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hyperextension at this level by the unopposed long extensor tendons, often resulting in a claw deformity.
More distal combined median and ulnar lesions have their effect primarily on the intrinsic muscles, resulting in the most disabling deformities with metacarpophalangeal hyperextension, interpha- langeal flexion, and thumb collapse.
Ziviani & Elkins (1986) used a series of four nonexclusive categories that described grips on the basis of the number of fingers held on the shaft of the writing implement, degree of forearm supination, hyperextension of the distal interphalangeal joint of the index finger, and thumb and index finger opposition.
the child attempts to compensate for difficulty with supination by using wrist hyperextension.
This position is frequently compromised in children who have hyperextension of the interphalangeal joint of the thumb; rather than a circular web space; these children form a "crescent moon" with a small open- ing.
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