A CORRELATIVE STUDY OF ANTHROPOMETRIC AND ELECTROPHYSIOLOGICAL DATA OF PATIENTS WITH CARPAL TUNNEL SYNDROME ATTENDING THE DEPARTMENT OF PHYSICAL MEDICINE AND REHABILITATION OF A TERTIARY CARE HOSPITAL
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 75
Abstract
BACKGROUND Carpal Tunnel syndrome is the most common entrapment neuropathy of upper limb. The established diagnostic tool for CTS is an electrodiagnostic study, which requires sophisticated machine and trained personnel to perform the study. Hence, in this study, we have made an attempt to test the significance of a simple screening tool based on wrist ratio (Johnson’s index) ≥0.7 and CTS. Wrist ratio is determined by dividing Thickness (T) of wrist at the level of distal crease by wrist width (W) at the same level and this ratio is correlated with median nerve sensory latencies among the patients presented with clinical features suggestive of CTS. Hence, T/W ratio can be used as a screening tool during pre-placement examinations of jobs that are prone to cause CTS. MATERIALS AND METHODS The institutional ethical committee has granted permission for the study and subsequently 50 cases of CTS based on clinical grounds are selected from outpatient unit of the Department of Physical Medicine and Rehabilitation of a tertiary care hospital from April 2016 to September 2016. Patients with features of Peripheral neuropathy, Cervical radiculopathy and toxic neuropathy are excluded. Among the selected patients, after getting an informed consent, T/W ratio of dominant hands is determined by using a standard Vernier-Calliper and later they are subjected to standard Electrodiagnostic procedures. Reference values for each parameter was taken from the standard text books. All the data were entered in Microsoft excel sheet, rechecked and analysed with SPSS16 version statistical software. For categorical variables, Chi square test and for continuous variables, descriptive analysis was used in statistical analysis. RESULTS In this study, out of 50 cases, 44 were female (88%) and 6 were male (12%) with F:M ratio 7.3:1 Age group ranged from 21 - 62 years with a mean age of 40.5. T/W ratio ≥0.7 in 46 (92%) and <0.7 in 4 (8%) noted. In the T/W ratio ≥0.7 category, Median nerve DL was >3.3 (Group a) in 44 (95.7%) and <3.3 (Group b) in 2 (4.3%) cases. In T/W ratio <0.7 category, Median nerve DL was >3.3(Group c) in 2 (50%) and <3.3 (Group d) in 2 (50%) cases. Comparison of variables under each group was done by Chi-square test. Positive correlation was found between Median sensory latencies and T/W ratio ≥0.7 (p<0.05). Hence, it is proved that T/W ratio ≥0.7 has got positive correlation with Median nerve sensory DL >3.3. CONCLUSION T/W ratio ≥0.7 has got significant correlation with Median nerve DL>3.3. Hence, it can be used as a simple screening tool in the evaluation of patients with suspected CTS.
Authors and Affiliations
Santhosh Kothirappallil Raghavan, Roy Rama Chandran, Charvakan Suthan, Mitu Chirakkalthazhath Shankar, Dhanya Raj
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