Standing, sitting or lying supine
Anterior or lateral to the patient.
May I touch your hand? ( or point to the demonstrated area ).
Please bend your elbow and position your hand so that your thumb
points up (if standing or sitting). Raise your thumb straight up
and keep your other fingers bent (or demonstrate, which is easier).
Now move your thumb toward and away from your body. (or demonstrate
again, which is easier). (If needed, hold in this position while
I try to move your thumb.)
Guide the patient to position the radioulnar joint in neutral
pronation and supination. Guide the patient to extend all joints
of the thumb while keeping the other fingers flexed. Observe that
as the thumb extends, a short thick tendon, anterior to the tendon
of the extensor pollicis brevis, is observed. As the thumb is
abducted and adducted, the abductor pollicis longus becomes prominent
when the thumb is adducted, as the extensor pollicis brevis is less
active. Palpate this short tendon, which is the abductor pollicis longus
tendon. With unclear muscle activity, provide added resistance by having
the patient ìholdî while you gradually produce a push on the metacarpal 1
of the thumb in the direction of thumb carpometacarpal adduction with the
thumb in adduction.
VH -