Claw hand, causes, symptoms and treatment

 Claw Hand: Causes, Symptoms, and Treatment

The human hand is one of the most intricate structures of the body, capable of performing delicate as well as powerful tasks. But certain nerve injuries can severely affect its movement and appearance. One such condition is known as Claw Hand — a deformity that gives the hand a claw-like look.

🔹 What Is Claw Hand?

Claw Hand is a deformity of the hand in which the fingers are bent at the joints, giving them the appearance of a claw.
This occurs when the muscles that control finger movements become weak or paralyzed due to nerve damage — most commonly the ulnar nerve, and sometimes the median nerve.

In this condition, the metacarpophalangeal joints (knuckles) are hyperextended, while the interphalangeal joints (finger joints) are flexed.
As a result, the fingers curl abnormally, and the person is unable to straighten them fully.

🔹 Anatomy Behind Claw Hand

To understand claw hand, it’s important to know how hand muscles and nerves work together.

• The ulnar nerve controls most of the small muscles of the hand (especially those that flex and extend the fingers).

• The median nerve helps control thumb movement and sensation in the palm.

When the ulnar nerve is injured, the ring and little fingers are most affected, bending into a claw shape.
If both the ulnar and median nerves are damaged, the deformity becomes more severe, affecting all fingers.

🔹 Causes of Claw Hand

Claw hand can be congenital (present at birth) or acquired due to injury or disease.
Common causes include:

1. Ulnar nerve injury — most frequent cause

   • Can result from fractures, prolonged pressure, or cuts around the elbow or wrist.

2. Leprosy (Hansen’s disease) — a common cause in developing countries, leading to nerve damage.

3. Brachial plexus injury — damage to the network of nerves supplying the arm and hand.

4. Spinal cord injury — can lead to paralysis or deformity of the hand muscles.

5. Peripheral neuropathy — seen in diabetes, alcoholism, or vitamin deficiency.

6. Trauma or burns — causing scarring or muscle contracture.

🔹 Symptoms of Claw Hand

The symptoms of claw hand can vary depending on the severity and cause but often include:

• Claw-like curling of the ring and little fingers

• Weak grip strength

• Loss of fine motor skills (difficulty writing, buttoning clothes, etc.)

• Numbness or tingling in the affected fingers

• Wasting of hand muscles, especially between the thumb and index finger (interosseous spaces)

• Deformity more visible when the hand is at rest

🔹 Types of Claw Hand

Type	Nerve Involved	Fingers Affected	Description
Ulnar Claw Hand	Ulnar nerve	Ring and little fingers	Commonly seen after ulnar nerve palsy; affects small muscles of the hand.
Median Claw Hand	Median nerve	Index and middle fingers	Occurs due to median nerve damage, often near the wrist.
Total Claw Hand	Both ulnar and median nerves	All fingers	Seen in severe nerve injuries or leprosy, causing full-hand deformity.

🔹 Diagnosis

Diagnosis of claw hand involves a detailed neurological and physical examination.
Your doctor or physiotherapist may check:

• Muscle strength and grip power

• Finger movements and range of motion

• Sensation testing (for numbness or loss of feeling)

• Nerve conduction studies (NCS) or electromyography (EMG) to assess nerve damage

• X-rays or MRI scans to rule out bone or joint problems

🔹 Treatment Options

Treatment depends on the underlying cause, severity, and duration of the deformity. The main goals are to restore function, improve appearance, and prevent further nerve damage.

1. Medical Treatment

• Treat the underlying condition (e.g., diabetes, infection, or inflammation).

• Vitamin B-complex supplements for nerve health.

• Anti-inflammatory or pain-relieving medications for nerve irritation.

2. Physiotherapy

• Range-of-motion exercises to prevent stiffness.

• Strengthening exercises for remaining functional muscles.

• Splinting: A hand splint keeps fingers in a neutral position, reducing deformity.

• Electrical stimulation therapy to activate weak muscles.

3. Surgical Treatment

If nerve damage is severe or long-standing:

• Nerve repair or grafting to restore conduction.

• Tendon transfer surgery to balance finger movements.

• Joint contracture release in advanced deformities.

Early surgical intervention often yields better results.

🔹 Complications

If left untreated, claw hand can lead to:

• Permanent hand deformity

• Loss of grip and hand function

• Chronic pain or stiffness

• Social and psychological impact due to visible deformity

🔹 Prevention Tips

While not all causes can be prevented, certain steps can lower the risk:

• Avoid prolonged pressure on elbows or wrists.

• Use protective gear during activities that risk hand injury.

• Maintain good posture while working on computers.

• Manage diabetes and nutritional deficiencies properly.

• Seek early medical care if numbness or weakness develops in the hand.

🔹 Prognosis and Recovery

Recovery from claw hand largely depends on the extent of nerve damage and timeliness of treatment.
With proper medical care, physiotherapy, and surgery if needed, many patients regain good hand function.
However, chronic or untreated cases may have limited recovery.

🔹 Conclusion

Claw Hand is more than just a cosmetic deformity — it’s a sign of nerve damage that affects hand function and quality of life.
Understanding its causes, recognizing symptoms early, and seeking timely medical help are essential for full recovery.
With proper care, exercises, and sometimes surgery, most people can regain strength and mobility in their hands.