Pre-operative electrodiagnostic testing predicts time to resolution of symptoms after carpal tunnel release

2015 ◽  
Vol 41 (2) ◽  
pp. 137-142 ◽  
Author(s):  
J. R. Fowler ◽  
M. Munsch ◽  
Y. Huang ◽  
W. C. Hagberg ◽  
J. E. Imbriglia
Keyword(s):  
Carpal Tunnel Syndrome ◽  
No Value ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Carpal Tunnel Release ◽  
Nerve Conduction Studies ◽  
Level Of Evidence ◽  
Electrodiagnostic Testing ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release

The purpose of this study was to determine if nerve conduction studies predict time to resolution of symptoms after carpal tunnel release. A total of 56 patients undergoing open carpal tunnel release were prospectively enrolled. Pre-operative presence of nocturnal symptoms and daytime numbness/tingling were documented. Pre-operative nerve conduction studies were reviewed and classified as mild, moderate, or severe. After open carpal tunnel release, patients were contacted by phone within 48 hours, at 1 week, and then at 2-week intervals for up to 9 months or until both nocturnal and daytime symptoms had resolved. This study found that patients with mild or moderate carpal tunnel syndrome experience a faster time to resolution of daytime numbness and tingling when compared with patients with severe carpal tunnel syndrome. Nocturnal symptoms resolved quickly in both groups. The results of this study are in contrast to previous studies that found little to no value of nerve conduction studies in predicting post-operative functional and subjective outcomes. Level of Evidence: IV

Neurophysiological Recovery After Open Carpal Tunnel Decompression: Comparison of Simple Decompression and Decompression with Epineurotomy

2003 ◽  
Vol 28 (5) ◽  
pp. 450-454 ◽  
Author(s):  
N. BORISCH ◽  
P. HAUSSMANN
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Carpal Tunnel Release ◽  
Nerve Conduction Studies ◽  
Motor Latency ◽  
Significant Difference ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release ◽  
Simple Decompression

Two hundred and seventy-three patients with carpal tunnel syndrome without advanced neurophysiological changes (distal motor latency below 11 ms) were randomized to treatment by open carpal tunnel release with, or without, epineurotomy. Patients were examined clinically and by nerve conduction studies preoperatively and at 3, 6 and 12 months postoperatively. We found no statistically significant difference between simple decompression and decompression combined with epineurotomy with regard to either the clinical or the neurophysiological outcome.

Carpal tunnel decompression in patients with normal nerve conduction studies

2019 ◽  
Vol 45 (3) ◽  
pp. 260-264 ◽  
Author(s):  
Samuel P. Mackenzie ◽  
Oliver D. Stone ◽  
Paul J. Jenkins ◽  
Nicholas D. Clement ◽  
Iain R. Murray ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Clinical Features ◽  
Carpal Tunnel ◽  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Study Groups ◽  
Nerve Conduction Studies ◽  
Level Of Evidence ◽  
Tunnel Syndrome ◽  
Normal Nerve Conduction

Some patients present with typical clinical features of carpal tunnel syndrome despite normal nerve conduction studies. This study compared the preoperative and 1-year postoperative QuickDASH scores in patients with normal and abnormal nerve conduction studies, who underwent carpal tunnel decompression. Of the 637 patients included in the study, 19 had clinical features of carpal tunnel syndrome but normal nerve conduction studies, and underwent decompression after failure of conservative management. Preoperative QuickDASH scores were comparable in both groups (58 vs 54.8). However, there were significant differences between the normal and abnormal nerve conduction study groups in the QuickDASH at 1 year (34.9 vs 21.5) and change in QuickDASH postoperatively (23.1 vs 33.4). Patients with normal nerve conduction studies had comparable preoperative disability scores compared with those with abnormal studies. Although they had a significant improvement in QuickDASH at 1 year, this was significantly less than those with abnormal nerve conduction studies. Level of evidence: III

Use of Nerve Conduction Studies and the Pressure-Specified Sensory Device in the Diagnosis of Carpal Tunnel Syndrome

