Ulnar Claw (Injury of Ulnar Nerve In The Wrist)

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1- Introduction

2- Anatomical Overview

3- Treatment

4- purposes 


Claw hand is a condition characterized by the abnormal bending or curving of the fingers, resulting in a claw-like appearance. This deformity typically affects the fourth and fifth fingers but can involve other fingers as well. Claw hand can be caused by nerve damage, such as ulnar nerve palsy, or muscle imbalances in the hand. Conditions like diabetes, injury, or certain neurological disorders can contribute to the development of claw hand.

© image from Moore's Clinically Oriented Anatomy

Anatomical Overview

Ulnar nerve injury can result in extensive motor and sensory loss to the hand. An injury to the nerve in the distal part of the forearm denervates most intrinsic hand muscles. Power of wrist adduction is impaired, and when an attempt is made to flex the wrist joint, the hand is drawn to the lateral side by the FCR(Flexor Carpi Radialis) (supplied by the median nerve) in the absence of the “balance” provided by the FCU(Flexor Carpi Ulnaris). After ulnar nerve injury, the person has difficulty making a fist because, in the absence of opposition, the metacarpophalangeal joints become hyperextended, and he or she cannot flex the 4th and 5th digits at the distal interphalangeal joints when trying to make a fist. Furthermore, the person cannot extend the interphalangeal joints when trying to straighten the fingers. This characteristic appearance of the hand, resulting from a distal lesion of the ulnar nerve, is known as claw hand.

© image from Moore's Clinically Oriented Anatomy


  • Physical Therapy: Exercises to strengthen the muscles and improve flexibility can help improve hand function and reduce deformity.

  • Splinting: Wearing a splint can help keep the fingers in a more natural position, prevent further deformity, and aid in functional use of the hand.

  • Medications:

    • Pain Relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage pain and inflammation.
    • Corticosteroids: Injections or oral medications can reduce inflammation in certain cases.
  • Nerve Repair: If claw hand is caused by nerve damage, such as ulnar nerve palsy, surgical intervention may be necessary to repair or decompress the affected nerve.

  • Tendon Transfers: In cases where muscle function is lost, a tendon transfer surgery can redirect a working tendon to replace the function of a damaged one.

  • Surgery: For severe cases, surgical correction of the deformity, such as releasing tight ligaments or repositioning tendons, may be required.


  • Restore Functionality: Improve the ability to perform daily tasks and activities by restoring normal hand and finger movements.
  • Alleviate Pain: Reduce or eliminate any pain associated with the condition.
  • Enhance Strength and Flexibility: Strengthen the muscles and improve the flexibility of the fingers and hand.
  • Prevent Progression: Stop the condition from worsening, which could lead to further deformity and loss of function.
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