• Brandon M Carius, Curt R Canine, and Brit Long.
• Brooke Army Medical Center, JBSA Fort Sam Houston, TX, United States of America; 121 Field Hospital, Camp Humphreys, Republic of Korea. Electronic address: brandon.m.carius.mil@mail.mil.
• Am J Emerg Med. 2020 Sep 1; 38 (9): 1992.e1-1992.e2.

AbstractIntrinsic plus hand describes a rare and painful contracture of the intrinsic hand muscles with excessive flexion at the metacarpophalangeal joints and extension at the interphalangeal joints. Resulting from many causes to include trauma and neurologic injury, intrinsic plus hand can involve any number of fingers. Emergency department (ED) assessment should include evaluation for cerebrovascular injury, infection, compartment syndrome, and deep vein thrombosis (DVT). Conservative splinting is generally unsuccessful and ultimately requires operative intervention. We highlight the case of a 61-year-old otherwise healthy male who awoke to a painful and mildly swollen left hand with his fingers held in a contracted position. Evaluation in the ED found no active range of motion in the digits, severe pain with any passive motion, and a negative upper extremity ultrasound for DVT. Ultimately, orthopedic and neurology consults in the ED agreed upon a diagnosis of intrinsic plus hand.Published by Elsevier Inc.

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