Phalen sign

ファーレン徴候

WordNet

1. place signs, as along a road; "sign an intersection"; "This road has been signed"
2. (medicine) any objective evidence of the presence of a disorder or disease; "there were no signs of asphyxiation"
3. a perceptible indication of something not immediately apparent (as a visible clue that something has happened); "he showed signs of strain"; "they welcomed the signs of spring" (同)mark
4. a character indicating a relation between quantities; "dont forget the minus sign"
5. a fundamental linguistic unit linking a signifier to that which is signified; "The bond between the signifier and the signified is arbitrary"--de Saussure
6. a gesture that is part of a sign language
7. a public display of a message; "he posted signs in all the shop windows"
8. engage by written agreement; "They signed two new pitchers for the next season" (同)contract, sign on, sign_up
9. approve and express assent, responsibility, or obligation; "All parties ratified the peace treaty"; "Have you signed your contract yet?" (同)ratify
10. communicate silently and non-verbally by signals or signs; "He signed his disapproval with a dismissive hand gesture"; "The diner signaled the waiters to bring the menu" (同)signal, signalize, signalise
11. mark with ones signature; write ones name (on); "She signed the letter and sent it off"; "Please sign here" (同)subscribe
12. be engaged by a written agreement; "He signed to play the casino on Dec. 18"; "The soprano signed to sing the new opera"
13. communicate in sign language; "I dont know how to sign, so I could not communicate with my deaf cousin"
14. having a handwritten signature; "a signed letter"

PrepTutorEJDIC

1. (ある事実・状態・感情などの)『表れ』,印,気配,徴侯(indication);(…の)こん跡,計跡《+『of』+『名』》・『身ぶり』,手まね,合図 / 『標識』,看板 / (数学・音楽などの)記号 / (…の)『象徴』,シンボル(symbol)《+『of』+『名』》・《文》(…の)『前兆』,きざし《+『of』+『名』》・宮(きゅう)(黄道12区分の一つ) ・〈手紙・書類・作品など〉‘に'『署名する』・(…に)〈名前など〉‘を'書く《+『名』+『on』(『to』)+『名』》 / …‘を'雇う契約に署名する・…‘を'合図する,知らせる;…に合図する・署名する・契約書に署名して雇われる
2. =ti

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/06/26 12:55:53」(JST)

wiki en

[Wiki en表示]

Transverse section across the wrist and digits. (The median nerve is the yellow dot near the center. The carpal tunnel is not labeled, but the circular structure surrounding the median nerve is visible.)

Phalen's maneuver is a diagnostic test for carpal tunnel syndrome discovered by an American orthopedist named George S. Phalen.

Technique

The patient is asked to hold their wrist in complete and forced flexion (pushing the dorsal surfaces of both hands together) for 30–60 seconds. The lumbricals attach in part to the flexor digitorum profundus tendons. As the wrist flexes, the flexor digitorum profundus contracts in a proximal direction, drawing the lumbricals along with it. In some individuals, the lumbricals can be "dragged" into the carpal tunnel with flexor digitorum profundus contraction. As such, Phalen's maneuver can moderately increase the pressure in the carpal tunnel via this mass effect, pinching the median nerve between the proximal edge of the transverse carpal ligament and the anterior border of the distal end of the radius. By compressing the median nerve within the carpal tunnel, characteristic symptoms (such as burning, tingling or numb sensation over the thumb, index, middle and ring fingers) conveys a positive test result and suggests carpal tunnel syndrome. Because not all individuals will draw the lumbricals into the carpal tunnel with this maneuver, this test cannot be perfectly sensitive or specific for carpal tunnel syndrome.

Accuracy

In studies of diagnostic accuracy, the sensitivity of the Phalen's maneuver ranged from 51% to 91% and its specificity from 33% to 88%.

Reverse Phalen's test

This test is 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 and the carpal tunnel pressure has the tendency to increase throughout the test's duration. In contrast, the change in carpal tunnel pressure noted in the standard Phalen's test is modest and plateaus after 20 to 30 seconds.

The average pressure change for Phalen's test at one and two minutes was only 4 mm Hg. The average pressure changes in the carpal tunnel for the reverse Phalen's test were 34 mm Hg at one minute into the test and 42 mm Hg at the two minute point.

