The Clenched Fist Syndrome (CSF) is a rare disorder that is classified as a psychopathological hand disorder. It is considered a conversion disorder.

Features of the Clenched Fist Syndrome:

(1) The patient has an underlying psychiatric disorder (depression, obsessive compulsive disorder, schizophrenia, etc).

(2) The patient has a dystonia with flexion contracture of multiple fingers.

(3) The patient lacks insight into the connection between the hand problems with the psychiatric disorder.

(4) Exclusion of a neuromuscular or vascular disorder that could explain the findings better.


The condition is usually unilateral but can be bilateral. Ulnar-sided fingers are most commonly affected.


Problems in management:

(1) The patient refuses psychiatric treatment.

(2) The clinician misdiagnoses the condition, resulting in delayed diagnosis or unnecessary interventions such as surgery.

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