Prevention
Is used to preserve the function of the fingers. It includes physical exercise, stretching, proper bodily function and myofascial release (massage, foam roller). Exercises are focused on the forearm muscles, such as the extensor carpi ulnaris; extensor digitorum to antagonize the flexion of the fingers.
Massaging the forearm muscles also alleviates the tightness that occurs with muscles exertion. Stretching allows the muscles more flexibility, decreasing interference with the innervations of the ulnar nerve to the fingers.
Caused by median nerve lesions. The hand will show hyper-extension of the metacarpophalangeal joints (MCP) from the unopposed extensor digitorum as well as weakened extension and flexion of the Interphalangeal (IP) joints of the 2nd and 3rd digits (index and middle) due to deficits in the radial lumbricals and lateral half of the flexor digitorum profundus. The pathogenesis is similar to that of ulnar clawing (loss of the relevant lumbricals and the flexor digitorum profundus along with unopposed action of forearm extensors), and a median claw hand will appear similar to an ulnar claw when the patient with a median claw is asked to make a fist.
The following signs may be used to distinguish median nerve clawing from ulnar nerve clawing clinically.
| Ulnar nerve | Median nerve |
|---|---|
| Deficit is primarily in 4th and 5th fingers | Deficit is primarily in 2nd and 3rd fingers. |
| Deficit is most prominent at rest and when the patient is asked to extend his fingers. | Deficit is most prominent when the patient is asked to make a fist. |
| Often accompanied by inability to abduct or adduct the 2nd, 3rd, 4th, and 5th finger. | Often accompanied by difficulty opposing the thumb. |
| Often accompanied by apparent atrophy of the first dorsal interosseous muscle of the hand | Often accompanied by wasting of muscles of the thenar eminence |
Read more about this topic: Ulnar Claw
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