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Closed Fist Sign

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Other Names

  • Closed-Fist Sign


Closed fist sign for carpal tunnel syndrome
  • Evaluate wrist pain by attempting to reproduce symptoms of carpal tunnel syndrome


  • Patient is seated or standing
  • Patient is asked to flex hand into a closed fist for 60 seconds
  • Positive test:
    • Paresthesias in the median nerve distribution



  • De Smet et al[1]
    • Sensitivity: 61%
    • Specificity: 92%
    • LR+: 7.3
    • LR-: 0.4

See Also


  1. De Smet L, Steenwerckx A, Van den Bogaert G, Cnudde P, Fabry G. Value of clinical provocative tests in carpal tunnel syndrome. Acta Orthop Belg. 1995;61(3):177-82. Review. PubMed PMID: 8525813.
Created by:
John Kiel on 10 October 2019 15:09:41
Last edited:
25 March 2023 08:15:12