Zancolli Lasso Technique Versus Brand Technique in Hand Clawing: A Comparative Study of Functional Outcomes

Background: Ulnar nerve palsy has a negative impact onbasic daily activities. The ulnar nerve lesions seem to be farworse than the median and radial nerves. Tendon transferoffers the sole solution in neglected cases of ulnar nerveinjuries by providing active-controlled motion. Tendon transfersare performed to eradicate claw deformity and restore handgrip.Objective: To evaluate the effectiveness of the ZancolliLasso procedure (ZLP) vs. Brand technique "Extensor CarpiRadialis Longus Transfer" in treating hand clawing.Patients and Methods: Twenty patients who suffered fromisolated ulnar nerve palsy, regardless the level of injury, withhand clawing after one year or more from the initial injurytime with no clinical signs of nerve recovery participated inthis prospective study. Ten patients were operated on usingthe Zancolli Lasso procedure (group A), and ten patients usedExtensor Carpi Radialis longus tendon transfer (group B).Prior to and following surgery, patients underwent bothsubjective and objective evaluations.Results: Group A showed significantly shorter operativetime, while Group B showed better Hand Assessment Tool(HAT) score and hand grip measurements. Both groups showedsignificant differences in the variable PIP and DIP joint rangeof motion.Conclusion: ZLP is an easier surgical choice for clawdeformity correction with shorter operative time, while ECRLbestows better handgrip improvement and patient-reportedoutcomes. Thus, ECRL is favored in manual workers, whereasZLP is favored in patients with medical comorbidities whenevera shorter operative time is recommended.