The right hand of Leonardo da Vinci (1452–1519): ulnar or median nerve palsy?

Recently, an article entitled ‘The right hand palsy of Leonardo da Vinci (1452–1519): new insights on the occasion of the 500th anniversary of his death’ was published in the Journal of the Royal Society of Medicine that proposes a diagnosis of ulnar nerve palsy (claw hand) on Leonardo da Vinci’s right hand.¹ This diagnosis was based on a Giovan Ambrogio Figino’s (1548–1608) drawing, in which Leonardo is represented with his right hand in an atypical position and, consequently, the authors suggest a ‘claw hand’ diagnosis. However, we believe that this diagnosis may be mistaken, mainly for the fact that the representation of Leonardo’s hand on Figino’s drawing does not match the classical representation² of the ‘claw hand’. In Figino’s drawing, it is notorious that Leonardo’s hand is represented on the position of the ‘hand of benediction’, which is the result of an injury to the median nerve. The classical² and recent³ descriptions associated to the clinical elucidation of the ‘hand of benediction’ show itself clearly similar to what is exposed on Figino’s drawing, such as:

• Loss of flexion on the inter phalangeal joints from the first to the third fingers and flexion impairment of the fourth and fifth fingers.

• Loss of flexion on the inter phalangeal distal joints of the second and third fingers.

• Inability to flex the metacarpo phalangeal joints of the second and third fingers. Therefore, when the patient attempts to close the fist, the second and the third fingers remain partially extended (hand of benediction).

Furthermore, differently from what is represented on Figino’s drawing, the patient with ulnar nerve injury (claw hand) has all of its metacarpo phalangeal joints hyperextended.²

Declarations

Competing Interests

None declared.