Hand of Benediction (proximal median neuropathy definition)

Ulnar Claw

Nerve involved

Proximal median nerve lesion

Distal ulnar nerve lesion

Digits affected

2^nd + 3^rd digits most affected

4^th + 5^th digits affected

Presentation with an open palm and at rest

Normal

4^th + 5^th MCPJs hyperextended

4^th + 5^th Interphalangeal joints flexed

Presentation when making a fist

2^nd + 3^rd MCPJs hyperextended

2^nd + 3^rd Interphalangeal joints neutral

Normal

Additional signs

Wasting of the thenar eminence

Wasting of the hypothenar eminence and dorsal interossei