Hand of benediction

Cause

The term "hand of benediction" has been used to refer to damage of the median nerve. However, the name is misleading as the patients with this median nerve problem usually can flex all fingers except for the index finger. The index finger is still extended at the metacarpophalangeal joint (MCP joint) when the ulnar nerve innervated muscles (the interossei muscles) are still working. The index finger is not flexed at the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints, which looks like a pointing finger. Pointing Finger is therefore a much better term to recognize this condition.

The middle finger is flexed because of the connection between the flexor digitorum profundus (FDP) tendons, which is called the Quadriga phenomenon.

Name

Main article: Benediction

The term "hand of benediction" refers to the similarity to a sign commonly used in Catholicism, which is said to originate from Saint Peter. Some sources speculate that Peter himself may have had ulnar nerve entrapment.

References

References

1. "The Hand Examination". Stanford Medicine.
2. (2022). "High Median Nerve Paralysis: Is the Hand of Benediction or Preacher's Hand a Correct Sign?". Plastic and Reconstructive Surgery - Global Open.
3. (2012). "The quadriga phenomenon: A review and clinical relevance". Journal of Hand Surgery.
4. (23 September 2015). "The strange origin of the pope's gesture of blessing". CBS News.
5. (17 September 2015). "From Vulcan salute to papal blessing: Ulnar nerve damage caused original benediction sign". New York Institute of Technology.
6. (2015). "Analysis of the Papal Benediction Sign: The ulnar neuropathy of St. Peter". Clinical Anatomy.