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Ulnar claw is caused by damage to the ulnar nerve, which can occur from injury or long-term wear. Treatment may include steroid injections, pain medication, splints, surgery, and physical therapy. Dupuytren’s contracture, a rare tissue formation in the palm, can also lead to ulnar claw.
An ulnar claw is the result of extreme trauma or damage to the ulnar nerve, which runs from the shoulder to the hand. For the thumb and first half of the hand, the median nerve is responsible for motion and sensation; the ulnar nerve is responsible for the last fingers. As the lesion goes untreated, the ring and little fingers will become difficult to extend, giving the hand the appearance of a primitive claw.
Ulnar nerve damage can occur in a variety of ways. According to The New York Times Online Health Guide, this claw and associated paralysis is an extreme result of peripheral neuropathy. This is damage to the ulnar nerve from injury or even from subtle causes such as habitual leaning on elbows or palms. In this arm position, the ulnar nerve is particularly exposed to long-term wear. The latter slow-developing causes are more likely to turn out not with an ulnar claw, but with numb, weak, tingling fingers.
In infants, this damage can be the result of Klumpke’s palsy. Also known as brachial palsy, this condition is caused by injury to the shoulder nerves of the brachial plexus during or after birth. This will reveal itself not just in an ulnar claw, but in the complete inactivity of a hand or even the entire arm. Claw may or may not be among the symptoms, however, as the arm and hand are just as likely to be completely limp as they are to twitch unnaturally.
In most cases, doctors will take a multifaceted approach to treating an ulnar claw. Steroid injections and pain medications can relieve inflammation in the short term. A splint could contain the lesion causing the nerve damage. Surgery may also be part of the treatment, to remove the cause of the injury and even to repair the damaged nerve. With or without surgery, physical therapy may also be part of the answer.
Surgery is perhaps the only way to relieve symptoms of another condition, called Dupuytren’s contracture, which could turn into an ulnar claw. This rare tissue formation in the palm limits nervous activity and ultimately the proper use of the fingers. According to the US National Institutes of Health, this condition most often affects smokers, alcoholics and diabetics. As the growth on the palm side takes up more and more space, the apparent claw will become more pronounced and the fingers more painful to fully extend.
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