Ulnar Claw Hand

Comments

1. Khalid says

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   Excellent informative video

2. Caroline says

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   Super helpful! Thank you, I always get these mixed up!

3. anna cox says

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   Simply explained but with plenty of detail. You have a gift for teaching. Thank you!

4. Jen says

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   Hi there;

   I stumbled across this video and was hoping I could bend your ear or perhaps someone in your comments for some advice.
   1 year ago I suffered a three foot fall injuring my wrist forearm. Comminuted radius and ulna # including dislocation. I had a conscious sedation in the ED ( I’m an ER Nurse fyi) and then Ortho reset again a few days later in the fracture clinic before applying the fibreglass cast. I started to have edema quite noticeable by day three of fibreglass cast and sharp electric intermittent pain. The edema continued and my fingers were dusky with a noticeable cooler feel than the opposite hand. The electric pain would wake me up and last for seconds to minutes. I was seeing the Ortho weekly and was made aware of my symptoms. He had no concerns. Was instructed to elevate my arm and keep wiggling my fingers. My symptoms progressed and I eventually had to circumvent the Orthopod and present to ER who made arrangements for my cast to be removed and reapplied. This was after enduring these symptoms for 4 weeks and 4 days. There was a marked increase in my symptoms after this which unfortunately brought me back to the ER after 4 days and the cast was again removed. I was instructed to wear a Velcro wrist splint; however my hand was too edematois for the XL Velcro splint. For reference: My hand prior to injury would fit a small or medium splint.
   I was diagnosed with CRPS at this time by the ORTHO who was my MRP at the time. I have only had to take over the counter meds and topical creams.
   I was seen at TWH in Toronto by the pain clinic who denied a diagnosis of CRPS.
   I had an MRI through my family MD which suggested a positive ulnar variance as well as concerns for perforated/torn cartilage. Recommendations were an angio MRI (was ordered by my family MD but booked incorrectly and has not been done, The Radiologist also recommended the hand clinic, ortho and plastics. Referred to an Upper Limb Clinic. Limb clinic Ortho felt CRPS was a “nightmare’ and was uninterested in the impression by the Radiologist or the history of prolonged exposure to a very tight cast. She denied claw hand and felt the reason for my symptoms were from encapsulation of my wrist joint as my injury was so old. For reference: I have not been able to pronate or supinate since the onset of injury and not a progression. She ordered a CT scan of my wrist and waiting for her diagnosis and treatment plan which will be discussed May 27, 2025 at the Upper Limb Clinic.
   I have been in physio and seeing OT 1-2x per week for 9 months.. They are treating me as CRPS. My fine motor has and is improving in my first three digits. Four and 5 remain like a claw. Sensation and color of my palm remain impaired. Currently I have symptoms of ulnar palsy. Claw hand. In addition; I continue to be unable to pronate and supinate.
   I’m waiting consult with plastics at TWH but no date has been confirmed for this.
   What specialty would be best to lead up my plan for treatment and recovery? What would be the best diagnostic imaging ? I have been driving this all through my family MD as the original ORTHO remains committed to a diagnosis of CRPS, despite the history reported here. I developed frozen should suddenly in October but is progressing well with physio.
   I’m very active and have essentially lost much of my abilities which include paddle boarding, kayaking, skiing, snow shoeing, piano, guitar, personal care etc. I’m not working. I’m an RN in ER. I’m a 52 year old healthy female. Hashimotos. On synthroid and take Wellbutrin. Lost my oldest child 4 years ago suddenly.
   I haven’t worked since the injury, which was in May, 2024.

   Thank you.