MCP joint hyperextension with PIP joint and DIP joint flexion caused by an imbalance between strong extrinsics and deficient intrinsics.
Why is it called intrinsic plus?
The deformity of the hand, with flexed MP (metacarpo-phalangeal) joint and extended PIP (proximal interphalangeal) joint, is called the intrinsic-plus hand. It is primarily caused by the fibrous contracture of the intrinsic muscles of the hand.
What is an intrinsic plus cast?
Intrinsic Plus Splint A splint that has volar and dorsal components. Intrinsic plus describes a position of 20–30° of wrist extension, 70–80° MCP flexion, and full PIP/DIP extension (Fig. This splint should always use plaster, as it molds more tightly to the shape of the hand and maintains the required position.
What is intrinsic hand?
Four muscle groups comprise the intrinsic hand. These are the thenar, hypothenar, interossei and the lumbrical muscles. [2][3][9][1] The thenar muscle, or thenar eminence, is a collection of three muscles at the fleshy base of the thumb (first digit) on the palmar aspect that acts to exert movement about the thumb.
What is lumbrical plus?
Lumbrical tightness, also called lumbrical plus syndrome, is a relatively rare complication of flexor digitorum profundus (FDP) tendon laceration, which occurs when the proximal part of the retracted flexor tendon exerts its pull through the lumbrical on the extensor apparatus.
What is intrinsic minus position?
Loss of intrinsic muscle contraction results in impairment of the MCP joint flexion and interphalangeal joint extension, leading to an MCP hyperextension and interphalangeal joints flexion of the fourth and fifth fingers (Duchenne sign). This posture is known as the intrinsic minus or claw posture.