Claw Hand: Diagnosis and Management
Claw Hand: Diagnosis and Management
Claw Hand: Diagnosis and Management
OF
CLAW HAND
Complied by:
Aditya Pratama Saanin
Advised by :
Dr. Donny H. Hamid Sp.S
Range of
Inspection Palpation
motion
• Wasting of interossei
• Hypothenar wasting
• Brittle nails
• Abnormal sensation on fingers 4 or 5, usually on the
sides of the palm
Clinical • Numbness, decreased sensation
Symptom •
•
Tingling, burning sensation
Hand weakness
• Pain and / or paresthesia such as tingling that
radiates downward from the elbow to the arm until
the ulnar border of the hand
• Loss of hand sensation in the distribution of the ulnar
nerve
• Claw hand deformity that is typical of chronic lesions
FROMENT SIGN
(First Palmar Interossei
and Adductor Pollicis)
• Splinting:
-- To immobilize all or part of a hand in a position that will promote healing and
prevent deformity
-- To correct an existing deformity and promote function in that part
-- To supply power to compensate for weakness
• Surgical correction:
-- Active or dynamic procedure: Called so because they bring extra active muscular
forces in places of those lost because of muscle paralysis
Brands transfer
Srinivasan’s Extensor Diversion Graft operation
• to divert part of the
excessive extensor force
acting on the MCP joint &
causing hyper-extension of
the same towards its flexor
aspect
• The advantage of this
operation is that, it is
technically less demanding
than brand’s operation and
fingers can be individually
corrected
• Elliptical segment of
volar
fibrocartilaginous
plate is resected
Suture the volar
plate with heavy
silk; If desired insert
transarticular ‘K’
wires to maintain
position of the joints
Zancolli’s capsulodesis
Thank you