Anti-Claw Procedure with Modified Dynamic Flexor Digitorum Superficialis Transfer for Ulnar Nerve Palsy: Our Experience

Abstract

INTRODUCTION: The ulnar nerve palsy is a distressing injury, resulting in clawing of hand. The cause of clawing is due to paralysis of the interosseous muscles in the presence of functioning long extensor and long flexors of fingers. Various methods have been proposed to correct this deformity which include both static and dynamic procedures. In this study, we share our experience with flexor digitorum superficialis tendon transfer using Zancolli’s modification for anti-claw correction. MATERIALS AND METHODS: It was a retrospective case series study. A record of 53 patients was included in the study, during a period between June 2013 to July 2017 with ulnar nerve palsy. The procedure done was flexor digitorum superficialis tendon transfer as dynamic anti-claw procedure. The follow-up period was three months. The outcomes assessed were grip strength by using sphygmomanometer and active range of motion of fingers assessed by fingers tips touching the palm. RESULTS: Fifty-three patients were included out of them, there were fifty males and three females. The mean age was 28±10 years. All patients underwent flexor digitorum superficialis transfer for ulnar claw hand. 84.9% patients have good grip strength and 83% showed good active range of motion. CONCLUSION: Flexor digitorum superficialis tendon transfer is found to be effective, reliable and reproducible technique in ulnar nerve palsy where patient need grip strength, good range of motion and acceptable hand function for daily routine work.

Keywords

• anti-claw procedure
• ulnar nerve palsy
• flexor digitorum superficialis transfer
• ulnar claw hand