A 24 year old construction worker presents to his physician after an injury on the job. Physical examination is remarkable for marked flexion of the ring and little fingers of the left hand. Which of the following additional findings would most likely be found on physical examination?
**Core Concept**
The patient's presentation of marked flexion of the ring and little fingers of the left hand is indicative of a specific type of injury that affects the musculature and innervation of the hand. This condition is related to the anatomy of the hand, specifically the muscles and nerves that control finger movement.
**Why the Correct Answer is Right**
The correct answer, wasting of the dorsal interosseous muscles, is related to the injury of the ulnar nerve, which is responsible for the innervation of these muscles. The ulnar nerve runs along the medial aspect of the arm and forearm, and its damage can lead to weakness and wasting of the muscles it supplies, including the dorsal interosseous muscles. The dorsal interosseous muscles are responsible for finger spread and adduction, and their wasting would result in the characteristic flexion deformity observed in the patient.
**Why Each Wrong Option is Incorrect**
**Option A:** Loss of sensation on the back of the thumb is more related to the radial nerve, which supplies the back of the thumb. However, the patient's presentation does not suggest radial nerve involvement.
**Option B:** Loss of sensation on the palmar side of the forefinger is related to the median nerve, which supplies the palmar surface of the thumb, index, and middle fingers. Again, the patient's presentation does not suggest median nerve involvement.
**Option D:** Wasting of the thenar eminence is related to the median nerve, which supplies the muscles of the thenar eminence. The patient's presentation does not suggest median nerve involvement.
**Clinical Pearl / High-Yield Fact**
The ulnar nerve runs along the medial aspect of the arm and forearm, and its damage can lead to weakness and wasting of the muscles it supplies, including the dorsal interosseous muscles. This is an important clinical correlation to remember, as ulnar nerve injury is a common cause of hand weakness and deformity.
**✓ Correct Answer: C. Wasting of the dorsal interosseous muscles**