Hand of benediction

The hand of benediction, also known as benediction sign or preacher's hand, occurs as a result of prolonged compression or injury of the median nerve at the forearm or elbow.[1][2]

Cause

The term "hand of benediction" refers 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 phenomena.[3]

History

The term "hand of benediction" refers to the similarity to a sign commonly used in Roman Catholicism, which is said to originate from Saint Peter. Some sources suggest that Peter himself may have had ulnar nerve entrapment.[4][5][6]

References
  1. "Image of Hand of benediction". Stanford Medicine. Retrieved 28 May 2017.
  2. "The Hand Examination | Stanford Medicine 25". stanfordmedicine25.stanford.edu. Stanford Medicine. Retrieved 28 May 2017.
  3. Schreuders, T. A. R. (2011-12-14). "The quadriga phenomenon: a review and clinical relevance". Journal of Hand Surgery (European Volume). 37 (6): 513–522. doi:10.1177/1753193411430810. PMID 22170246.
  4. "The strange origin of the pope's gesture of blessing". www.cbsnews.com. Retrieved 2020-10-11.
  5. "From Vulcan salute to papal blessing: Ulnar nerve damage caused original benediction sign: New anatomy analysis reveals the origin of today's familiar hand blessing". ScienceDaily. Retrieved 2020-10-11.
  6. Futterman, Bennett (2015). "Analysis of the Papal Benediction Sign: The ulnar neuropathy of St. Peter". Clinical Anatomy. 28 (6): 696–701. doi:10.1002/ca.22584. ISSN 1098-2353.
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