The effects of low median nerve block on thumb abduction strength

The relative contributions of the abductor pollicis longus (APL) and abductor pollicis brevis (APB) to thumb abduction strength (TAS) were determined after a selective nerve block in 21 normal volunteers. The median nerve was anesthetized (blocked) at the wrist. Needle electromyography verified paralysis of the APB and usually the opponens pollicis; in 6 study subjects, the superficial head of the flexor pollicis brevis (FPB) was also paralyzed. The APL, innervated by a branch of the posterior interosseous nerve, remained functionally intact. TAS was measured by a mechanical device before and after median nerve block. Median nerve block at the wrist resulted in a dramatic decrease in TAS in all volunteers. The mean loss of TAS was 70.3% in men and 74.3% in women. Postblock TAS tended to be greater in those subjects with retained function of the FPB. This study verifies that TAS is primarily a function of the APB.