Nice, very nice...If only that hand was isolated to the left, it would be a perfect 10.
(I don't like very much to come up with "what-if" scenarios, so you can consider this opinion the exception. They can be quite frustrating to the photographer as, sometimes, there is just not another way to do the photo, as it was probably the case here.
I remember once someone coming up with suggestion about how another placement would have improved a river bank shot of mine. I had to point out, quite politely that, should I have followed those suggestions, they would have placed me 10 ft in the air right above the river, lol...)
PK