What is the medical term for making a fist?

Medical Term for Making a Fist

The medical term for making a fist is "hand gripping" or "isometric handgrip." 1

Anatomical and Clinical Context

Hand gripping is a physical action that involves several key components:

1. Mechanism: Making a fist involves the maximum squeezing or clenching of the hand, often with the fingers flexed tightly against the palm 1

2. Muscle groups involved:

   • Flexor digitorum superficialis and profundus (finger flexion)
   • Flexor pollicis longus (thumb flexion)
   • Intrinsic hand muscles including lumbricals
   • Forearm muscles that control wrist and finger movement

3. Clinical applications: Hand gripping is recognized as a specific physical counterpressure maneuver (PCM) that can be used in medical contexts, particularly for preventing syncope 1

Medical Uses of Hand Gripping

Hand gripping has important applications in clinical medicine:

As a Physical Counterpressure Maneuver

• Definition: "Isometric handgrip" consists of "clenching fist at maximum contraction with or without an item in the hand" 1
• Clinical use: Used to prevent syncope by increasing blood pressure rapidly when presyncope symptoms occur 1
• Technique: The maximal squeezing of a rubber ball (approximately 5–6 cm in diameter) or similar soft object for the maximum tolerated time or until symptoms disappear 1

In Diagnostic Imaging

• Used as a dynamic maneuver during ultrasound examination of the wrist
• "Clenched fist" maneuvers may be performed during ultrasound to improve detection of low-grade injuries in the wrist 1

Pathological Conditions Related to Fist Clenching

Several pathological conditions involve abnormal fist clenching:

1. Clenched Fist Syndrome:

   • A rare disorder where patients keep one or both hands tightly clenched 2
   • Usually follows minor trauma and is associated with swelling, pain, and paradoxical stiffness
   • Traditionally considered psychiatric in origin, though some cases may have neurological components 3
   • Extension of fingers is always possible under anesthesia 2

2. Dystonic Clenched Fist:

   • Can occur in neurological conditions like Parkinson's disease, Corticobasal Ganglionic Degeneration, and Dystonic-Complex Regional Pain Syndrome 4
   • May respond to botulinum toxin treatment 4

Clinical Pearls and Pitfalls

• Diagnostic confusion: A clenched fist presentation may sometimes be mistaken for carpal tunnel syndrome due to similar symptoms of finger contracture and numbness 5

• Treatment approach: Surgical treatment is generally not indicated for clenched fist syndrome and may worsen symptoms 5

• Proper examination: When evaluating a patient with a clenched fist, it's important to distinguish between:

  • Voluntary muscle contraction
  • Underlying contractures
  • Neurological causes
  • Psychiatric causes

• Human bite injuries: Clenched-fist injuries can occur when a fist strikes teeth, creating a specific type of human bite wound that requires careful evaluation and treatment due to high infection risk 1

In summary, while "hand gripping" or "isometric handgrip" is the medical term for making a fist, this action has significant clinical applications in preventing syncope and can also present pathologically in several medical and psychiatric conditions.