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The thenar eminence is the mound formed at the base of the thumb on the palm of the hand by the intrinsic group of muscles of the thumb. [1] The skin overlying this region is the area stimulated when trying to elicit a palmomental reflex. The word thenar comes from Ancient Greek θέναρ (thenar) 'palm of the hand'. [2]
In medicine, split hand syndrome is a neurological syndrome in which the hand muscles on the side of the thumb (lateral, thenar eminence) appear wasted, whereas the muscles on the side of the little finger (medial, hypothenar eminence) are spared.
In uncooperative patients, the skin wrinkle test offers a pain-free way to identify denervation of the fingers. After submersion in water for 5 minutes, normal fingers will become wrinkled, whereas denervated fingers will not. [16] In "Ape hand deformity", the thenar muscles become paralyzed due to impingement and are subsequently flattened. [17]
In the thenar eminence, the recurrent branch of the median nerve provides motor innervation to: [4] opponens pollicis muscle; abductor pollicis brevis muscle; superficial part of flexor pollicis brevis muscle; A separate, more proximal branch of the median nerve additionally provides motor innervation to the 1st and 2nd lumbricals of the hand.
The intrinsic muscles of the thumb can be divided into two groups; the thenar eminence and other muscles. The thenar eminence refers to the group of muscles on the palm at the base of the thumb. The three muscles composing the thenar eminence are the abductor pollicis brevis, flexor pollicis brevis and opponens pollicis. [5]
Palmar erythema has no specific treatment. Management is based on the underlying cause. When its cause is treated then patients get relief. If it is attributable to a particular drug then the drug should be withdrawn.
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A post-operative photo of repair of a complete rupture of the ulnar collateral ligament. Note the K-wire to brace the joint. The ulnar collateral ligament is an important stabilizer of the thumb. Thumb instability resulting from disruption of the UCL profoundly impairs the overall function of the involved hand.