Pick-up test: an indication for opponensplasty in patients with severe carpal tunnel syndrome.
OBJECTIVE
To use a pick-up test to assess thenar motor deficit and results of opponensplasty.


METHODS
Eight consecutive patients with idiopathic severe carpal tunnel syndrome and severe thenar motor deficit were identified. All were females aged 39 to 60 (mean, 53) years and right-hand dominant. The severity of thenar motor deficit was assessed using the pick-up test. Failure to pick up a coin with the thumb and index finger only in a normal pulp-to-pulp pincer grip was an indication for an opponensplasty (in addition to open carpal tunnel release) to hasten recovery of thumb abduction. Treatment outcome was assessed using the pick-up test at 6, 8, and 12 weeks.


RESULTS
Preoperatively, all patients were unable to perform the pick-up test. At postoperative 6 weeks, all patients could pick up the coin with no difficulty and were satisfied with the result of opponensplasty. There was no relapse at subsequent follow-ups and no donor-site morbidity in terms of cosmesis, scar pain or infection. Grip strength and the range of wrist motion were 63% and 92% of the normal side, respectively.


CONCLUSIONS
The pick-up test is a simple and reliable means of identifying those in need of an opponensplasty.
Yip
Siu-Leung
SL
Department of Orthopaedics and Traumatology, Kwong Wah Hospital, 25 Waterloo Road, Yau Ma Tei, Kowloon, Hong Kong. aslyip@gmail.com
Yen
Chi-Hung
CH
Chan
Wai-Lam
WL
Leung
Hon-Bong
HB
Mak
Kan-Hing
KH
D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000503:physiopathology* / Q000601:surgery*; D019299:Decompression, Surgical; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D052581:Pinch Strength / Q000502:physiology*; D016059:Range of Motion, Articular; D012720:Severity of Illness Index; D016896:Treatment Outcome