<prompt> Klumpkes paralysis results from lesion ofUpper brachial plexus injuryLower brachial plexus injuryRadial nerve injuryC5, C6 and C7 injury  <response>: Ans. b Lower brachial plexus injury. Ref. B L, Surgery, 22nd ed., 380Klumpkes paralysis- Site of injuryLower trunk of brachial plexus.- Cause of injuryUndue abduction of arm, as in clutching something with the hands after a fall from height or sometimes in birth injury.- Nerve root involvedMainly T1 party Cg- Muscles paralysed- Intrinsic muscles of the hand T1.- Ulnar flexors of the wrist fingers C8DeformityClawhand due to unopposed action of the long flexors extensors of fingers.In a clawhand there is hyperextension at the metacarpo-phalangeal flexion at the interphalangeal joints.- DisabilityCutaneous anesthesia analgesia in a narrow zone along the ulnar border of forearm hand.- Horners syndrome-ptosis, miosis, anhydrosis, enopthalmos, loss of ciliospinal reflex may be associated. MH05, AI05, Kar05 