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Postoperative diagnostic potentials of median nerve strain and applied pressure measurement after carpal tunnel release.
BMC Musculoskeletal Disorders ( IF 2.3 ) Pub Date : 2020-01-11 , DOI: 10.1186/s12891-019-3033-y
Yuichi Yoshii 1 , Wen-Lin Tung 2 , Hiroshi Yuine 3 , Tomoo Ishii 1
Affiliation  

BAKGROUND The objective of this study is to investigate the prognostic values of median nerve strain and applied pressure measurement for the assessment of clinical recovery after carpal tunnel release. METHODS Forty-five wrists, from 45 idiopathic carpal tunnel syndrome patients who treated with open carpal tunnel release, were evaluated by ultrasound. Median nerve strain, pressure applied to the skin, and ratio of pressure-strain were measured at the proximal part of the carpal tunnel. In addition, distal latencies in the motor and sensory nerve conductions studies and cross-sectional area of median nerve were measured. The parameters were compared before and after the open carpal tunnel release. According to patient recovery, the receiver operating characteristic curves were generated to evaluate the prognostic values of the parameters. The areas under the receiver operating characteristic curves were compared among parameters. RESULTS There was a significant increase in the median nerve strain, and significant decreases in the pressure applied to the skin and ratio of pressure-strain after carpal tunnel release (P < 0.01). There were significant decreases in the distal latencies and the cross-sectional area after carpal tunnel release (P < 0.01). The areas under the curves were 0.689, 0.773, 0.811, 0.668, 0.637, and 0.562 for the pressure, strain, pressure-strain ratio, motor latency, sensory latency, and area, respectively. CONCLUSIONS The results suggest that elasticity of the median nerve and pressure around the nerve recover quickly after carpal tunnel release. Pressure-strain ratio was the most reliable parameter to reflect clinical recovery. The measurement of strain and applied pressure can be useful indicators to evaluate effectiveness of the carpal tunnel release. TRIAL REGISTRATION Registered as NCT04027998 at ClinicalTrials.gov. Retrospectively registered on July 22, 2019.

中文翻译:

腕管松解后正中神经拉伤的术后诊断电位和应用压力测量。

BAKGROUND 本研究的目的是研究正中神经拉伤和应用压力测量的预后价值,以评估腕管松解后的临床恢复情况。方法 45 名特发性腕管综合征患者接受开放式腕管松解术治疗的 45 只手腕通过超声评估。在腕管近端测量正中神经应变、施加于皮肤的压力和压力应变比。此外,测量了运动和感觉神经传导研究中的远端潜伏期和正中神经的横截面积。比较开放腕管释放前后的参数。根据患者恢复情况,生成受试者工作特征曲线以评估参数的预后值。比较各参数的受试者工作特征曲线下面积。结果腕管松解后正中神经拉力明显增加,皮肤压力和压力-拉力比明显降低(P < 0.01)。腕管松解后远端潜伏期和截面积显着降低(P < 0.01)。压力、应变、压力-应变比、运动潜伏期、感觉潜伏期和面积的曲线下面积分别为 0.689、0.773、0.811、0.668、0.637 和 0.562。结论 结果表明,腕管松解后正中神经的弹性和神经周围的压力迅速恢复。压力-应变比是反映临床恢复的最可靠参数。应变和施加压力的测量可以作为评估腕管松解效果的有用指标。试验注册 在 ClinicalTrials.gov 注册为 NCT04027998。于 2019 年 7 月 22 日追溯登记。
更新日期:2020-01-13
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