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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.
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 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 muscles of hypothenar eminence are from medial to lateral: Opponens digiti minimi; Flexor digiti minimi brevis; Abductor digiti minimi; The intrinsic muscles of hand can be remembered using the mnemonic, "A OF A OF A" for, Abductor pollicis brevis, Opponens pollicis, Flexor pollicis brevis (the three thenar muscles), Adductor pollicis, and the three hypothenar muscles, Opponens digiti ...
Atrophy of the thenar muscles, weakness of palmar abduction, and loss of sensibility (constant numbness as opposed to intermittent paresthesia) are signs of advanced neuropathy. Advanced neuropathy is often permanent. The nerve will try to recover after surgery for more than 2 years, but the recovery may be incomplete. [113]
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] The other two muscles that influences movement of the thumb are the adductor pollicis and the first dorsal interosseous muscle.
The abductor pollicis brevis is a flat, thin muscle located just under the skin. It is a thenar muscle, and therefore contributes to the bulk of the palm's thenar eminence. It originates from the flexor retinaculum of the hand, the tubercle of the scaphoid bone, and additionally sometimes from the tubercle of the trapezium.
Lack of ability to abduct and oppose the thumb due to paralysis of the thenar muscles. This is called "ape-hand deformity".[3]Sensory loss in the thumbs, index fingers, long fingers, and the radial aspect of the ring fingers.
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