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A condition affecting hand function

Ape hand deformity is a condition characterized by the inability to move the thumb away from the rest of the hand. This condition is often associated with damage to the median nerve, which can occur due to various reasons such as trauma, compression, or neuropathy. The name "ape hand" comes from the similarity of the hand's appearance to that of an ape's hand, where the thumb is in line with the other fingers and cannot oppose or abduct.

Anatomy and Pathophysiology

The median nerve is responsible for the innervation of several muscles in the hand, particularly those involved in the movement of the thumb. It innervates the thenar eminence, which includes the abductor pollicis brevis, flexor pollicis brevis, and opponens pollicis muscles. These muscles are crucial for the opposition and abduction of the thumb.

When the median nerve is damaged, these muscles become weak or paralyzed, leading to the characteristic appearance of the ape hand deformity. The thumb remains adducted and extended, in line with the other fingers, due to the unopposed action of the muscles innervated by the ulnar nerve and radial nerve.

Causes

Ape hand deformity can result from various causes, including:

• Carpal tunnel syndrome
• Trauma to the wrist or forearm
• Peripheral neuropathy
• Median nerve palsy
• Brachial plexus injury

Symptoms

The primary symptom of ape hand deformity is the inability to oppose or abduct the thumb. Other symptoms may include:

• Weakness in the hand
• Loss of fine motor skills
• Numbness or tingling in the thumb, index, and middle fingers
• Atrophy of the thenar eminence

Diagnosis

Diagnosis of ape hand deformity involves a thorough clinical examination and history taking. Tests may include:

• Electromyography (EMG) to assess muscle activity
• Nerve conduction studies to evaluate the function of the median nerve
• Imaging studies such as MRI or ultrasound to identify structural causes

Treatment

Treatment of ape hand deformity focuses on addressing the underlying cause and may include:

• Physical therapy to strengthen the hand muscles
• Occupational therapy to improve hand function
• Surgical intervention to repair nerve damage or relieve compression
• Use of splints or braces to support the hand

Prognosis

The prognosis for ape hand deformity depends on the cause and severity of the nerve damage. Early intervention and treatment can improve outcomes and restore hand function in many cases.

Related pages

• Median nerve
• Carpal tunnel syndrome
• Peripheral neuropathy
• Brachial plexus injury

Gallery

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  Ape hand deformity showing thumb alignment

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  Close-up of ape hand deformity

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  Ape hand deformity in a clinical setting

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