Phalen’s maneuver

Phalen’s maneuver is a diagnostic test for –

A. Ulnar nerve entrapment

B. Assess palmar arch

C. Radial Artery patency

D. Carpal tunnel syndrome

What is the procedure of test in Phalen’s maneuver?

Performed by fully flexing the wrist, then holding this position and awaiting symptoms. A positive test is one that results in paresthesia in the median nerve distribution within sixty seconds.

Phalen’s maneuver

Performed by fully flexing the wrist, then holding this position and awaiting symptoms. A positive test is one that results in paresthesia in the median nerve distribution within sixty seconds.

Which nerve is compressed in carpal tunnel syndrome.

Median Nerve

What is the mechanism of symptom production in positive Phalen’s maneuver?

Compression of median nerve between the proximal edge of the transverse carpal ligament and the anterior border of the distal end of the radius.

What is positive Phalen’s maneuver?

Characteristic symptoms –

• burning, tingling or numb sensation

• over the thumb, index, middle and ring fingers

• convey a positive test result and suggest carpal tunnel syndrome.

What is Reverse Phalen’s test?

Performed by having the patient maintain full wrist and finger extension for two minutes.

The reverse Phalen’s test significantly increases pressure in the carpal tunnel within 10 seconds of the change in wrist posture

Reverse Phalen’s test

Reverse Phalen’s test significantly increases pressure in the carpal tunnel within 10 seconds of the change in wrist posture

Which is more sensitive – Phalen’s maneuver and Tinel’s sign?

Phalen’s maneuver is more sensitive than Tinel’s sign.

In-Shorts

What is Wartenberg’s sign?

This is a neurological sign consisting of involuntary abduction of the fifth (little) finger, caused by unopposed action of the extensor digiti minimi.

What is Hoffmann-Tinel sign?

Tinel’s sign (also Hoffmann-Tinel sign) is a way to detect irritated nerves.

It is performed by lightly tapping (percussing) over the nerve to elicit a sensation of tingling or “pins and needles” in the distribution of the nerve.

Tinel sign potential sign seen in –

1. carpal tunnel syndrome,
2. cubital tunnel syndrome,[
3. anterior tarsal tunnel syndrome
4. symptomatic neuroma.