Hard to say without having a tool in hand really. Some designs just look awkward until you actually have them in your hands and use them.
As examples I'd offer up the Wave/Charge series from Leatherman. When I initially saw them I thought the blade offering from one corner of a rectangle would be be amazingly awkward. In practice however, it's only slightly awkward, and something you can get used to rather quickly.
Also, the Evolution scales from Wenger also look amazingly awkward, but when you actually use them, the knife seems to become an extension of your hand, similar to some of the high end tacticals with multifaceted ergonomic grips and fancy materials.
Indeed, I will go on record as saying that the Skeletool does indeed look awkward, but if you've read many of my reviews, you know I am wrong an awful lot!
Def