Claw Hand

Introduction[edit | edit source]

Claw Hand deformity is a condition where the fingers are bent into a position that looks like a claw. It may affect all of the fingers or only some of them depending on its cause. The fingers are usually bent or curved and the deformity can affect one hand or both hands. [1] Claw Hand is a hand deformity with hyperextension of the metacarpophalengeal (MCP) joints and flexion of the interphalengeal (IP) joints due to weakness of the intrinsic muscles of the hand. Claw finger deformity occurs during attempted finger extension in patients whose intrinsic finger muscles are weakened or paralyzed by neural impairments. The deformity is generally not acutely present after intrinsic muscle palsy.[2]

Causes[edit | edit source]

The causes of Claw Hand might include: [3][4]

Types[edit | edit source]

Claw Hand deformity can be:

Complete when it involves all the digits and therefore results from both Ulnar and Median Nerve Palsy.

Incomplete or Partial where it involves only ulnar 2 digits and is referred to as an isolated Ulnar Nerve Palsy.

Partial Ulnar Claw Hand

Signs and Symptoms[edit | edit source]

  • Muscle wasting of the interrosseous and hypothenar.
  • Numbness along the nerve involved.
  • Inability to extend the IP joints during extension of the fingers, to abduct and adduct fingers.
  • Unopposed action of the extensors and the flexors digitorum profundus as the lumbricals of digits 4 and 5 are paralyzed.

Diagnosis[edit | edit source]

The diagnosis can be made by using:

  • Electromyography (EMG) to check the muscles and nerves.
  • Nerve conduction studies to check the electrical signs move through a nerve.

Differential Diagnosis[edit | edit source]

The following conditions are established to make a differential diagnosis:[5]

Treatment[edit | edit source]

Claw Hand treatment may include:

  • Splinting
  • Surgery
  • Tendon transfer (graft)
  • Therapy to straighten the finger

Physiotherapy Management

Risk Factors[edit | edit source]

Some activities are considered as risk factors due to their nature:

  • External compression at the elbow.
  • Applying upper body weight to push down on the tool can cause nerve damage over time.
  • Prolong movements causing the elbow to lean as seen among cyclists, motorcyclists or people with desk jobs.


References[edit | edit source]

  1. Everything You Need to Know About Claw Hand. Available from: (Accessed 09/06/2021)
  2. Binder-Markey BI, Dewald JP, Murray WM. The biomechanical basis of the claw finger deformity: A computational simulation study. The Journal of hand surgery. 2019 Sep 1;44(9):751-61.
  3. Intrinsic Minus Hand (Claw Hand).  Available from:,strong%20extrinsics%20and%20deficient%20intrinsics. ( Accessed, 09/06/2021)
  4. Everything You Need to Know About Claw Hand. Available from: (Accessed 09/06/2021)
  5. 5.0 5.1 5.2 Available from: (Accessed, 09/06/2021)
  6. nabil ebraheim. Claw Hand, Ulnar Claw Hand - Everything You Need To Know. Available from: [Accessed, 09/06/2021]