From the Research
Claw hand, also known as intrinsic minus hand, is a deformity characterized by hyperextension of the metacarpophalangeal joints and flexion of the interphalangeal joints, resulting in a claw-like appearance of the hand. This condition typically occurs due to damage to the ulnar nerve, which controls many of the hand's intrinsic muscles, leading to an imbalance between the extrinsic and intrinsic hand muscles 1. The most common causes of claw hand include trauma, compression at the elbow (cubital tunnel syndrome), leprosy, or other peripheral neuropathies. Patients with claw hand experience weakness in grip strength, difficulty with fine motor tasks, and may have sensory changes in the ring and little fingers.
Key Characteristics of Claw Hand
- Hyperextension of the metacarpophalangeal joints
- Flexion of the interphalangeal joints
- Weakness in grip strength
- Difficulty with fine motor tasks
- Sensory changes in the ring and little fingers
Treatment Options
Treatment of claw hand depends on the underlying cause and may include:
- Splinting
- Physical therapy
- Nerve decompression surgery
- Tendon transfers to restore hand function Early intervention is crucial to prevent permanent contractures and maximize functional recovery 2.
Recent Studies
A recent study published in 2022 described a simple insertion of the transferred flexor digitorum superficialis tendon into the lumbrical muscle and proximal tendon, which showed comparable improvements in grip strength and proximal interphalangeal joint angle measurements among the three groups 1. Another study published in 2021 presented a novel technique for the treatment of claw hand deformity involving augmentation of the traditional volar plate capsulodesis with internal brace 2.
Recommendations
Based on the most recent and highest quality study, the definition of claw hand is a deformity characterized by hyperextension of the metacarpophalangeal joints and flexion of the interphalangeal joints, resulting in a claw-like appearance of the hand. Treatment should focus on addressing the underlying cause and restoring hand function through a combination of splinting, physical therapy, nerve decompression surgery, or tendon transfers. Early intervention is essential to prevent permanent contractures and maximize functional recovery 1.