[Volar flexion of the fingers. Its value in diagnosis of leprous paralysis of the intrinsic muscles of the fingers and in the study of the results of palliative interventions].

Active metacarpophalangeal flexion with simultaneous active extension of interphalangeal joints places the fingers in the position in preparation for prehension. This volar flexion of the fingers is due to the action of their intrinsic muscles, and this movement, which is irreplaceable, has been used by the author for the last twenty years as a specific exploratory test of intrinsic finger muscles. It can be investigated as an emergency procedure in cases of ulnar nerve wounds at the elbow or injury to the upper forearm before suture, and clearly demonstrates the presence of an ulnar claw hand. It is a very sensitive test since this position potentiates an ulnar claw hand in its early stage which would have passed unnoticed with fingers extended. This rapid examination is particularly valid during neurologic investigation of the hand in lepers in countries where this disease is endemic, and it forms part of the 10 tests that the author has selected for exploration, within 2 or 3 minutes, in a standing patient, of the facial, ulnar, median, superficial peroneal and posterior tibial nerves. The test is also the most effective evaluation criterion of palliative surgery for claw hand which to be considered as successful must restore volar flexion, as shown by a personal series of over 200 operated hands.