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Dr. Mark
Dr. Mark, Doctor (MD)
Category: Health
Satisfied Customers: 11946
Experience:  U.S. Physician/Surgeon in Neurosurgery
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My thumb does not bend at the first joint (knuckle) when I

Resolved Question:

My thumb does not bend at the first joint (knuckle) when I want it to. It moves easily, but it does not move when I try to grasp with my thumb. I regularly drop things b/c I can not grasp with the end of my thumb. I had surgery on my hand for Carpel Tunnel including trigger thumb. It did not work. My doctor called it an enigma.
Submitted: 7 years ago.
Category: Health
Expert:  Dr. Mark replied 7 years ago.
Do you mean pinching?

If you pinch your index finger and your thumb together (pinch a paper between your fingers), does it look more like the hand on the left or the right?

Customer: replied 7 years ago.
It looks more like the hand on the R. However, I can move my index finger to make it more round. I can move the thumb to make it move. It does not hurt, but to will it to work it will not click a pen. That makes it hard to write or open a jar or anything.
Expert:  Dr. Mark replied 7 years ago.

It may be helpful for your doctor to examine you for the possibility of "anterior interosseous syndrome"

As this can cause weakness in that thumb "pinching" motion like you mention.

Of course, without examing your hand, it is really difficult to tell, but the fact that it looks more like the hand on the right suggests weakness in muscles supplied by this nerve, which is a branch of the median nerve.

(Another branch of this is the one affected in carpal tunnel).

So seeing a specialist in peripheral entraptment neuropathies, like a orthopedic surgeon may be helpful.
Customer: replied 7 years ago.
So, Dr. Mark,
the Wikipedia said that sx decompression is effective at relieving s/s and ongoing nerve damage.
What type of sx is this about, and is there ongoing nerve damage? How long do I have before it is
damaged beyond repair?

I have been to an ortho sx and he stated that I was a enigma. He was clueless.
Do I need a real doctor?

Expert:  Dr. Mark replied 7 years ago.
Well, anterior interosseous syndrome comes from compression of that particular nerve, probably in the forearm.

This nerve is a pure motor nerve -- meaning the only symptoms would be weakness of the muscles -- in this case, particular muscles of the hand.

It is different from carpal tunnel, but involves a different branch of the median nerve -- and it is much less common than a carpal tunnel, so many doctors may be unfamiliar with this syndrome.

However, if you mention it, they can examine specifically for it, and then see if this is a possibility-- if it is, you probably would need a subspecialty referral to a physician that sees this condition more commonly.
Customer: replied 7 years ago.
Could it be from a compression in the shoulder?
I fell and broke the head of my humerus in July of '08.
It seems to have left some scar tissue b/c it still hurts
when I do something like raise my elbow to put deodorant on.
It is getting better b/c I exercise it till it hurts, and I can
see better range of motion.
Expert:  Dr. Mark replied 7 years ago.
While the origins of the median nerve are in that area, typically injury there would lead to more symptoms, including pain, numbness, and weakness in more of the hand muscles than just a couple of joints in the thumb. So it wouldn't be my first guess.

The best thing may to be evaluated by a hand specialist, who knows entraptment neuropathies, and can evaluate you fully.
Customer: replied 7 years ago.
HOw do I go about finding a doctor like that?
Look them up on the internet?
Expert:  Dr. Mark replied 7 years ago.
Ask your doctor to a referral to a hand surgeon in the area.

Or look for a plastic surgeon, or orthopedic surgeon who specializes in hand disorders, and have them investigate the possibility of anterior interosseous syndrome, as well as other reasons for your weakness.
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