2009 ◽  
Vol 34 (1) ◽  
pp. 60-65 ◽  
Author(s):  
D. J. SLUTSKY
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Diagnostic Yield ◽  
Carpal Tunnel Release ◽  
Nerve Conduction Studies ◽  
Control Group ◽  
Asymptomatic Volunteers ◽  
Before And After ◽  
Tunnel Syndrome

Sixty-nine patients with signs of carpal tunnel syndrome (CTS) underwent nerve conduction studies (NCS) and testing with the Pressure-Specified Sensory Device (PSSD). A total of 102 tests were performed (28 bilateral). Twenty patients underwent a carpal tunnel release and were retested after 4 to 6 months. The Symptom Severity Score (SSS) was calculated before and after surgery. A control group of 20 hands in 10 asymptomatic volunteers underwent identical testing. The NCS sensitivity was 87% with a specificity of 90% whereas the PSSD sensitivity was 81% with a specificity of 65%. The combined sensitivity of the two tests was 93%. In the operative group the SSS improved from a mean of 3.34 pre-operatively to 1.95 postoperatively. The NCS improved in 19/21 hands whereas the PSSD improved in 16/19 hands. The non-invasive SSS and PSSD can increase the diagnostic yield in CTS, especially when the NCS are normal.

Carpal Tunnel Release Despite Normal Nerve Conduction Studies in Carpal Tunnel Syndrome Patients

2021 ◽  
Vol 86 (1) ◽  
pp. 52-57
Author(s):  
Jun-Ku Lee ◽  
Byung-Nam Yoon ◽  
Jin Woo Cho ◽  
Han-Seung Ryu ◽  
Soo-Hong Han
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Carpal Tunnel Release ◽  
Nerve Conduction Studies ◽  
Tunnel Syndrome ◽  
Normal Nerve Conduction

The results of carpal tunnel release for carpal tunnel syndrome diagnosed on clinical grounds, with or without electrophysiological investigations: a randomized study

2012 ◽  
Vol 38 (1) ◽  
pp. 44-49 ◽  
Author(s):  
A. Żyluk ◽  
Z. Szlosser
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Carpal Tunnel Release ◽  
Randomized Study ◽  
Clinical Importance ◽  
Nerve Conduction Studies ◽  
Pinch Strength ◽  
Tunnel Syndrome ◽  
To Receive

We compared the results of carpal tunnel release in patients with the diagnosis of carpal tunnel syndrome based on only clinical grounds and those diagnosed on clinical and electrophysiological grounds. Ninety-three patients, 83 women (89%) and ten men (11%), meeting the criteria of ‘typical’ carpal tunnel syndrome, were randomly assigned to receive carpal tunnel release with ( n = 45, 48%) or without ( n = 48, 52%) nerve conduction studies. Patients were followed-up at 1 and 6 months, by assessments that included the Levine scores, filament tests, grip and pinch strength. No significant differences in Levine scores were found at the 1 and 6 months assessments. Statistically significant differences were noted in three-point pinch strength and sensation; however, they were not of clinical importance. The results of the study show that the results of carpal tunnel release in patients with typical symptoms are no better after nerve conduction studies and, therefore, nerve conduction studies can be omitted.

Neurophysiological Findings in Vibration-Exposed Male Workers

1999 ◽  
Vol 24 (2) ◽  
pp. 203-209 ◽  
Author(s):  
T. STRÖMBERG ◽  
L. B. DAHLIN ◽  
I. ROSÉN ◽  
G. LUNDBORG
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Carpal Tunnel Release ◽  
Nerve Conduction Studies ◽  
Cold Intolerance ◽  
Temperature Thresholds ◽  
Tunnel Syndrome ◽  
Vibration Perception ◽  
Male Workers

