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First web space contracture and hand function

C B Jensen1, G M Rayan, R Davidson

  • 1Department of Occupational Therapy, Oklahoma Memorial Hospital, Oklahoma City.

The Journal of Hand Surgery
|May 1, 1993
PubMed
Summary
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The normal first web space angle averages 100 degrees, decreasing with age. Thumb-index finger contractures significantly impair hand function, especially for small objects.

Area of Science:

  • Orthopedics
  • Hand Surgery
  • Biomechanics

Background:

  • The first web space is crucial for hand function.
  • Contractures can limit range of motion and dexterity.
  • Understanding normal angles is key to assessing pathology.

Purpose of the Study:

  • To establish the normal first web space angle in healthy adults.
  • To investigate the impact of simulated thumb-index finger contractures on hand function.

Main Methods:

  • 195 hands from 125 volunteers were measured for the first web space angle.
  • The Jebsen-Taylor Test was administered to 50 hands under three conditions: no contracture, 30-degree contracture, and 60-degree contracture.

Main Results:

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  • The mean first web space angle was 100 degrees, with no significant differences based on sex or hand dominance.
  • A significant decrease in the mean angle was observed in individuals aged 50-79 compared to younger groups.
  • Simulated contractures impaired performance on small object manipulation, card turning, feeding, and checker stacking subtests.
  • Compensatory strategies were employed for grasping large objects, mitigating functional loss.

    • Conclusions:

    • Age influences the first web space angle.
    • Thumb-index finger contractures significantly compromise fine motor skills and specific hand tasks.
    • The findings highlight the importance of maintaining first web space mobility for optimal hand function.