Figure 12-6
The typical "claw" hand resulting from an ulnar nerve injury known as ulnar claw hand.
The typical "claw" hand resulting from an ulnar nerve injury known as ulnar claw hand.
A young man appeared at the emergency room of the hospital following an apparent gang fight. He had suffered a deep knife wound to the anteromedial aspect of the right forearm approximately three inches from the wrist. The wound did not bleed much and was cleaned and stitched. The young man was told to return to the hospital in one week and have the wound examined and the stitches removed. He neglected the advice. When the skin around the wound became inflamed and began to itch he removed the stitches with his own knife. After the inflammation subsided, he noticed that his hand did not work as well as it used to. His hand had assumed the look of a claw with exaggerated extension of the metacarpophalangeal joints and flexion of the interphalangeal joints of the medial two fingers. The fingers could not be abducted or adducted, and adduction of the thumb was lost. When he attempted to pick up a piece of paper between his thumb and index finger the thumb would assume a hyperflexed position at the I-P joint. This is known as Froment's sign or Froment's paper sign and is characteristic of this disorder. In addition, the patient noticed a sensory loss primarily over the medial aspect of the palm. He did not seek additional medical attention. The disorder was permanent and caused great difficulty in handling manual labor jobs.
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