He was treated for psychotic symptoms on-and-off from his mid-twenties. Both authors contributed to the production and finalizing of the manuscript. The history of the raised fist, a global symbol of fighting oppression. Simmons BP, Vasile RG. The person has clenched fists and a full arm crossing. The authors declare that they have no competing interests. However, the diagnostic work-up of the clenched fists could have been more systematic from the start and throughout the course. Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D, The CARE group. Anyhow, to get a better understanding of the psychological underpinnings, we would have had to wait until he was able to communicate better. His relatives had never observed or heard our patient report symptoms compatible with stroke or cerebral insults prior to the current illness course. 1. clenched fist - a hand with the fingers clenched in the palm (as for hitting) fist. Factitious disorders. Cookies policy. PubMed Today, CFS seems to be the favored term. This was the first time he had been hospitalized. Although no organic etiology can be identified, the syndrome in most cases presents with pain and paradoxical stiffness. https://doi.org/10.1007/s11552-007-9072-0. The blood cultures revealed no growth. A 60-year-old white man with schizophrenia, cerebrovascular disease, diabetes mellitus type 2, and peripheral neuropathy, developed rather acutely bilateral clenched fists in the aftermath of a traumatic dislocated hip fracture that was operated on. Haloperidol tablets, sporadically used as on demand medication to calm him, were discontinued. Simmons and Vasile noted in their patients “… a consistent theme of repressed anger … The hand bound into a fist symbolically expresses anger …” [9]. In other words, the authors acknowledged conversion as a designation for at least some hand disorders. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The diagnostic work-up and treatment running parallel during this very sick patient’s hospital stay illustrate the complexity of clinical medicine – “medicine-at-work” – when there are several disorders with fluctuating clinical manifestations demanding collaboration by various medical specialists. J Psychosoc Nurs Ment Health Serv. What is the meaning of CLENCHED? They labelled the phenomenon “CFS” whereas Frykman, Wood, and Miller, based on their case series 3 years later, chose a different term, “the psycho-flexed hand” [10]. As a consequence, he was returned to the intensive care unit. Quick — make a fist! What did you get? All data generated or analyzed during this study are included in this published article. If the CFS were to be given status as a formal diagnosis in the ICD-10 classification, the closest fit would be F44.4 Dissociative motor disorder. In the hip-hop way, contemporary clenched-fist references show up out of familiar contexts, flush with new meanings. The case report follows the CARE guidelines [6]. There was no visible or palpable sign of Dupuytren’s contracture on either side. The clenched fist syndrome/psycho-flexed hand, first described in the early 1980s, has not yet entered the major psychiatric textbooks. We present a case we encountered in an intensive care unit. Furthermore, maybe his hands clutching onto the side rails was part of a freeze-response. In 2008 Batra et al. 1979;36:414–9. JRSM Open. ‘John's right hand clenched into a fist’. Meaning of clenched fist. The diagnosis of CFS is – at the time being – typological, that is, based on its similarity to those cases that have been described in the medical literature so far. It is also a common symbol of communism and can also be used as a salute to express unity, strength, or resistance History. The cultures were brought to the microbiology laboratory immediately for further cultivation. From his perspective, this is a sensible thing to do if you fear that somebody would try to pull you out of your bed, which was his relatives’ hypothesis. Curiously, the phenomenon has been illuminated mainly in journals and textbooks on hand surgery. No organic d …. Attempts to treat the clenched hands were obsolete as our patient was unable to cooperate in any way. 2013;32:245–50. Our patient was hospitalized after a fall that caused a left hip fracture that was operated on. Clenching Your Fists Increases Willpower Steely muscles can lead to a steely resolve. The publication of this article was supported by the Publication fund of UiT – The Arctic University of Norway. It was decided to stop further oral nutrition (fluids, food, pills) in an attempt to prevent further aspirations to his lungs. Sadock BJ, Sadock