Abstract
Intrinsic plus hand describes a rare and painful contracture of the intrinsic hand
muscles with excessive flexion at the metacarpophalangeal joints and extension at
the interphalangeal joints. Resulting from many causes to include trauma and neurologic
injury, intrinsic plus hand can involve any number of fingers. Emergency department
(ED) assessment should include evaluation for cerebrovascular injury, infection, compartment
syndrome, and deep vein thrombosis (DVT). Conservative splinting is generally unsuccessful
and ultimately requires operative intervention. We highlight the case of a 61-year-old
otherwise healthy male who awoke to a painful and mildly swollen left hand with his
fingers held in a contracted position. Evaluation in the ED found no active range
of motion in the digits, severe pain with any passive motion, and a negative upper
extremity ultrasound for DVT. Ultimately, orthopedic and neurology consults in the
ED agreed upon a diagnosis of intrinsic plus hand.
Keywords
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References
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Article Info
Publication History
Published online: May 22, 2020
Accepted:
May 18,
2020
Received:
May 15,
2020
Identification
Copyright
Published by Elsevier Inc.
