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Deep palmar nerves.

Froment's sign tests for palsy of the ulnar nerve, specifically, the action of adductor pollicis. [1] Froment sign can also refer to cogwheel effect seen in essential tremor.

Process

To perform the test, a patient is asked to hold an object, usually a piece of paper, between their thumb and index finger. The object is then pulled away.

  • A normal individual will be able to maintain a hold on the object without difficulty.
  • However, with ulnar nerve palsy, the patient will experience difficulty maintaining a hold and will compensate by flexing the FPL (flexor pollicis longus) of the thumb. Clinically, this compensation manifests as flexion of the IP joint of the thumb (rather than extension, as would occur with correct use of the adductor pollicis). Note that the FPL is normally innervated by the anterior interosseous branch of the median nerve. Please be aware, anterior interosseous branch comes off more proximally than the wrist, in evaluating lacerations near the wrist.

Eponym

It is named for Jules Froment.[2][3]

References

  1. ^ "Ulnar Nerve - Wheeless' Textbook of Orthopaedics". http://www.wheelessonline.com/ortho/ulnar_nerve. Retrieved 2008-01-26. 
  2. ^ synd/1970 at Who Named It?
  3. ^ J. Froment. La préhension dans les paralysies du nerf cubital et le signe du pouce. La presse médicale, Paris, 1915, 23: 409.
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