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Updated: Jun 20, 2026
Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
Pick-up test: an indication for opponensplasty in patients with severe carpal tunnel syndrome
Siu-Leung Yip1, Chi-Hung Yen, Wai-Lam Chan
1Department of Orthopaedics and Traumatology, Kwong Wah Hospital, 25 Waterloo Road, Yau Ma Tei, Kowloon, Hong Kong. aslyip@gmail.com
Purpose:
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.
Conclusion:
The pick-up test is a simple and reliable means of identifying those in need of an opponensplasty.
