The ‘Hand of benediction’ or ‘Pope’s hand’ can be manifested either when the patient attempts to make a fist or when the patient tries to open the hand.

Median nerve injury causes ‘Hand of Benediction’ hand when patient is asked to make a fist (or flex the fingers) while injury to the ulnar nerve causes the ‘Hand of Benediction’ hand when the patient is asked to open the hand (or extend the fingers).

The manifestation of the injuries to either nerve are often both referred to as ‘Hand of benediction’ since both hands looks the same. However, the manifestation resulting from the injury to the proximal median nerve injury is the one most commonly referred to as ‘Hand of benediction’ while the manifestation due to injury of the distal ulnar nerve is simply called ‘Ulnar clawing’ for differentiation.

Reference 1

in Neuromuscular and Nervous Systems

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