Treatment of claw hand.

Palliative treatment of the intrinsic muscles paralyses aims at correcting the claw deformity and improving prehension. This treatment will vary according to whether the claw be actively corrected or not when M.P. hyperextension is prevented. In the first category it suffices to maintain M.P. joint either by capsulodesis or tenodesis so that the long extensors can extend the interphalangeal joints. Tendons transfers are indicated to reinforce the flexion force of the fingers particularly when there is an associated long flexor tendon paralysis. These transfers should be fixed to the proximal part of the proximal phalanx. When the claw is not actively correctable, associated cutaneous, tendinous or joint lesions co-exist and these will demand priority treatment. Tendon transfers when possible are necessary to extend the distal phalanges and should be fixed distally.