Benediction sign is associated with injury to which nerve?

• A. Radial nerve
• B. Ulnar nerve
• C. Median nerve
• D. Axillary nerve

Answer: (C)

Benediction sign reflects loss of function in the median nerve’s forearm flexors that bend the index and middle fingers. When a person tries to make a fist, the index and middle fingers cannot flex because the flexor digitorum superficialis and the lateral part of flexor digitorum profundus are paralyzed. As a result, those two digits stay extended, producing a benediction-like appearance. The ring and little fingers can still flex, driven by the ulnar-innervated portion of the flexors, so you see a partial fist with digits 4 and 5 flexed. This sign specifically points to a median nerve injury proximal to where those flexors are innervated, such as in the upper forearm or elbow.