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November 13, 1954


JAMA. 1954;156(11):1105. doi:10.1001/jama.1954.02950110067027

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To the Editor:—  I am not in agreement with some of the statements made concerning median and ulnar nerve paralysis in the article entitled "The Thumb as a Clinical Aid in Diagnosis" (J.A.M.A.155:729 [June 19] 1954). Dr. Fay states that median nerve paralysis makes it impossible for the thumb to be tightly held against the side of the index finger. The compression forces exerted in this movement are by the adductor of the thumb and the first dorsal interosseus, both innervated by the ulnar nerve. The movement is very difficult for a patient with ulnar nerve paralysis, and the patient will grasp an object in the web space by flexing the interphalangeal joint, using the long flexor of the thumb. In figure 1A, a patient with complete ulnar nerve paralysis of the right hand is attempting to hold a piece of paper between his thumb and index

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