Claw Hand Deformity: Causes, Nerve Lesions & Rehab

Overview of Claw Hand Deformity: Causes, Nerve Lesions & Rehab

Learn about claw hand deformity, its root causes in ulnar nerve damage, and how physiotherapy, splinting, and exercises restore hand function.

The intrinsic muscles of the hand (interossei and lumbricals) are responsible for flexing the knuckles while keeping the fingers straight. When the ulnar nerve is compromised, these muscles fail, allowing the extensor muscles to pull the hand into a claw position.

Common Causes & Pathophysiology

Common causes of claw hand include deep lacerations to the wrist, severe elbow fractures, brachial plexus injuries (Klumpke's palsy), cervical spine trauma, or advanced untreated cubital tunnel syndrome.

Common symptoms include localized tenderness, sharp pain during movements, swelling, bruising, and muscular tightness or spasms in the affected region.

Evidence-Based Physiotherapy Treatment

Rehabilitation program at Bethesda Physio & Rehab Clinic Neuro Rehab: 1) Custom anti-claw splinting (keeping MCP joints flexed), 2) Neuromuscular electrical stimulation (NMES) to interossei muscles, 3) Daily passive stretching to maintain joint glide, and 4) Functional coordination drills.

Rehabilitation must be progressive, moving from pain reduction to strength restoration. Patients are advised to work under guided supervision to prevent reinjury.

Clinical Outlook & Next Steps

Early and accurate diagnosis is critical to avoid transforming acute tissue strains or nerve compressions into chronic dysfunction. If you suspect an injury, consult a physiotherapist for a personalized evaluation.