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Claw hand is a medical condition that results in bent or curved fingers. In severe cases, the condition can make the patient’s hand appear similar to that of an animal’s claw. This condition can be disabling and it may prevent the patient from engaging in normal activities.
A claw hand is often confused with a disease called Dupuytren’s contracture, or Dupuytren’s disease. This disease also results in a claw hand, however there is a key difference. Dupuytren’s contracture patients suffer from abnormal lumps in the fingers and palm, as well as very thick, strong cords of tissue that pull at the fingers. Claw hand does not produce nodules in the hands. An accurate diagnosis may be confusing if the patient suffers from both claw hand and Dupuytren’s contracture.
This condition may be one that the patient is born with. If the patient is born with a claw hand, it is known as a congenital abnormality. Patients who acquire the condition often do so as a result of an injury. Specifically, it may be due to an ulnar nerve injury, or an ulnar nerve dysfunction.
Patients may acquire this problem as a result of a direct blow to the area, such as an elbow dislocation or fracture. It may also be related to long-term stress or pressure on the nerve, which may in turn be caused by the swelling of surrounding body structures. Some patients may acquire an ulnar nerve injury due to peripheral neuropathy, which is a term for nerve damage often due to diabetes.
The most obvious symptom of claw hand is the appearance of the hand and fingers. If the condition is due to an ulnar nerve injury, the patient may also experience a tingling or burning pain and numbness. Patients may have pain and difficulty moving the fingers, as well as weakness and decreased sensation in the area.
To diagnose the condition, a doctor will evaluate all the symptoms and the time frame in which the symptoms occurred. He may use nerve conduction studies or an electromyography (EMG) to check for nerve damage. If the condition is congenital, the patient should have typically been diagnosed with it at birth.
The treatment for claw hand depends on the severity of the case and its cause. A doctor may recommend physical therapy to attempt to straighten the fingers. Splinting may also help.
In severe cases, the patient may choose to undergo surgery. This may help remove any scar tissue, or fix any tendon or nerve problems. If scar tissue is contributing to the problem, the doctor may first try needle aponeurotomy, which utilizes a needle to break the cord of scar tissue. It is possible for the condition to recur, in which case the patient may need to undergo surgical treatment again.