Can decrease in hand grip strength in carpal tunnel syndrome be explained by interosseous muscle and intermetacarpal space dimensions?
Abstract
Objectives. To investigate the correlation of the grip strength
with sonographic measurement of interosseous muscle (IOM) and intermetacarpal
space (IMS) of the hands in carpal tunnel syndrome (CTS) patients. Methods.
A total of 96 hands of 48 female patients constituted the study group. Of
those, 36 hands of 18 patients (mean age: 50.2 ± 9 years) had CTS confirmed by
electro-diagnostic tests. Sixty hands of 30 healthy volunteers (mean age: 45.2
± 9.7 years) constituted the control group. Grip strength was assessed by Jamar
hand dynamometer. IOM and IMS dimensions for all hands were measured
sonographically at three levels (2nd, 3rd and 4th
intermetacarpal; palmar side for IMS, dorsal side for IOM) by the same
radiologist. Spearman and Mann Whitney U tests were used for statistical
analysis. Results. The median hand grip strength was
determined as 11.3 kg (min-max = 7.2-18.1 kg) in the CTS group and 19.5 kg
(min-max = 7.8-30.5 kg) in the control group, with a statistical difference
between the two groups (p < 0.03).
In both groups, there was a positive correlation between the IOM-IMS dimensions
and grip strength (p < 0.05).
Sonographically, IOM-IMS measurements in CTS group were significantly lower
than control group (p < 0.01). Conclusion. To our knowledge, this is the first study evaluating the
correlation of grip strength and the sonographic IOM-IMS measurements in CTS
patients. The muscular atrophy, which
is generally a finding of advanced disease, may be revealed by sonographical
measurements earlier than the physical examination findings.
Keywords
hand grip strength carpal tunnel syndrome interosseous muscle intermetacarpal space dimensions ultrasound
References
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- [11] Presazzi A, Bortolotto C, Zacchino M, Madonia L, Draghi F. Carpal tunnel: Normal anatomy, anatomical variants and ultrasound technique. J Ultrasound 2011;14:40-6.
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- [13] Vlad V, Micu M, Porta F, Radunovic G, Nestorova R, Petranova T, et al. Ultrasound of the hand and wrist in rheumatology. Med Ultrason 2012;14:42-8.
- [14] Chammas M, Boretto J, Burmann LM, Ramos RM, Dos Santos Neto FC, Silva JB. Carpal tunnel syndrome - Part I (anatomy, physiology, etiology and diagnosis). Rev Bras Ortop 2014;49:429-36.
- [15] Simon NG, Ralph JW, Lomen-Hoerth C, Poncelet AN, Vucic S, Kiernan MC, et al. Quantitative ultrasound of denervated hand muscles. Muscle Nerve 2015;52:221-30.
Abstract
References
- [1] Gerritsen AA, de Krom MC, Struijs MA, Scholten RJ, de Vet HC, Bouter LM. Conservative treatment options for carpal tunnel syndrome: a systematic review of randomised controlled trials. J Neurol 2002;249:272-80.
- [2] Palti R, Vigler M. Anatomy and function of lumbrical muscles. Hand Clin 2012;28:13-7.
- [3] Eladoumikdachi F, Valkov PL, Thomas J, Netscher DT. Anatomy of the intrinsic hand muscles revisited: part II. Lumbricals. Plast Reconstr Surg 2002;110:1225-31.
- [4] Ramadan SU, Yiğit H, Gökharman D, Tunçbilek I, Dolgun NA, Kosar P, et al. Can renal dimensions and the main renal artery diameter indicate the presence of an accessory renal artery? A 64-slice CT study. Diagn Interv Radiol 2011;17:266-71.
- [5] Chammas M. Carpal tunnel syndrome. Chir Main 2014;33:75-94.
- [6] Young VL, Logan SE, Fernando B, Grasse P, Seaton M, Young AE. Grip strength before and after carpal tunnel decompression. South Med J 1992;85:897-900.
- [7] Chammas M, Boretto J, Burmann LM, Ramos RM, Neto FS, Silva JB. Carpal tunnel syndrome - Part II (treatment). Rev Bras Ortop 2014;49:437-45.
- [8] Miller TT, Reinus WR. Nerve entrapment syndromes of the elbow, forearm, and wrist. AJR Am J Roentgenol 2010;195:585-94.
- [9] Wong SM, Griffith JF, Hui AC, Lo SK, Fu M, Wong KS. Carpal tunnel syndrome: diagnostic usefulness of sonography. Radiology 2004;232:93-9.
- [10] Arts IM, Pillen S, Schelhaas HJ, Overeem S, Zwarts MJ. Normal values for quantitative muscle ultrasonography in adults. Muscle Nerve 2010;41:32-41.
- [11] Presazzi A, Bortolotto C, Zacchino M, Madonia L, Draghi F. Carpal tunnel: Normal anatomy, anatomical variants and ultrasound technique. J Ultrasound 2011;14:40-6.
- [12] Dong Q, Jacobson JA, Jamadar DA, Gandikota G, Brandon C, Morag Y, et al. Entrapment neuropathies in the upper and lower limbs: anatomy and MRI features. Radiol Res Pract 2012;2012:230679.
- [13] Vlad V, Micu M, Porta F, Radunovic G, Nestorova R, Petranova T, et al. Ultrasound of the hand and wrist in rheumatology. Med Ultrason 2012;14:42-8.
- [14] Chammas M, Boretto J, Burmann LM, Ramos RM, Dos Santos Neto FC, Silva JB. Carpal tunnel syndrome - Part I (anatomy, physiology, etiology and diagnosis). Rev Bras Ortop 2014;49:429-36.
- [15] Simon NG, Ralph JW, Lomen-Hoerth C, Poncelet AN, Vucic S, Kiernan MC, et al. Quantitative ultrasound of denervated hand muscles. Muscle Nerve 2015;52:221-30.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Articles |
| Authors | |
| Publication Date | July 4, 2018 |
| Submission Date | October 7, 2017 |
| Acceptance Date | November 28, 2017 |
| Published in Issue | Year 2018 Volume: 4 Issue: 3 |
