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The psycho flexed hand is a rare disorder characterized by fixed fingers contractures without  organic etiology. Most frequently the three ulnar digits are involved, but different combinations and extensions of the deformities are possible. Such condition is rather unknown and often misdiagnosed. A series of 19 cases, 9 males and 11 females, mean age of 56.2 years was reported. We proposed a classification of the psycho flexed hand in 6 types:

• type 1: prevalent flexion contracture at the MCP  and PIP  joints of the last two or three fingers; the thumb and the index are not affected
• type 2: prevalent flexion contracture at the  PIP and DIP joints of the last two or three fingers
• type 3:  flexion contracture of all the long fingers   
• type 4: flexion contracture of all the fingers of the hand, including the thumb (clenched fist syndrome)
• type 5: thumb in palm (the long fingers are not affected)
• type 6: fingers flexion  associated with flexion contracture of other joints at the upper extremity.

We performed non-operative treatment in 13 patients with recent deformities and surgical treatment in 6 patients. A rigorous rehabilitation program, mainly based on self -rehabilitation performed by patients at home, was effectuated in all cases. In all the treated patients except one of the operated cases  we obtained a satisfactory and durable correction of the deformities.