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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Purpose: To evaluate a patient for the Clenched Fist Syndrome (CFS).
Objective: clinical diagnosis, including family history for genetics, criteria for diagnosis