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Claw Hand M21.519 736.06

 

synonyms: Intrinsic Minus Hand 

Claw Hand ICD-10

Claw Hand ICD-9

  • 736.06

Claw Hand Etiology / Epidemiology / Natural History

  • Etiology is median/ulnar nerve injury:  ulnar nerve palsy, cubital tunnel syndrome, ulnar tunnel syndrome, median nerve palsy, Volkmann's ischemic contracture, leprosy (Hansen's disease, Charcot-Marie-Tooth disease (hereditary motor-sensory neuropathy), compartment syndrome of the hand
  • musculotendinous weakness or contracture leads to MCP hyperextension and IP joint flexion

Claw Hand Anatomy

  • radial two lumbrical are innervated by median nerve, ulnar two by ulnar nerve.
  • four dorsal interosseous which are abductors (DAB) with insertions on index, middle both radial and ulnar and ring fingers.  3 palmar adductors for index, ring and small
  • hypothenar muscles are innervated by ulnar n
  • thenar muscles except deep head of FPB(ulnar) and Adductor policis are innervated by median nerve

Claw Hand Clinical Evaluation

  • MCP hyperextension with PIP and DIP flexion.   

Claw Hand Xray / Diagnositc Tests

  • Hand films generally are normal.  

Claw Hand Classification / Treatment

  • operative treatment is directed at preventing MCP hyperextension either by passive tenodesis or an active tendon transfer.

Claw Hand Associated Injuries / Differential Diagnosis

  • Ulnar nerve Palsy
  • Median nerve Palsy
    Fractures, crush injury

Claw Hand Complications

  • Loss of function use of hand

Claw Hand Follow-up Care

Claw Hand Review References

  • Greens Operative hand surgery