A clawed hand occurs as a result of ulnar nerve palsy. Depending on the underlying cause of the disease, other symptoms may also occur. The treatment of the clawed hand is possible and promising in many cases.
What is a clawed hand?
The clawed hand can be seen particularly clearly on the ring finger and on the little finger. It is usually no longer possible to spread or squeeze your fingers. See AbbreviationFinder for abbreviations related to Claw Hand.
A clawed hand is a disorder of the hand, which manifests itself as functional failures in the bones. The hand can no longer be moved normally and sufferers have an abducted thumb that cannot be bent.
The metatarsophalangeal joint is also damaged and leads to the typical alignment of the fingers, which resembles a claw. Numbness in the little finger and the ball of the little finger often occurs in connection with a clawed or clawed hand. The unnatural position of the hand leads to further complaints and massive restrictions in everyday life.
Causes
The clawed hand is the cause of ulnar paralysis. This can have various causes. It is often due to external violence in the area of the upper arm. Fractures, injuries or surgical interventions can also trigger ulnar paralysis and thus the clawed hand.
In addition, a clawed hand develops when the ulnar nerve is subjected to long-term pressure. This is the case, for example, when the elbow is used as a support. This can eventually lead to paralysis and later the development of a clawed hand.
People who regularly do cycling are also at risk, since the ulnar nerve is also under heavy strain here. The same applies to bedridden people who put excessive strain on the nerve and patients who are not sufficiently padded during an operation on the corresponding part of the body.
In general, the causes can be traced back to damage to the ulnar nerve. It is also known as ulnar nerve syndrome. Tumors or cysts that settle in the area of the ulnar nerve can also be the cause.
Symptoms, Ailments & Signs
A clawed hand can primarily be recognized by the eponymous malposition of the fingers. Affected people notice that the base joints of the fingers are hyperextended and the end joints are slightly bent. The clawed hand can be seen particularly clearly on the ring finger and on the little finger. It is usually no longer possible to spread or squeeze your fingers.
The deformity causes other symptoms such as pain, numbness and cramps in the hand. Sensitivity disorders can also occur. If the anomaly occurs in connection with an injury to the hand, swelling, bleeding and other external signs can also occur in addition to the symptoms and discomfort mentioned.
A clawed hand often only becomes noticeable after months or even years, as the symptoms develop gradually. In most cases, permanent damage has already developed, for example nerve disorders or joint wear and tear due to the persistent misalignment of the fingers.
Furthermore, circulatory disorders can occur and scars can remain. If the clawed hand is treated early, late effects are unlikely. The postural abnormality recedes quickly after surgery or drug treatment and only slight pain and feelings of tension remain, which also subside after a few weeks.
Diagnosis & History
The suspicion of a clawed hand can usually be expressed by those affected themselves. The misalignment of the hand clearly shows that there is damage. Numbness in the fingers is also a first indication. The doctor can confirm the suspicion in a comprehensive discussion with the person concerned. For this purpose, the medical history is checked and the doctor also asks about everyday work.
After the anamnesis, a neurological examination is carried out. Various functional tests are used to test ulnar nerve function and to check for ulnar nerve palsy. One of the tests relates to the flexibility of the hand and fingers. This is followed by a so-called electromyography. This measures the nerve conduction speed, which in turn provides information about paralysis.
Once the clawed hand has been clearly diagnosed, the exact cause still needs to be determined. Ulnar paralysis is often the trigger, but other nerve diseases can also be responsible for the symptoms.
A clawed hand develops slowly and is usually recognized too late by those affected. However, if action is taken at an early stage, the paralysis can be reversed. If the disease has progressed too far, the only option is to alleviate the symptoms. The clawed hand is not fatal, but it results in far-reaching restrictions in everyday life for those affected.
Complications
In the case of the clawed hand, there are severe limitations in the movement and function of the hand. Those affected can no longer move their fingers properly and are often dependent on the help of other people in everyday life. Especially in children, the clawed hand can lead to considerable difficulties and significantly reduce the quality of life.
This can also disrupt and delay the development of the child. Furthermore, those affected suffer from a severe misalignment of the fingers, resulting in pain. The hand is often swollen. The hand and fingers suffer from numbness or are completely paralyzed. It comes to the typical tingling and other unpleasant sensory disturbances. In the worst case, the paralysis is irreversible and cannot be cured.
The treatment of the clawed hand is usually always causal and depends on the underlying disease that is causing the complaint. In many cases, however, an operation is necessary to treat the clawed hand. However, there are no particular complications. Those affected must continue to protect their hands and not expose them to heavy loads.
When should you go to the doctor?