Fractionated nerve conduction, vibrotactile sense, and temperature thresholds were studied in 73 symptomatic vibration-exposed male workers. Three symptomatic groups were distinguished: patients with isolated sensorineural symptoms; with isolated vasospastic problems; and with both. Clinical carpal tunnel syndrome occurred in 14 patients and abnormal cold intolerance (without blanching of the fingers) in 23. In the group as a whole, nerve conduction studies were abnormal in the median nerve but not in the ulnar nerve and vibration perception and temperature thresholds were impaired. Of the three symptomatic groups, patients with isolated sensorineural symptoms differed from controls. No differences were seen between patients with and without clinical carpal tunnel syndrome. With severe sensorineural symptoms the vibration perception thresholds, but not the values of the nerve conduction studies, were further impaired. The results indicated two injuries that are easily confused: one at receptor level in the fingertips and one in the carpal tunnel. Careful clinical assessment, neurophysiological testing, and examination of vibrotactile sense are required before carpal tunnel release should be considered in these patients.

LONGITUDINAL MEDIAN NERVE CONDUCTION STUDIES AFTER ENDOSCOPIC CARPAL TUNNEL RELEASE

Hand Surgery ◽  
1999 ◽  
Vol 04 (02) ◽  
pp. 145-149 ◽  
Author(s):  
Yukio Nakamura ◽  
Shigeharu Uchiyama ◽  
Hiroshi Toriumi ◽  
Hiroyuki Nakagawa ◽  
Tada-atsu Miyasaka
Keyword(s):  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Carpal Tunnel Release ◽  
Nerve Conduction Studies ◽  
Rapid Improvement ◽  
Endoscopic Carpal Tunnel Release ◽  
Idiopathic Carpal Tunnel Syndrome ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release

Forty hands of 36 patients who had undergone endoscopic carpal tunnel release (ECTR), utilising Chow's two-portal technique after being diagnosed with idiopathic carpal tunnel syndrome, were subjected to longitudinal median nerve conduction studies. The distal motor latency (DML) was examined pre-operatively on all the hands, which were re-examined at the post-operative 1st, 3rd, 6th and 12th months. Rapid improvement of DML was observed post-operatively in the first three months. These improvements patterns are not much different from those after open carpal tunnel release (OCTR) reported in the literatures. We consider that the data reported herein can be used as standards of DML course after ECTR.

Return to work following ultrasound guided thread carpal tunnel release versus open carpal tunnel release: a comparative study

2021 ◽  
pp. 175319342110512
Author(s):  
Derek B. Asserson ◽  
Taylor J. North ◽  
Peter C. Rhee ◽  
Allen T. Bishop ◽  
Jeffrey S. Brault ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Return To Work ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Work Status ◽  
Ultrasound Guided ◽  
Level Of Evidence ◽  
Hospital Employees ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release

A retrospective review of hospital employees at a single employer institution who underwent ultrasound guided thread carpal tunnel release (TCTR) or open carpal tunnel release (OCTR) between January 2018 and August 2020 was performed to ascertain differences in return-to-work status. Patient age, sex, occupation, handedness, severity of carpal tunnel syndrome, prior treatments and surgical outcomes were reviewed. A total of 18 patients underwent TCTR and 17 patients underwent OCTR. The TCTR group averaged 12 days to return to work without restrictions, as opposed to 33 days for the OCTR group. Resolution of symptoms was afforded in all patients without any complications regardless of surgical technique. While both TCTR and OCTR were effective, our data indicates that TCTR resulted in a shorter return to work. Level of evidence: III

Vibration White Finger

1988 ◽  
Vol 13 (2) ◽  
pp. 171-176
Author(s):  
J. C. BOYLE ◽  
N. J. SMITH ◽  
F. D. BURKE
Keyword(s):  
Carpal Tunnel Syndrome ◽  
No Value ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Provocation Test ◽  
Nerve Conduction Studies ◽  
Vibration White Finger ◽  
Cold Provocation Test ◽  
Tunnel Syndrome ◽  
Cold Provocation

Nineteen consecutive patients claiming compensation for vibration white finger were reviewed. The cold provocation test was found to be of no value in confirming a diagnosis of vibration white finger. Small cysts were apparent on the radiographs in 61% of patients’ wrists but none had developed significant degenerative changes of the wrist or digits. In this group of claimants, 63% had carpal tunnel syndrome on nerve conduction studies.

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