Definition

Claw hand is a condition that causes curved or bent fingers. This makes the hand appear like the claw of an animal.

Alternative Names

Ulnar nerve palsy - claw hand; Ulnar nerve dysfunction - claw hand; Ulnar claw

Considerations

Someone can be born with claw hand (congenital), or they can develop it because of certain disorders, such as a nerve injury.

Causes

Causes may include:

• Congenital abnormality
• Genetic diseases, such as from Charcot-Marie-Tooth disease
• Nerve damage in the arm
• Scarring after a severe burn of the hand or forearm
• Rare infections, such as leprosy

When to Contact a Medical Professional

If the condition is congenital, it is usually diagnosed at birth. If you notice claw hand developing, contact your health care provider.

What to Expect at Your Office Visit

Your provider will examine you and look closely at your hands and feet. You will be asked questions about your medical history and symptoms.

The following tests may be done to check for nerve damage:

• Electromyography (EMG) to check the health of the muscles and the nerves that control the muscles
• Nerve conduction studies to check how fast electrical signals move through a nerve

Treatment depends on the cause. It may include:

• Splinting
• Surgery to fix problems that may be contributing to the claw hand, such as nerve or tendon problems, joint contractures, or scar tissue
• Tendon transfer (graft) to allow movement of the hand and wrist
• Hand therapy to straighten the fingers

References

Davis TRC. Tendon transfers for median, radial, and ulnar nerve palsy. In: Wolfe SW, Pederson WC, Kozin SH, Cohen MS. Green's Operative Hand Surgery. 68h ed. Philadelphia, PA: Elsevier; 2022:chap 31.

Feldscher SB. Therapy management of tendon transfers. In: Skirven TM, Osterman AL, Fedorczyk JM, Amadio PC, Feldscher SB, Shin EK, eds. Rehabilitation of the Hand and Upper Extremity. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 44.

Sapienza A, Green S. Correction of the claw hand. Hand Clin. 2012;28(1):53-66. PMID: 22117924 pubmed.ncbi.nlm.nih.gov/22117924/.