Snapshot A 32-year-old woman presents to the emergency room with severe right arm pain after being involved in a motor vehicle collision. She has a comminuted open fracture of the right distal radius and ulna. She is taken to the operating room where lesions to the distal ulnar artery and nerve are noted. She undergoes multiple surgical procedures over the following several months until her radius and ulna appear well healed. However, she has residual hand weakness and is unable to completely open her hand after making a fist. On exam, her 4th and 5th metacarpophalangeal joints are hyperextended while her 4th and 5th interphalangeal joints are flexed. Introduction Lesions to different nerves of the upper extremity will lead to specific hand distortions login to view 3 more bullets Relevant anatomy login to view 40 more bullets Ulnar Claw Hand Physical exam login to view 4 more bullets Pathoanatomy login to view 5 more bullets Hand of Benediction Physical exam login to view 3 more bullets Pathoanatomy login to view 6 more bullets Klumpke Total Claw Hand Physical exam login to view 5 more bullets Pathoanatomy login to view 9 more bullets