The Clenched Fist Syndrome: A Presentation of Eight Cases and an Analysis of the Medicolegal Aspects in Denmark

Abstract

Clenched fist is a rare disorder of the hand associated with fixed contractures of fingers. The condition is often preceded by minor trauma or surgery, but these do not explain the severity of the contractures. Extension of the fingers is painful and hygienic problems can be considerable. Psychiatric disease is frequent in clenched fist patients. The patients may express a strong wish for amputations. In a review of eight patients with clenched fist who had claimed economic compensation from the Danish Patient Insurance Association, four patients had amputations. Three of them subsequently developed new contractures.

Median Neuropathy After Blood Draw Mimics Painful Clenched Fist Syndrome in a Child

“…The psychopathological underpinnings of this diagnosis are widely accepted both in the psychiatric and in the hand surgery literature. 1,[4][5][6][7][8][9][10][11][12][13][14] However, controversy existed concerning the degree that symptoms are consciously produced; although some have argued clenched fist to be factitious in nature (unconsciously motivated, but with consciously produced symptoms), 4,5 it is now widely considered a true conversion disorder (unconsciously motivated with unconsciously produced symptoms). 7,12 Rare, poorly understood syndromes are liable to be given a presumptive explanation before their true pathophysiological etiology is elucidated.…”

Correction of Severe Contracture of Intrinsic Plus Hand with a Modified Ilizarov Mini-Fixator

“…While this deformity is often due to direct hand trauma, malnutrition, or ischemia, it can also occur without any obvious causes [1,2]. The differential diagnosis includes the psychoflexed hand, a rare clinical condition with fixed finger contractures whose etiology is undetermined and it is often associated with psychiatric pathology [3][4][5].…”

Necessity of secondary Syme amputation of the foot after severely destroyed hindfoot injury due to suicidal jump from height in a psychiatric patient: Case presentation and brief review of literature

“…"fourth stage of management") are joint replacement, joint arthrodesis with or without required correction of misalignment ( Figures 9A-C with or without exposure of osteosynthesis plates or endoprostheses with or without infection, treatment of other trauma-or surgeryrelated complications such as malignancy or failed ORIF, and silicone epitheses can become necessary to restore or improve statics, function, and aesthetics in the further course ( Figures 10A-B) [10,37,[54][55][56][57][58][59][60]. It must be noted that surgical amputation after complication of minor trauma or surgery regardless any problems with the wound healing can be the "last exit" for functional recovery of patients with psychiatric disorders as well [61].In the literature, it is still controversial in decision making whether we should perform a primary surgical amputation or limb salvage procedures in non-critically ill polytraumatized patients with severely destroyed hindfoot injuries. Patients with limb salvage procedures reported less favorable outcomes than patients sustaining primary surgical amputation related to mobility, activity, social interaction, emotional behavior, pain with walking, returning to work, and the number of required rehospitalizations for secondary surgical procedures [9,[62][63][64][65].…”