gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Preoperative Two Point Discrimination Predicts Response to Carpal Tunnel Release

Meeting Abstract

  • presenting/speaker Lauren Wessel - Hospital for Special Surgery, New York, United States
  • Charles Ekstein - Hospital for Special Surgery, New York, United States
  • Danielle Marshall - Hospital for Special Surgery, New York, United States
  • Duretti Fufa - Hospital for Special Surgery, New York, United States
  • Daniel Osei - Hospital for Special Surgery, New York, United States

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-802

doi: 10.3205/19ifssh0923, urn:nbn:de:0183-19ifssh09239

Veröffentlicht: 6. Februar 2020

© 2020 Wessel et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objectives/Interrogation: Two-point discrimination (2PD) correlates to digital innervation and is used as a measure of carpal tunnel severity. However, there is no study to date that has assessed whether preoperative 2PD scores predict symptom severity or response to surgery. The primary aim of this study was to determine the predictive value of preoperative 2PD scores on postoperative symptom severity following carpal tunnel release.

Methods: All patients who underwent carpal tunnel release by a single fellowship-trained surgeon between 2014 and 2018 were retrospectively reviewed. Diagnosis was based on CTS-6 criteria, and surgery was offered based on failure of conservative management. Evaluation of static 2PD was performed and absent preoperative 2PD was defined as a measurement >10 mm. Pre- and postoperative QuickDASH and Levine-Katz scores were recorded. Pearson correlation coefficients assessed the relationship between preoperative 2PD scores, postoperative 2PD scores, and patient-rated outcome scores.

Results and Conclusions: Eighty-four hands were analyzed in this study. Mean post-operative follow-up was 1.8 years. Mean pre- and postoperative 2PD was 7.6mm (n=67) and 6.5mm (n=52), respectively. A higher initial 2PD was associated with an increased likelihood of improvement in 2PD postoperatively (r2 = 0.088, p=0.006) unless 2PD was absent (Figure 1 [Fig. 1]). Additionally, there was a positive correlation between pre- and postoperative 2PD (r2 = 0.61, p<0.05) (Figure 2 [Fig. 2]). Patients with absent preoperative 2PD were the least likely to demonstrate postoperative improvement in 2PD from baseline with only 40.0% (6/20) of patients demonstrating improvement in contrast to 68.8% (44/64) patients otherwise (p = 0.03).