| 제목 |
Correlation between the severity of carpal tunnel syndrome and the ulnar variances |
| 소속 |
Korea University Guro Hospital, Department of Rehabilitation Medicine1 |
| 저자 |
Byung Jun Kim1*, So Youn Chang1, Dae Wook Lee1, Joon Shik Yoon1† |
| 사사 |
This research was supported by Basic Science Research Program through the National Research Foundation of Korea(NRF) funded by the Ministry of Science, ICT & Future Planning (NRF-2020R1A2C1009024) |
Objective
We noted that certain patients diagnosed with CTS, according to clinical criteria and electrophysiological evaluations, had positive ulnar variance that had persisted for several years. Prior study found a positive relationship between decreased cross-sectional area around the distal radioulnar joint and positive ulnar variance on radiologic investigation. We evaluated whether ulnar variance is related with the severity of carpal tunnel syndrome evaluated by electrophysiological evaluation
Method
A retrospective study was performed who were diagnosed by as carpal tunnel syndrome from January 2019 to July 2021 at our hospital. Diagnosis was made by clinical criteria and electrophysiological evaluation. Patients who had EMG and wrist or hand x-ray to appropriately evaluate ulnar variance. Total 84 carpal tunnel syndrome patients data were collected. Each patient's hand was evaluated individually, that total 139 hands with carpal tunnel syndrome were evaluated. 72 hands with positive ulnar variance were enrolled in group 1. 65 hands with neutral ulnar variance and 2 hands with negative ulnar variance were enrolled in group 2. EMG results ranged from mild to severe. Severity was rated to score for statistical analysis as follow: mild=1, moderate=2, severe=3.
The Mann-Whitney U-test was used to compare the EMG severity of each group The relationships between the ulnar variance and the median distal motor latency (DML) were examined using independent sample t-test.
Results
Severity of EMG on group 1 (positive ulnar variance) was 1.94 (moderate to severe) on average, whereas 1.49 (moderate to severe) on group 2 (neutral and negative ulnar variance). The hands with ulnar positive variance were more severe with significance statistically (p<0.05).
Correlation between the ulnar variance and the median distal motor latency (DML) using the data of 136 hands (The hands which showed no response with wrist stimulation of median nerve were excluded (1 hand on group 1, 2 hands on group 2)) also showed significance statistically (p<0.05). Hands with positive ulnar variance had more tendency of prolonged median distal motor latency (DML).
Conclusions
We found a relationship between severity of carpal tunnel syndrome evaluated by electrophysiological evaluation and positive ulnar variance using radiologic investigation shows a meaningful correlation. |
|
Table 1. Comparison of severity of CTS among two groups
Table 2. Comparison of median nerve distal motor latency (DML) among two groups
Figure 1. Comparison of severity of CTS among two groups
|
