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In an athetoid hand, says Starr, the interossei and lumbricales, which flex the metacarpo-phalangeal and extend the phalangeal joints, are affected; rarely are the long extensors and the long flexors affected. Therefore the hand is usually in the so-called interosseal position, with flexion of the proximal and extension of the middle and distal phalanges.
When it is injured at or above the elbow, there is paralysis of the flexor carpi ulnaris, the ulnar half of the flexor digitorum profundus, all the interossei, the two medial lumbricals, and the adductors of the thumb.
The motor symptoms predominate, the muscles affected being the extensors of the wrist and fingers, and the supinators. If the hand and proximal phalanges are supported, the second and third phalanges may be partly extended by the interossei and lumbricals.
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