Carpal Tunnel Syndrome Research Today is a free monthly online journal that collates and summarizes the latest research about Carpal Tunnel Syndrome, including details on symptoms, causes, trauma, diagnosis, physiotherapy. | |||||||||
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Muscle Atrophy at Diagnosis of Carpal and Cubital Tunnel Syndrome.Mallette P, Zhao M, Zurakowski D, Ring D Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA; Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA; Children’s Hospital Boston, Boston, MA. PURPOSE: This study was designed to test the hypothesis that patients with an initial diagnosis of cubital tunnel syndrome are more likely to present with muscle atrophy than patients with an initial diagnosis of carpal tunnel syndrome. METHODS: A list of patients presenting to the office of a single hand surgeon from January 2000 to June 2005 with an initial diagnosis of isolated, idiopathic carpal tunnel syndrome or cubital tunnel syndrome was generated from billing records. The medical records of 58 patients with cubital tunnel syndrome and 370 patients with carpal tunnel syndrome were reviewed for age, gender, diabetes, and presence of atrophy. RESULTS: Twenty-three of 58 patients with an initial diagnosis of cubital tunnel syndrome had atrophy compared with only 62 out 370 patients with an initial diagnosis of carpal tunnel syndrome. Multiple logistic regression revealed that age (odds ratio, 1.06; 95% CI, 1.04-1.08) and diagnosis (cubital tunnel patients were more likely than carpal tunnel patients to present with atrophy; odds ratio, 4.5; 95% CI, 2.7-8.6) were factors significantly associated with atrophy at presentation. CONCLUSIONS: Patients with carpal tunnel syndrome present earlier in the course of their disease than patients with cubital tunnel syndrome. Patients with cubital tunnel syndrome are more likely to present with muscle atrophy, reflecting advanced nerve damage that may not respond to surgery. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic IV. Published 3 July 2007 in J Hand Surg [Am], 32(6): 855-858.
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