Hand of benediction

Hand of benediction

The hand of benediction results from a severed Median nerve at the level of the elbow or upper arm.[1][2][3] The ability to flex the digits 2–3 at the metacarpophalangeal joints, proximal interphalangeal joints and distal interphalangeal joints is lost. Flexion at the proximal interphalangeal joints of digits 4–5 is weakened, but flexion at the metocarpophalangeal joints and distal interphalangeal joints remains intact. The extensors are left unopposed and digits 2–3 remain extended while attempting to make a fist.[4]

The name arises from the invocation of a blessing used in Christian circles (see Benediction).

Blessing

Distinction from Ulnar Claw

See also: Ulnar claw

Some sources[5] use the term "hand of benediction" to include both the condition described above and ulnar clawing, which is a common source of confusion. Both signs have similar presentations, but the term "hand of benediction" more frequently refers only to damage to the median nerve and is seen with attempted flexion of all the digits, while "ulnar claw" refers exclusively to damage to the ulnar nerve and is seen with attempted extension of all the digits.

References

  1. ^ "BRACHIAL PLEXUS – nerves & important lesions". Columbia University. http://cpmcnet.columbia.edu/student/ssn/anatomy/brachial_plexus.pdf. Retrieved 2011-09-02. 
  2. ^ "Medscape: Medscape Access". Cme.medscape.com. http://cme.medscape.com/viewarticle/527751_8. Retrieved 2011-09-02. 
  3. ^ "Fundamentals of neurology: an ... - Google Books". Books.google.com. http://books.google.com/books?id=ktEPPiLeiWoC&lpg=PA227&ots=DJ6XDYRklu&dq=popes%20blessing%20nerve&pg=PA227#v=onepage&q&f=false. Retrieved 2011-09-02. 
  4. ^ "Netter Image". Netterimages.com. http://www.netterimages.com/image/7639.htm. Retrieved 2011-09-02. 
  5. ^ "Taber's Medical Dictionary:benediction hand". Tabers.com. 2009-06-23. http://www.tabers.com/tabersonline/ub/view/Tabers/143428/26/benediction_hand. Retrieved 2011-09-02. 

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