Grade 2 disability of hand including trophic ulcers, total claw hand, auto-amputation of little finger and thumb and wasting of thenar and
hypothenar muscles; LL leprosy.
The deep ulnar nerve is responsible for motor control of intrinsic hand function through innervation of the dorsal and palmar interossei, the lumbricals of fourth and fifth digits, the
hypothenar muscles (abductor, flexor and opponens digiti minimi), adductor pollicis muscle and the deep head of flexor pollicis brevis.
In muscle testing there was significant atrophy in thenar and
hypothenar areas of both hands and dorsum of both feet without involvement of trunk or extraocular muscles.
Motor evaluation revealed right forearm dorsal and volar, and right hand interosseous muscle atrophy as well as atrophy of the thenar and
hypothenar areas.
A club that is too short will have the butt end lying against the
hypothenar eminence leaving the hook of the hamate vulnerable to injury (Fig.
Ventrally the manus has four subequal interdigital plantar pads and two carpal pads (thenar and
hypothenar).
For clinical work, stimulation was applied to the median or ulnar nerve at the wrist by a constant current pulse and the EMG was recorded from the thenar or
hypothenar muscles in the hand.
The electrodes were attached to the thenar and
hypothenar eminences by means of double-sided adhesive collars at least 15 min before the start of data collection.
The carpal tunnel occupies the region between the thenar and
hypothenar eminences in the hand.
Types of pattern in the thenar area and four interdigital areas [I.sub.1], [I.sub.2], [I.sub.3] and [I.sub.4] and
hypothenar area were recorded.
(1999) reported a 20 % incidence of the palmar type of the PMA in the adult, being more frequent in females than in males [1.3 (ratio) 1], occurring unilaterally more than bilateral [5 (ratio) 1] and slightly more frequent on the right than on the left [1.1 (ratio)1] The palmar cutaneous branch of the median nerve (PCB) is purely sensory, customarily branches from the median nerve, and supplies sensory sensation to the palm and variable areas over the thenar and
hypothenar eminences.
The CMAP amplitude abnormalities were only found in 2 of 43 SBMA patients (4.65%), in agreement with a very chronic and slowly progressive denervation process, in which reinnervation via collateral sprouting can keep pace with anterior horn cell loss.[sup][28] In addition, prior studies have reported that the proximal limb muscles were usually more severely affected than the distal limb muscles in SBMA patients.[sup][29],[30] The thenar and
hypothenar muscles were affected to a similar extent in the SBMA patients.