VA, Ruiz PR. https://doi.org/10.1016/S0753-9053(96)80015-9. https://doi.org/10.1111/j.1742-1241.2007.01086.x, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/, https://doi.org/10.1186/s13256-018-1729-5. On the 38th day the neurologist found that the electromyography (EMG) and nerve conduction studies showed changes consistent with a sensorimotor polyneuropathy affecting his lower extremities. However, he had small wounds in the left fossa cubiti caused by syringes and peripheral venous catheters associated with blood test and intravenous infusions. It is relevant to ask whether the cerebral lesions could have caused the clenched fists. statement and Established 1996. https://doi.org/10.1007/s11552-007-9072-0. Cefotaxime administered intravenously, 1 g three times a day, was started on day 18. Conflict happens. There may be some maceration of the palm as a result of faulty hygiene. Hand (N Y). No conclusive diagnosis was made. Cordivari C, Misra P, Catania S, Lees AJ. He did not excel at school, and started at an early age to work in the local fishing industry. Due to the various medical complications the course of his illness ended fatally after 1.5 months. On the 20th day, a neurological examination found only slightly reduced muscle strength (grade 4–4+) for adduction and abduction of his shoulders bilaterally and a tendency to lead pipe rigidity in his wrist joints. Clenched Fist Injury Definition A clenched fist injury (CFI) is a bite wound on the hand, caused when a person's closed fist strikes the teeth of another person, usually in the course of a fight. When Boris Johnson gave his televised address on Sunday evening, many people noticed how often he clenched his fists. PubMed Central The patient’s clenched fists seen from different angles. Grunert et al. New blood cultures were taken. He held the job until at the age of 30 he moved to another part of the country. Thumb to the side. The Eyes. Share in the comments! 1996;15:100–8. https://doi.org/10.1258/shorts.2012.012046. Why his hands would not open, we cannot easily explain. How do you use CLENCHED in a sentence? Alas, in clinical practice, the distinction is not always that clear. We encountered a patient with clenched hands that challenged our diagnostic skills. Batra S, Sarasin A, Gul A, Kanvinde R. Psychoflexed hand: a forgotten entity. Arch Gen Psychiatry. Also, the nosological status should be clarified. 2008;62:1634–6. In teenagers there is usually a family conflict [3, 9]. Many of these were described as “rather passive, emotionally needy individuals who tended to focus psychological conflicts on physical symptoms.” Another group was characterized as “…angry, hostile persons who were suspicious and tended to act out their anger maladaptively.” The first group had the best prognosis with regard to returning to work after treatment. The intermittent slight lead pipe rigidity of his upper left extremity might be explained either by the vascular changes or by his antipsychotic medication. On testing for passive extension of the wrist joints, proximal and distal interphalangeal joints, and metacarpophalangeal joints of his four ulnar fingers only slight extension was allowed for. 2015 Jun;7(1):161-5. doi: 10.1007/s12593-014-0134-6. In an often quoted article, the Canadian psychiatrist Erwin K. Koranyi wrote: “No single psychiatric symptom exists that cannot at times be caused or aggravated by various physical illnesses” [1]. Further research should strive to gain more knowledge on etiology, pathogenesis, clinical manifestations, and treatment. J Med Case Rep. 2013;7(1):223. Thus, we have to step back. Studies have shown clenching our fists helps us better handle physical or emotional discomfort, and even give us a sense of control and empowerment. Your motto is "everyone chooses the path of their own," and your path is usually … with object ‘she clenched her fists, struggling for control’. Clinical medicine very often entails an inherent uncertainty regarding diagnosis, treatment, and prognosis. Although the hip surgery was technically successful, it was not possible to physically mobilize our patient. Mutually exclusive examine, describe, and it appeared obvious that it was considered the place! 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Difficult to detect and diagnose correctly in clinical practice, the cefotaxime dosage was to!, you agree to our Terms and Conditions, California Privacy Statement and Cookies policy various differential... Used as on demand medication to calm him, were discontinued in order to improve blood.
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