Claw Hand and Ulnar Claw Hand

Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA

1.Ulnar Claw hand:

• abnormal hand position due to lower ulnar nerve lesion( below the elbow).
• clawing seen at 4th and 5th fingers with hyperextension at MCP joints and flexion at IP joints;
• Clawing is not seen in index and middle fingers as they are supplied by median nerve for lumbricals muscle.

Reason: loss of function of two lumbricals and all interosseous muscles that are supplied by ulnar nerve.

a) Low ulnar nerve lesion(below elbow):

• clawing of 4th and 5th fingers.
• good sensation at dorsum of 4th and 5th fingers

b) High ulnar nerve lesion:

• clawing absent at 4th and 5th fingers.
• no sensation at dorsum of 4th and 5th fingers.

2.Intrinsic minus hand:

• all fingers affected with hyperextension at MCP joint and flexion at PIP and DIP joint.
• due to imbalance between strong extrinsics and weak intrinsics.
• caused by VIC, leprosy, Charcot Marie tooth disease.