The agreement of clinical evaluation and electrodiagnostic studies in a modified surgical technique in carpal tunnel syndrome management. | ||||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||||
| Articles in Press, Accepted Manuscript, Available Online from 18 December 2022 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejprs.2022.178090.1228 | ||||
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| Authors | ||||
Khaled M. Elsherbeny1; Adel Hussein Amr2; Eman Mohamed   3
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| 1Department of plastic, Burn and maxillofacial surgery, faculty of Medicine, Ain-Shams university, Cairo, Egypt. | ||||
| 2Department of plastic, Burn and Maxillofacial surgery, faculty of medicine, Ain-Shams university, Cairo, Egypt | ||||
| 3Department of Plastic, Burn and Maxillofacial Surgery, Faculty of Medicine, Ain- Shams University,Cairo, Egypt. | ||||
| Abstract | ||||
| Background: Electrodiagnostic studies had become a routine workup in the evaluation of carpal tunnel syndrome (CTS). The presence of a relatively considerable group of patients with positive clinical findings and negative electrodiagnostic studies constitutes a problem that faces plastic surgeons. In these group of patients, the question remains whether to do to surgery or not?. Release of median nerve is the primary objective of surgical treatment. open approach is still one of the most preferred methods of release. This includes transverse carpal ligament release as well as antebrachial fascia. This observational prospective study includes a group of patients that undergone surgery for treatment of CTS with improved technique of release resulting in symptoms relief after 1 year following surgery. The results were analyzed to correlate the agreement of electrodiagnostic studies and clinical findings in CTS as well as the benefit of the improved technique in management of carpal tunnel syndrome. Aim of work: A- refining a surgical method for carpal tunnel treatment and testing its effect on surgical outcome B-checking the agreement between electrodiagnostic studies and clinical evaluation in diagnosis of CTS. Patients and methods: 26 adult patients (22females,4males) were included in this prospective study from July 2016 to July 2020. All patients had awakening night pain with numbness in fingers suggestive of CTS. Durkan carpal compression test and electrodiagnostic studies were done. All patients underwent surgery in the form of transverse carpal ligament and antebrachial fascia release where the distance of release was measured. Results: All patients didn’t experience awakening night pain or numbness in fingers after one year postoperatively which constitutes 100% cure rate. The mean distance of antebrachial fascia release was (1.92±0.27) cm. There were no tender scars, hyperesthesia at wrist region or limitation of movements in fingers. Durkan compression test sensitivity is 80.8%, the electrodiagnostic studies sensitivity is 38.5%, the agreement between the Durkan compression test and electrodiagnostic studies as regard diagnosis was 42%. Conclusion: Antebrachial fascia release for (1.92±.27) cm resulted in complete symptom relief with no complications. The electrodiagnostic studies alone showed least sensitivity in diagnosis of CTS and poor agreement with clinical evaluation. | ||||
| Keywords | ||||
| carpal tunnel syndrome; Durkan compression test; Antebrachial fascia; Electrodiagnostic studies | ||||
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