Ape hand deformity

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Ape hand deformity
Synonyms	Simian hand
Pronounce	N/A
Specialty	Neurology, Orthopedics
Symptoms	Inability to oppose the thumb, flattening of the thenar eminence
Complications	N/A
Onset	N/A
Duration	N/A
Types	N/A
Causes	Median nerve injury
Risks	Carpal tunnel syndrome, trauma
Diagnosis	Physical examination, Electromyography
Differential diagnosis	N/A
Prevention	N/A
Treatment	Surgery, physical therapy
Medication	N/A
Prognosis	Varies depending on cause and treatment
Frequency	Rare
Deaths	N/A

Ape hand deformity

Ape hand deformity

Ape hand deformity is a condition characterized by the inability to oppose the thumb to the other fingers, resulting in a hand posture that resembles that of an ape. This condition is primarily associated with median nerve dysfunction, which affects the thenar eminence muscles responsible for thumb opposition.

Causes

Ape hand deformity is most commonly caused by injury or compression of the median nerve. This can occur due to:

• Carpal tunnel syndrome
• Trauma to the wrist or forearm
• Peripheral neuropathy
• Brachial plexus injury
• Tumors or cysts compressing the nerve

Pathophysiology

The median nerve innervates the thenar muscles, including the opponens pollicis, abductor pollicis brevis, and flexor pollicis brevis. These muscles are responsible for the opposition and flexion of the thumb. When the median nerve is compromised, these muscles become weak or paralyzed, leading to the characteristic posture of the thumb in ape hand deformity.

Clinical Presentation

Patients with ape hand deformity typically present with:

• Inability to oppose the thumb
• Flattening of the thenar eminence
• Weakness in thumb flexion and abduction
• Sensory loss in the lateral three and a half fingers

Diagnosis

Diagnosis of ape hand deformity involves:

• Clinical examination to assess thumb opposition and thenar muscle function
• Electromyography (EMG) and nerve conduction studies to evaluate median nerve function
• Imaging studies such as MRI or ultrasound to identify structural causes of nerve compression

Treatment

Treatment of ape hand deformity depends on the underlying cause and may include:

• Physical therapy to strengthen hand muscles and improve function
• Splinting to support the thumb and improve hand posture
• Surgical intervention to relieve nerve compression or repair nerve damage
• Occupational therapy to assist with adaptive techniques for daily activities

Prognosis

The prognosis for ape hand deformity varies depending on the cause and severity of the nerve injury. Early diagnosis and treatment can improve outcomes, but severe or prolonged nerve damage may result in permanent dysfunction.

See Also

• Median nerve
• Carpal tunnel syndrome
• Peripheral neuropathy
• Brachial plexus injury