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The hand assumes a characteristic attitude: the index and middle fingers are extended at the metacarpo-phalangeal joints owing to paralysis of the interosseous muscles attached to them; the little and ring fingers are hyper-extended at these joints in consequence of the paralysis of the lumbricals; all the fingers are flexed at the inter-phalangeal joints, the flexion being most marked in the little and ring fingers claw-hand or main en griffe.
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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