If numbness in the hand is noticed, the family doctor should be consulted. Other symptoms, such as a functional failure of the fingers or the typical misalignment of the hand, also require clarification. A doctor’s help is necessary when the signs of a disease persist for days or weeks and impair the quality of life. If other symptoms appear, a doctor must be consulted on the same day. After an accident or fall, a doctor must be consulted immediately, especially if the claw hand symptoms are accompanied by pain or injury.
People who cycle regularly, have had an operation on their hand, or are bedridden are particularly likely to develop clawed hands. Anyone who is part of this risk group must always consult their family doctor or a sports medicine specialist with physical complaints. At the latest when unusual functional disorders or chronic pain set in, the clawed hand must be diagnosed and treated medically. Those affected should see their general practitioner or a specialist. The best thing to do with children is to go to the pediatrician. During the treatment of a clawed hand, close monitoring by the doctor is necessary. The patient should visit the doctor regularly and inform them about the mobility of the hand and any discomfort.
Treatment & Therapy
The clawed hand must be treated individually. The therapy depends on the causes of the ulnar paralysis, the circumstances and the individual symptoms of the person concerned. Generally, both conservative and surgical procedures are used to treat a claw hand. If it was caused by a pressure load, it is often possible to remedy the symptoms simply by resting the affected arm. A splint can also be used for this.
If non-surgical treatment does not work, surgery can help. Depending on the situation, the doctor decides whether the paralysis can be corrected by surgery. The decisive factor is whether it is possible to relocate the ulnar nerve. Scar tissue removal can also give the nerve more space and fix the clawed hand. After the procedure, the patient usually has to rest for several weeks.
Outlook & Forecast
With early conservative therapy, there is a chance that the clawed hand will recede. Surgical intervention can reduce the pain. However, motor or sensory failures cannot usually be completely eliminated. In the long term, the ulnar nerve palsy can grow together with the surrounding tissue. The prospect of recovery is then rather poor, since further movement restrictions occur.
If the patient follows the doctor’s guidelines and continues to follow physical therapy and rest, a clawed hand can continue to be used to perform everyday tasks for many years. A prerequisite for a good prognosis is permanent protection of the affected hand. The patient must not use the clawed hand for support and must avoid frequent bending and stretching movements. However, the pain must always be treated with prescription pain medication.
If no treatment is given, the symptoms of pressure paresis increase in intensity. After just a few months, the deformity can be so severe that recovery is no longer possible. The patient is then permanently dependent on aids such as crutches. The restrictions represent a significant cut in quality of life. Life expectancy is not reduced by ulnar nerve palsy. However, physical and psychological sequelae can develop that impair well-being. Nerve damage and circulatory disorders can occur over the course of life.
Prevention
A clawed hand is easy to prevent. It is already sufficient to pad the arm well during corresponding work or activities in order to minimize the risk. Cyclists can put on appropriate padding to avoid a clawed hand.
In general, it helps to protect the area around the elbows and to consult a doctor immediately at the first warning sign. Responding immediately when there is tingling in the fingers and a slight flexion can prevent serious consequences.
A clawed hand that occurs as a result of a fracture or injury is difficult to prevent. Diseases such as tumors, inflamed tissue or cysts that compress the ulnar nerve cannot always be avoided.
Aftercare
In the case of a clawed hand, the patient usually only has a few follow-up measures available. As a rule, this disease should be diagnosed very early on, so that there are no further complications and so that the symptoms do not continue to worsen. The clawed hand cannot heal on its own either, so treatment by a doctor is always necessary.
An early diagnosis always has a positive effect on the further course of the disease. In most cases, a surgical intervention is necessary, which can significantly alleviate the symptoms. After such a procedure, bed rest is necessary. The sufferer should rest and continue to rest his body. No strenuous or physical stress or activities should be carried out.
The affected hand in particular should not be strained. Many patients are restricted in their everyday life due to the clawed hand and need the help of family members and other relatives. In most cases, physiotherapy measures are also necessary, whereby those affected can repeat many of the exercises at home. The clawed hand usually does not reduce the life expectancy of the affected person.
You can do that yourself
A clawed hand requires individual treatment by a doctor. If the condition is mild, drug therapy can be supported by rest and targeted stretching and relaxation exercises. If the complaints are based on pressure, these measures are usually sufficient to remedy the clawed hand. The cause of the excessive strain on the fingers must be determined and corrected in order to achieve long-term improvement.
A pronounced clawed hand usually requires an operation in which the ulnar nerve is relocated or scar tissue is removed. Those affected should arrange an appointment for surgery early on before further complications arise. After an operation, the patient has to take it easy for a few weeks. Depending on the cause, various measures such as relaxation exercises or stretching measures can promote recovery. Cyclists suffering from claw hand should consider switching sports.
Especially after a surgical procedure, renewed stress on the finger bones can have serious consequences and may even cause permanent damage. If the cause is unknown, the person concerned should arrange for further investigations. The condition may be due to a cyst or tumor that needs to be removed.
