Striatal Hand Deformities: Manifestations, Diagnosis, and Treatment Perspectives

Striatal hand deformity is a dystonic postural abnormality often observed in patients with Parkinson disease. It is infrequently discussed and often misdiagnosed. The presentation can be confused as a rheumatologic or osteoarthritic condition, delaying appropriate management. This scoping review assessed the existing literature on striatal hand deformities, including study characteristics, treatment modalities, and reported outcomes.

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, a comprehensive search was performed across PubMed, Cochrane, Scopus, Google Scholar, Web of Science, and OpenAlex using terms related to "hand deformities," "neostriatum," and "striatal hand." Eligible studies discussed striatal hand deformities; non-peer-reviewed works, abstracts, and opinion pieces were excluded. Extracted data included study design, intervention type, and treatment outcomes. Due to heterogeneity, a narrative synthesis was conducted.

Thirty-six studies met inclusion criteria: 19 case reports, 8 reviews, 6 observational studies, and 3 textbook chapters. Botulinum toxin and levodopa were the most frequently discussed treatments (8 studies each), with mixed outcomes. Surgical approaches and subthalamic nucleus deep brain stimulation were described in a few studies, showing variable results. Nonpharmacologic strategies such as physiotherapy appeared in 9 studies, with limited benefit. Six studies reported minimal or no improvement across interventions.

This review highlights limited evidence, particularly in hand surgery, on diagnosing and managing striatal hand deformities. Pharmacologic treatments such as botulinum toxin showed inconsistent outcomes, and nonpharmacologic strategies were underexplored. Systematic studies to establish evidence-based diagnostic and treatment protocols are lacking.