Peripheral nerve injuries: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Peripheral nerve injuries

Sample item

After a supracondylar fracture, a patient with cubital tunnel compression has a hand with hyperextension of the ring and little finger metacarpophalangeal joints and flexion at the interphalangeal joints. Which sign tests for ulnar nerve weakness by assessing adductor pollicis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Froment's sign

In ulnar nerve palsy, the adductor pollicis is paralysed, so when gripping a sheet of paper between thumb and index finger, the patient substitutes flexor pollicis longus (anterior interosseous, median nerve), flexing the thumb interphalangeal joint, which is Froment's sign. Claw hand in low ulnar palsy results from paralysis of the ulnar lumbricals.

Option by option

  • A. Tinel's sign

    Tinel's sign is percussion over a nerve to elicit tingling, and is not specific to the ulnar nerve.

  • B. Phalen's sign

    Phalen's test is for carpal tunnel syndrome.

  • C. Froment's sign (correct)

    Correct. Froment's sign demonstrates paralysis of adductor pollicis in ulnar palsy.

  • D. Finkelstein's test

    Finkelstein's test is for De Quervain's tenosynovitis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Froment's sign. In ulnar nerve palsy, the adductor pollicis is paralysed, so when gripping a sheet of paper between thumb and index finger, the patient substitutes flexor pollicis longus (anterior interosseous, median nerve), flexing the thumb interphalangeal joint, which is Froment's sign.

Why is "Tinel's sign" not the answer?

Tinel's sign is percussion over a nerve to elicit tingling, and is not specific to the ulnar nerve.

Why is "Phalen's sign" not the answer?

Phalen's test is for carpal tunnel syndrome.

Why is "Finkelstein's test" not the answer?

Finkelstein's test is for De Quervain's tenosynovitis.

What concept does this question test?

It tests Peripheral nerve injuries in Orthopaedics. Claw hand in low ulnar palsy results from paralysis of the ulnar lumbricals.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Peripheral nerve injuries?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.