The extended wrist posture significantly changes the pressure within the carpal tunnel and may be more useful as a provocative examination maneuver. Reverse Phalen's maneuver results in a significantly higher intracarpal canal hydrostatic pressure as compared to a traditional Phalen's. This is thought to add to the sensitivity of conventional screening methods.

Comparison

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

References

UpToDate Contents

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• 1. 手根管症候群：臨床症状および診断 carpal tunnel syndrome clinical manifestations and diagnosis
• 2. 亜急性または慢性の手首の疼痛を有する成人の評価 evaluation of the adult with subacute or chronic wrist pain
• 3. 手根管症候群：治療および予後 carpal tunnel syndrome treatment and prognosis
• 4. 関節リウマチの臨床症状 clinical manifestations of rheumatoid arthritis
• 5. 母指痛患者の評価 evaluation of the patient with thumb pain

English Journal

• The quantitative relationship between physical examinations and the nerve conduction of the carpal tunnel syndrome in patients with and without a diabetic polyneuropathy.

• Jeong DH, Kim CH.
• Annals of rehabilitation medicine.Ann Rehabil Med.2014 Feb;38(1):57-63. doi: 10.5535/arm.2014.38.1.57. Epub 2014 Feb 25.
• OBJECTIVE: To understand the quantitative correlation between the clinical severity and physical examinations along with the electrodiagnostic findings by subjects with carpal tunnel syndrome (CTS) and also the influence of diabetic polyneuropathy (DPN) on physical examinations by subjects with CTS.
• PMID 24639927

• [Symptomatology of carpal tunnel syndrome during pregnancy and puerperium].

• Breborowicz M1, Gruca-Stryjak K, Krzyścin M, Romanowski L, Breborowicz G.
• Ginekologia polska.Ginekol Pol.2013 Oct;84(10):841-5.
• OBJECTIVES: Epidemiology of the carpal tunnel syndrome (CTS) during pregnancy remains to be fully elucidated. The purpose of the following study is to determine occurrence of that complication in a population of pregnant women. So far the literature in Polish lacks information that might enable adeq
• PMID 24273905

• [Treatment of carpal tunnel syndrome with mini-incision decompression].

• Jin GQ1, Yang J, Li CY, Ming XF, Zhao XF, Cheng CS.
• Zhongguo gu shang = China journal of orthopaedics and traumatology.Zhongguo Gu Shang.2012 Jan;25(1):58-61.
• OBJECTIVE: To introduce the method of the transverse carpal ligament (TCL) transection through palmar mini-incision for carpal tunnel syndrome (CTS) and evaluate its efficacy and safety.METHODS: From January 2006 to September 2007, 15 patients (18 hands) with CTS were treated with palmar longitudina
• PMID 22489526

Japanese Journal

• 手根管症候群の診断と治療に対する私たちの方針

• 高萩 周作,尾田 宣仁,石井 正三,吉川 朋成
• 脊髄外科 : 日本脊髄外科研究会機関誌 16(2), 143-148, 2002-07-31
• … The positive rate was 50% with Tinel's sign and approximately 90% with Phalen's sign. …
• NAID 110002953532

• Endoscopic carpal tunnel pressure measurement: a reliable technique for complete release

• Hashizume Hiroyuki,Nanba Yoshifumi,Shigeyama Yukio,Hirooka Takahiko,Yokoi Tadashi,Inoue Hajime
• Acta Medica Okayama 51(2), 1997-04
• … <p>Carpal tunnel syndrome is diagnosed by clinical symptoms, Tinel's sign, Phalen's test and electromyography. …
• NAID 120002305479

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★リンクテーブル★

リンク元	「ファーレン徴候」
関連記事	「sign」

「ファーレン徴候」

　　[★]

英

Phalen's sign Phalen sign

同

ファレン徴候、Phalen徴候、wrist flexion test

関

ファレンテスト(ファーレンテスト Phalen test)

筋絞扼症候群

[show details]

ファーレン徴候 : 56 件
ファレン徴候 : 9 件

• ファレンテスト陽性は、手根管症候群を示唆する
• 手関節を強く屈曲位にして1-2分保つと、指のしびれが増強し、正常にすると戻る。

<youtube>http://www.youtube.com/watch?v=LyoMPOqh_YM</youtube>

「sign」

　　[★]

• n.

• 徴候、兆候、サイン、(数学)符号

関

indication、manifestation、signature、stigma、stigmata、symptom、symptomatic