Finkelstein’s test: A biomechanical analysis

Kutsumi, Keiji; Amadio, Peter C.; Zhao, Chunfeng; Zobitz, Mark E.; Tanaka, Tatsuro; An, Kai Nan

doi:10.1016/j.jhsa.2004.07.001

Cited by 46 publications

(30 citation statements)

References 4 publications

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“…It has been hypothesized that the development of de Quervan's disease, a stenosing tenosynovitis of the first dorsal compartment of the wrist, is associated with repeated overstretching of EPB and APL tendons, causing accumulative injury to the gliding mechanism (e.g., Finkelstein, 1930; Keon-Cohen, 1951). This hypothesis has been supported by the Finkelstein's test (Finkelstein, 1930), a classic diagnostic test for de Quervain's disease, in which the EPB and APL tendons are stretched in a particular thumb/wrist position to reproduce the patient's pain (Kutsumi et al, 2005). In the pipetting task, about 70% of the pushing power was generated from the CMC joint (Wu et al, 2012) and the CMC motions were generated mainly by the EPB and APL.…”

Section: Discussionmentioning

confidence: 98%

Analysis of the musculoskeletal loading of the thumb during pipetting – A pilot study

Sinsel

Shroyer

et al. 2014

Journal of Biomechanics

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Previous epidemiological studies indicate that the use of thumb-push mechanical pipettes is associated with musculoskeletal disorders (MSDs) in the hand. The goal of the current study was to analyze the loading in the muscle–tendon units in the thumb during pipetting. The hand is modeled as a multi-body linkage system and includes four fingers (index, long, ring, and little finger), a thumb, and a palm segment. Since the current study is focused on the thumb, the model includes only nine muscles attached to the thumb via tendons. The time-histories of joint angles and push force at the pipette plunger during pipetting were determined experimentally and used as model input; whereas forces in the muscle–tendon units in the thumb were calculated via an inverse dynamic approach combined with an optimization procedure. Results indicate that all nine muscles have force outputs during pipetting, and the maximal force was in the abductor pollicis brevis (APB). The ratio of the mean peak muscle force to the mean peak push force during the dispensing cycle was approximately 2.3, which is comparable to values observed in grasping tasks in the literature. The analysis method and results in the current study provide a mechanistic understanding of MSD risk factors associated with pipetting, and may be useful in guiding ergonomic designs for manual pipettes.

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Section: Discussionmentioning

confidence: 98%

Analysis of the musculoskeletal loading of the thumb during pipetting – A pilot study

Sinsel

Shroyer

et al. 2014

Journal of Biomechanics

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“…Many clinicians erroneously refer to Eichhoff's recommendation to place the thumb within the hand and subsequently bring the hand into ulnar abduction as the Finkelstein test. Interestingly, recent biomechanical analysis has shown that the Finkelstein test has a bias toward the extensor pollicis brevis tendon over the abductor pollicis longus, and it was suggested that de Quervain's syndrome may in fact be a pathology of the extensor pollicis brevis tendon and subsheath (Kutsumi et al, 2005). Surgical releases of the subsheath have resulted in complete relief of symptoms (Louis, 1987).…”

Section: Discussionmentioning

confidence: 99%

Performing arts medicine – Instrumentalist musicians: Part III – Case histories

Dommerholt¹

2010

Journal of Bodywork and Movement Therapies

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“…Les manoeuvres de Finkelstein (inclinaison ulnaire du poignet, pouce en adduction active) et Brunelli (inclinaison radiale du poignet, abduction active du pouce), qui mettent sous tension les tendons du premier compartiment dorsal (notamment celui du court extenseur du pouce lors de la manoeuvre de Finkelstein), sont positives et reproduisent la douleur [25]. Plus précisément, on obtient la manoeuvre de Finkelstein en repliant le pouce dans la paume, en repliant les doigts sur ce pouce et en effectuant une flexion cubitale mettant alors en tension le passage des tendons sur l'interligne radio-carpien (Fig.…”

Section: Diagnostic Cliniqueunclassified