EVALUATION OF THE EFFECTIVENESS OF PROVACATIVE TESTS AND BOSTON SCALE IN PATIENTS DIAGNOSED WITH CARPAL TUNNEL SYNDROME
Journal Title: Kocatepe Medical Journal - Year 2022, Vol 23, Issue 2
Abstract
ABSTRACT OBJECTIVE: The most common peripheral nerve entrapment in the upper extremity is the median nerve entrapment in the wrist area and is called carpal tunnel syndrome (CTS). The diagnosis is made by anamnesis, physical examination, Boston scale (functional and sensory scoring) and EMG. In the decision of surgical treatment, the scoring system is important in comparison clinical and / or symptoms before and after surgery. In our study, the effectiveness of preoperative provocative tests (Falen and Tinel's test) and Boston scale and postoperative Boston scale in patients diagnosed with isolated CTS were discussed. MATERIAL AND METHODS: 41 patients without TOS (thoracic outlet syndrome), trauma and cervical disc hernia were included in the total of 152 patients who were diagnosed with CTS between 01.01.2016/ 01.05.2020 in İnönü University Neurosurgery Clinic. Mini open surgery was performed. Patients were evaluated in terms of age, gender, side sign, EMG, provocative tests, Boston scale and comorbidities. Statistically, Shapiro-Wilk test, Mann-Whitney U test, independent samples t test, chi-square test, Kruskal Wallis test, One Way Variance analysis were used. (P <0.05) value was considered statistically significant. IBM SPSS Statistics 25.0 program was used for the analysis. RESULTS: Of the 41 patients included in the study, 6 (14.6%) were men and 35 (85.4%) were women. EMG revealed moderate severity 23 patients (56.1%), severe CTS 15 patients (36.6%) and very severe 3 patients (7.3%). Preoperative and postoperative mean Symptom Severity Scale and Functional Capacity of the patients were 34 ± 3, 12 ± 2 and 28 ± 5, 11 ± 3 respectively. Tinel test was positive in 25 (61%) patients, Falen Test was positive in 22 (53.7%) patients. A statistically significant correlation was found between the preoperative provocative tests, the Boston scale, and the postoperative Boston scale (p <0.05). CONCLUSIONS: Delay on the diagnosis and/or treatment of CTS causes muscle atrophy and loss of function. In this disease group, we think that provocative tests and a good definition of the Boston scale will prevent delay in surgical decision making and that postoperative Boston scale will be useful in follow-up.
Authors and Affiliations
Ramazan PAŞAHAN, Bora TETİK
Keywords
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- EP ID EP702617
- DOI https://doi.org/10.18229/kocatepetip.789246
- Views 89
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