Which test reproduces carpal tunnel symptoms by maintaining wrist flexion?

• A. Tinel sign
• B. Phalen test
• C. Froment's sign
• D. Finkelstein test

Answer: (B)

Phalen maneuver reproduces carpal tunnel symptoms by holding the wrist in full flexion. When the wrist is flexed, the carpal tunnel narrows and intratunnel pressure rises, compressing the median nerve. This transient compression often produces numbness, tingling, or paresthesias in the median-nerve distribution (thumb, index, middle, and the radial half of the ring finger), typically within about a minute of the position being held. The test is positive when these symptoms are evoked in this flexed position.

In contrast, tapping over the median nerve (Tinel sign) tests for nerve irritation at the nerve as it passes the carpal tunnel but doesn’t specifically rely on sustained flexion; Froment's sign evaluates ulnar nerve function with weakness of the adductor pollicis, and Finkelstein’s test assesses De Quervain's tenosynovitis, a different pathology.