Clinic of Hand, Plastic and Microsurgery, Katharinenhospital, Klinikum Stuttgart, Stuttgart, Germany.
Clinic of Traumatology, Hand, Plastic and Reconstructive Surgery, University of Ulm, Ulm, Germany.
J Hand Ther. 2019 Jan-Mar;32(1):64-70. doi: 10.1016/j.jht.2017.06.001. Epub 2017 Oct 14.
A within-subject research design was used in this study. The difference of the range of motion (ROM) with and without ulnar nerve block was analyzed.
For the clinical evaluation of the functional effects of ulnar nerve palsy at the hand the relevance of clinical tests is in discussion.
The aim of the study was to evaluate the predictive value of 2 clinical tests for a simulated ulnar nerve lesion by motion analysis with a sensor glove.
In 28 healthy subjects, dynamic measurements of the finger joints were performed by a sensor glove with and without ulnar nerve block at the wrist. In the 0° metacarpophalangeal (MCP) stabilization test, the subjects were asked to stabilize the MCP joints actively in 0° while moving the interphalangeal joints, whereas at the 90° MCP stabilization test, the subjects stabilized the MCP joints actively in the 90° position.
In the 0° MCP stabilization test, no remarkable changes of the ROM were found at the MCP joints; at the proximal interphalangeal joints 2-5, the ROM decreased with ulnar nerve block, significantly at the index, middle, and ring fingers (P < .05). In the 90° MCP stabilization test, the average ROM of the MCP joints 2-5 significantly increased with ulnar nerve block (P < .05), whereas at the PIP joints, the average ROM decreased (P < .05).
The 90° MCP stabilization test had a high predictive value for the discrimination between healthy subjects and subjects with a simulated peripheral ulnar nerve lesion.
The results could be relevant for the determination of the functional effect of ulnar nerve palsy and the quantification of clawing in hand rehabilitation.
II.
本研究采用了一种受试者内研究设计。分析了在有和没有尺神经阻滞的情况下运动范围（ROM）的差异。
对于手部尺神经麻痹的临床评估，临床检查的相关性尚存在争议。
本研究的目的是通过传感器手套的运动分析评估 2 项临床检查对模拟尺神经损伤的预测价值。
在 28 名健康受试者中，通过传感器手套在手腕处进行尺神经阻滞前后手指关节的动态测量。在 0°掌指（MCP）稳定试验中，要求受试者主动稳定 MCP 关节在 0°，同时移动指间关节；而在 90° MCP 稳定试验中，要求受试者主动稳定 MCP 关节在 90°位置。
在 0° MCP 稳定试验中，MCP 关节的 ROM 没有明显变化；在近侧指间关节 2-5，ROM 在尺神经阻滞时减小，在食指、中指和环指显著减小（P <.05）。在 90° MCP 稳定试验中，MCP 关节 2-5 的平均 ROM 在尺神经阻滞时显著增加（P <.05），而在 PIP 关节时，平均 ROM 减小（P <.05）。
90° MCP 稳定试验对区分健康受试者和模拟周围尺神经损伤的受试者具有较高的预测价值。
这些结果可能与确定尺神经麻痹的功能效果和在手康复中量化爪形手有关。
II 级。
