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Thumb opposition does not always represent the function of the median nerve due to variations in thenar muscle innervation. One hundred and thirty hands of 109 idiopathic carpal tunnel syndrome (CTS) patients with an undetectable compound muscle action potential of the abductor pollicis brevis (APB-CMAP) were classified into one of four groups; Type 1 (86.2%) had thenar muscle atrophy and could not perform thumb opposition; Type 2 (10.8%) had thenar muscle atrophy but could perform thumb opposition; Type 3 (2.3%) did not have thenar muscle atrophy and could perform thumb opposition, but needle electromyography of the APB showed neurogenic changes and Type 4 (0.8%) had no thenar muscle atrophy, could perform thumb opposition, and needle electromyography showed no neurogenic changes. Over 10% of severe CTS patients have mild or no muscle atrophy and intact thumb opposition. The purpose of this study was to investigate the variations in thenar muscle innervation in patients with severe CTS.
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http://dx.doi.org/10.1142/S0218810414500208 | DOI Listing |
J Clin Orthop Trauma
November 2025
Department of Orthopaedics, Dhanalakshmi Srinivasan Medical College Hospital, Siruvachur, Tamilnadu, India.
Thumb-in-palm deformity significantly limits hand function in arthrogryposis multiplex congenita (AMC), resulting from intricate interactions between contracted thumb-index web skin, restrictive intrinsic musculature, joint instability, and compromised extrinsic tendons, collectively causing thumb adduction, flexion, and poor opposition. Due to the complexity of this deformity, surgical outcomes have historically varied. We introduced a severity-based classification system-mild, moderate, or severe-to guide treatment decisions.
View Article and Find Full Text PDFChildren (Basel)
July 2025
Gotoschool Inc., Tokyo 150-0043, Japan.
Retained primitive reflexes are associated with delayed motor and behavioral development in children with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). This study examined the effects of a 12-week structured exercise intervention on reflex integration, motor coordination, and socio-behavioral outcomes in these populations. Fifteen children with ASD (13 boys, 2 girls) and twelve with ADHD (8 boys, 4 girls), aged 6-12 years, participated in rhythmic, balance, and coordination-based exercises.
View Article and Find Full Text PDFNeuroimage
August 2025
Department of Experimental Medicine, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
The aim of this study was to investigate changes in cortical hemodynamic activity within a frontoparietal network during the administration of an innovative action observation (AO) and proprioceptive stimulation (PS) protocol, and to examine whether this activity could predict the efficacy of the protocol in evoking M1 plasticity, reflected in significant long-term changes in M1 excitability. AO-PS was composed of 50 bursts of combined stimuli. Each burst consisted of five couples of AO and PS during which participants observed a video showing thumb opposition movements and simultaneously received a mechanical vibration on the extensor pollicis brevis muscle (stimulation frequency 80 Hz).
View Article and Find Full Text PDFHand Surg Rehabil
July 2025
Department of Paediatric Orthopaedic and Reconstructive Surgery, Centre de référence STREAM, Sorbonne Medical University, Trousseau Hospital, 26 avenue du Dr Arnold Netter, 75012 Paris, France; Centre de référence des Anomalies des Membres CEREFAM, Hôpitaux de Saint Maurice, France; School of S
Background: As several skin incision patterns have been described when performing index pollicization, it is currently difficult to know whether one incision is superior to another.
Hypothesis: Functional and aesthetic outcomes of two techniques of pollicization that differ in the incision pattern (Buck-Gramcko and Malek's technique) were analyzed.
Patients And Methods: Of 81 patients operated on between 1987 and 2021, 43 self-questionnaires were completed on 48 pollicized hands and 24 were reviewed for the study.
JBJS Case Connect
July 2025
Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, Nagano, Japan.
Case: A 6-year-old boy presented with a low-grade fibromyxoid sarcoma located at the base of the thumb following an unplanned resection. A wide resection was performed, including removal of the proximal first metacarpal, trapezium, thenar muscles, and thumb tendons. Reconstruction was performed using a parascapular osteocutaneous flap to achieve stable thumb opposition position, combined with free tendon grafts to restore thumb interphalangeal and metacarpophalangeal joint motion.
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