Q: I have a deformed right hand. I got this deformity when an orthopaedic maltreated my supracondylar fracture and now it is not normal. I was 5 years old then and now I am 40. I cannot close my hand in a fist position and it is in a claw like position. I cannot the touch the tip of my fingers with my thumb. I cannot lift heavy weights and I find it difficult to turn the knob of a door. I am willing to undertake surgery and spend money to rectify my hand.

A:It seems that you have developed an ulnar nerve palsy following the treatment of supracondylar fracture in childhood. Ulnar nerve supplies three and half fingers of the hand (thumb, index, middle and half ring finger). This is known as a claw hand deformity. It results in the inability to use the thumb and the involved fingers. The treatment is always surgical. Minimum of two operations are required. The first is on the thumb to correct the movement of opposition and the second one to correct the claw deformity of the involved fingers. After surgery, the patient needs to undergo extensive physical therapy. Overall results are satisfactory and the patient can get good use of the hand.