{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,26]],"date-time":"2025-05-26T13:47:46Z","timestamp":1748267266100,"version":"3.40.5"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p>Ulnar nerve injury initiates an imbalance between the intrinsic muscles and extrinsic extensors of the ring and small fingers, which leads to the characteristic hyperextension of the metacarpophalangeal (MP) joints and flexion of the proximal interphalangeal joints of these 2 digits\u2014commonly referred to as the ulnar claw hand. In addition to these changes in the static posture of the hand, ulnar nerve palsy severely impairs grasp due to deficient active MP joint flexion. In most cases, motor balance can be restored by preventing MP joint hyperextension and augmenting MP joint flexion using the Zancolli lasso procedure (ZLP). Ulnar neuropathy can cause a second motor imbalance between the ulnar intrinsics and the extensor digit minimi leading to an abduction deformity of the small finger known as Wartenberg\u2019s sign. The inability to adduct the small finger can be a great source of frustration to patients. Using a cadaveric biomechanical model, we have developed a simple modification of the Zancolli lasso procedure that simultaneously corrects claw deformity and Wartenberg\u2019s sign and we report its efficacy in 2 clinical cases.<\/jats:p>","DOI":"10.1097\/bth.0000000000000459","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T06:00:08Z","timestamp":1698645608000},"page":"45-48","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Modification of the Zancolli Lasso Procedure for Simultaneous Correction of Wartenberg\u2019s Sign"],"prefix":"10.1097","volume":"28","author":[{"given":"Brynn A.","family":"Hathaway","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha J.","family":"Burch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chloe C.","family":"Krasnoff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew R.","family":"Zeiderman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel S.","family":"Solomon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2024,3]]},"reference":[{"key":"R1-20250512","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1177\/230949901502300104","article-title":"Zancolli lasso procedure for correction of paralytic claw hands","volume":"23","author":"Gupta","year":"2015","journal-title":"J Orthop Surg (Hong Kong)"},{"key":"R2-20250512","doi-asserted-by":"crossref","first-page":"S118","DOI":"10.1016\/j.hansur.2020.11.012","article-title":"Correction of ulnar claw hand and Wartenberg\u2019s sign","volume":"41S","author":"Bauer","year":"2022","journal-title":"Hand Surg Rehabil"},{"key":"R3-20250512","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1007\/s00064-012-0207-2","article-title":"Operative treatment of claw deformity by lassoplasty","volume":"25","author":"Pillukat","year":"2013","journal-title":"Oper Orthop Traumatol"},{"key":"R4-20250512","doi-asserted-by":"crossref","first-page":"70","DOI":"10.5704\/MOJ.2211.012","article-title":"Anti-claw procedure with modified dynamic flexor digitorum superficialis transfer for ulnar nerve palsy: our experience","volume":"16","author":"Iqbal","year":"2022","journal-title":"Malays Orthop J"},{"key":"R5-20250512","first-page":"594","article-title":"Kleine Hiffsmittel der neurologichen Diagnostik","volume":"3","author":"Wartenberg","year":"1930","journal-title":"Nervenarzt"},{"key":"R6-20250512","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/S0363-5023(76)80037-8","article-title":"The abducted little finger in low ulnar nerve palsy","volume":"1","author":"Blacker","year":"1976","journal-title":"J Hand Surg Am"},{"key":"R7-20250512","first-page":"325","article-title":"Extensor digiti minimi tendon \u201crerouting\u201d transfer in permanent abduction of the little finger","volume":"17","author":"Bellan","year":"1998","journal-title":"Chir Main"},{"key":"R8-20250512","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1007\/s11552-011-9320-1","article-title":"Investigation of radialization and rerouting of the extensor digiti minimi (EDM) in the abduction deformity of the little finger: a cadaver study","volume":"6","author":"van Aaken","year":"2011","journal-title":"Hand (N Y)"},{"key":"R9-20250512","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1016\/S0363-5023(10)80142-X","article-title":"Extensor digiti minimi tendon transfer to correct abducted small finger in ulnar dysfunction","volume":"16","author":"Dellon","year":"1991","journal-title":"J Hand Surg Am"},{"key":"R10-20250512","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/S0266-7681(05)80016-6","article-title":"Wartenberg\u2019s sign. A new method of surgical correction","volume":"20","author":"Voche","year":"1995","journal-title":"J Hand Surg Br"},{"key":"R11-20250512","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.main.2004.05.003","article-title":"The \u201cnecktie lasso\u201d: a new technique for the simultaneous treatment of Wartenberg\u2019s sign and claw deformities in the hand due to ulnar nerve palsy","volume":"23","author":"Belmahi","year":"2004","journal-title":"Chir Main"},{"key":"R13-20250512","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1097\/00003086-197410000-00008","article-title":"Early tendon transfer in upper extremity peripheral nerve injury","volume":"104","author":"Burkhalter","year":"1974","journal-title":"Clin Orthop Relat Res"},{"key":"R14-20250512","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.2106\/00004623-197355080-00011","article-title":"Metacarpophalangeal flexor replacement for intrinsic-muscle paralysis","volume":"55","author":"Burkhalter","year":"1973","journal-title":"J Bone Joint Surg Am"}],"container-title":["Techniques in Hand &amp; Upper Extremity Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/BTH.0000000000000459","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,12]],"date-time":"2025-05-12T16:12:46Z","timestamp":1747066366000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/BTH.0000000000000459"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,26]]},"references-count":13,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.1097\/bth.0000000000000459","relation":{},"ISSN":["1531-6572"],"issn-type":[{"type":"electronic","value":"1531-6572"}],"subject":[],"published":{"date-parts":[[2023,10,26]]}}}