Which type of grip is easiest for a patient with difficulty opposing the thumb?

• A. Digital prehension
• B. Three point chuck
• C. Lateral prehension
• D. Tip pinch

Answer: (C)

When thumb opposition is difficult, choose a grip that relies less on bringing the thumb across the palm and more on a stable pinch with the thumb pressed against the side of the index finger. Lateral prehension, also known as the key pinch, does just that: the thumb adducts and contacts the lateral aspect of the index finger, creating a secure grip without requiring strong thumb opposition or extensive thumb rotation. This makes it easier for someone with limited thumb opposition to grasp and manipulate objects like a key or a small, flat item.

Other grips involve more precise thumb opposition or complex finger alignment: tip pinch requires tip-to-tip contact, digital prehension uses pad-to-pad contact across multiple digits with the thumb opposed, and the three-point chuck adds the middle finger in a tripod pattern. All of those demand more opposing thumb control and finger coordination, which is why they’re more challenging when thumb opposition is impaired.