Claw Hand Deformity: What Happens to the Ulnar Nerve?

Claw hand deformity is when the fingers bend in to look like a claw. It has several potential causes with ulnar nerve injury being the most common cause. Claw hand deformity can affect all or some of the fingers and occurs in one or both hands.

This article will discuss the causes, risk factors, and diagnosis. It will also cover claw hand deformity treatment options.

healthcare provider looking at person's hand

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Claw Hand Deformity and Ulnar Nerve: What’s the Link?

Claw hand deformity is typically a complication of an ulnar nerve injury.

The ulnar nerve runs from the neck down the arm and into the hand. It is responsible for transmitting signals to the forearm muscle (the flexor carpi ulnaris) that flexes and adducts the hand (draws it toward the body) and the muscle that flexes the fingers (flexor digitorum profundus).

The ulnar nerve also gives sensation to part of the fourth finger and the entire fifth finger.

When there is an injury to the ulnar nerve it cannot properly control the hand.

Causes and Risk Factors

When the ulnar nerve is damaged and weakens the muscles or causes decreased sensation this is called ulnar nerve palsy.

Ulnar nerve palsy can be caused by:

  • Trauma or injury that affects the nerve
  • Long periods of pressure on the palm or the elbow
  • Repeated elbow bending
  • Compression from swelling or other internal structures
  • Ulnar neuropathy

Other causes that can lead to claw hand deformity include:

Risk factors that increase the likelihood of developing ulnar nerve palsy and a subsequent claw hand deformity are:

  • Previous elbow fracture or dislocation
  • Elbow joint swelling
  • Cysts in or near the elbow
  • Elbow arthritis or bone spurs
  • Activities that cause repetitive elbow bending

How Does Claw Hand Deformity Feel?

Claw hand deformity can make people feel uncomfortable and insecure about its appearance.

The hand can be stiff or painful. If it was caused by nerve damage, there may be a loss of sensation and function. Movement can be limited, making it difficult to perform daily tasks like gripping objects or opening doors.

Effects of Claw Hand Deformity

Claw hand deformity can affect someone both physically and emotionally.

The physical changes and the implications of those changes can cause someone to feel a sense of loss or make them feel inadequate.

The physical effects of claw hand deformity make it difficult to grab, grip, or pinch. There will be hand weakness which can make everyday activities difficult to perform.

Claw Hand Deformity Diagnosis

If someone suspects that they have claw hand deformity a healthcare provider would need to diagnose it. This would involve the provider examining the hand and reviewing the patient's health history. Other diagnostic tools would include:

Does Claw Hand Deformity Go Away?

Claw hand deformity recovery will depend on the type and severity of nerve injury. Mild injuries have a higher rate of recovery. Severe injuries in which the nerve iss completely cut have a low chance of recovery.

People who do recover will need rehabilitation to regain hand and finger strength. They may not regain all of their muscle strength.

Treatment and Neuropathy Management

Claw hand deformity treatment can involve surgery, exercises, and splinting.

One of the surgical techniques used to treat claw hand is described in a study from 2023. The study found success in treating claw hand due to ulnar nerve injury using autografts (tissue taken from one spot in the body and used in another spot) nerve transfer within a platelet-rich plasma (PRP) tube. More research is needed but the study holds promise for future ulnar nerve repairs.

Other surgical techniques release the contracture to prevent lasting effects.

Other Names for Claw Hand

Over the years there have been other names given to claw hand deformity. These terms are outdated and unkind. Most of the terms refer to animals as the hands look like an animal hand.

One reference, lobster hands, actually refers to a different condition called ectrodactyly.

Hand Exercises, Splinting, and Physical Therapy

Typically, if bending in the fingers is not too severe then surgery may not be necessary. Nonsurgical treatment options include:

Summary

Claw hand deformity is a result of ulnar nerve injury, infection, or is something someone is born with. Treatment will need the oversight of a healthcare provider and can involve splinting, exercise, or surgery. It is a difficult condition to treat with success rates varying based on the underlying cause.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Lane R, Nallamothu SV. Claw hand.

  2. Mount Sinai. Ulnar nerve dysfunction.

  3. Mount Sinai. Claw hand.

  4. OrthoInfo. Ulnar nerve entrapment at the elbow (cubital tunnel syndrome).

  5. Foy CA, Micheo WF, Kuffler DP. Inducing ulnar nerve function while eliminating claw hand and reducing chronic neuropathic painPlast Reconstr Surg Glob Open. 2023;11(4):e4927. doi:10.1097/GOX.0000000000004927

By Patty Weasler, RN, BSN
Patty is a registered nurse with over a decade of experience in pediatric critical care. Her passion is writing health and wellness content that anyone can understand and use.