From the Research
Claw hand, also known as intrinsic minus hand, is a deformity that should be treated with surgical intervention, specifically the Zancolli-Lasso procedure, as it has shown to be a simple and viable treatment option for patients with this condition, as evidenced by a recent case study 1. The diagnosis of claw hand typically involves a physical examination and a review of the patient's medical history to determine the underlying cause of the deformity.
- The condition can result from ulnar nerve damage, which affects the intrinsic hand muscles responsible for finger movement.
- Treatment depends on the underlying cause but may include physical therapy with specific exercises to maintain flexibility and strength, splinting to prevent further deformity, and in some cases, surgical intervention to repair damaged nerves or tendons.
- For mild cases, regular stretching exercises (holding fingers straight for 30 seconds, repeated 5 times daily) can help maintain function.
- Medications like gabapentin (300-600mg three times daily) or pregabalin (75-150mg twice daily) may be prescribed if nerve pain is present.
- Prompt medical evaluation is essential as early intervention improves outcomes. The Zancolli-Lasso procedure is a surgical technique that involves the transfer of the flexor digitorum superficialis tendon to the lumbrical muscle, which has been shown to be effective in correcting claw hand deformity, as demonstrated in a study published in the Journal of plastic, reconstructive & aesthetic surgery 2.
- The procedure can be performed via a single incision in the palm, reducing operative time.
- The study found that the improvements in proximal interphalangeal joint angle measurements, grip strength, and Brand's criteria were comparable among the three groups, including the lumbrical insertion procedure.
- Another study published in the International journal of surgery case reports also found that the Zancolli-Lasso procedure was effective in treating claw hand deformity, with major improvement obtained in a young male patient who underwent the procedure 1. Overall, the Zancolli-Lasso procedure is a viable treatment option for patients with claw hand deformity, and prompt medical evaluation and early intervention are essential to improve outcomes and prevent permanent contractures and loss of hand function.
- A comprehensive approach for claw hand is essential, and supple mobile joints and the Bouvier maneuver are the most decisive factors, as noted in a study published in the Hand surgery & rehabilitation journal 3.
- The study also found that palliative surgery requires prior preparation of paralytic hands, and that the Zancolli's lasso technique is preferred because of its effectiveness in case of a positive Bouvier's test.