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

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How does thenar atrophy influence the outcome of carpal tunnel release?

Meeting Abstract

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  • presenting/speaker Adrienn Lakatos - Hand Surgery Center, Miskolc, Hungary
  • Balazs Lenkei - Hand Surgery Center, Miskolc, Hungary
  • Zsolt Szabo - Hand Surgery Center, Miskolc, Hungary

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. DocIFSSH19-1092

doi: 10.3205/19ifssh0721, urn:nbn:de:0183-19ifssh07213

Published: February 6, 2020

© 2020 Lakatos et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Visible thenar atrophy is described as the more severe stage of carpal tunnel syndrome. Our hypothesis was that patients operated presenting thenar atrophy have worse outcome.

Methods: Our self-made prospective database was used to evaluate the preoperative and postoperative data. The question form was filled preoperatively then postoperatively at 1 week, at 6 weeks and at 3 months. The patients were distributed into two groups: with and without thenar atrophy. Subjective data as daytime numbness, nighttime numbness, nighttime pain, disturbance in everyday work and satisfaction were recorded and evaluated on Visual Analogue Scale 1-10 (VAS). Grip and pinch strengths were measured using hand dynamometer grip gauge and pinch gauge. Significance was evaluated using Z-test (p=0,05).

Results and Conclusions: 467 patients with carpal tunnel syndrome were operated in our center from 01.01.2014. to 31.08.2018. 10 patients had to be excluded due to lack of data. 182 had visible thenar atrophy prior the operation while 275 patients had no thenar atrophy. In both groups the average age was 61 and 65 years respectively. 75% of the patients were women.

We found no significant difference between the average values of the two groups neither preoperatively, nor postoperatively. 12 weeks after the operation the daytime numbness decreased by 3,41 VAS points in the group with thenar atrophy and by 3,63 VAS points in the group without thenar atrophy. The level of nighttime numbness dropped by 5,98 points if there was thenar atrophy and by 6,18 points if there was not. By this time both groups reached the preoperative strength values and the group with atrophy even increased the grip strength by 0,4 kg and the pinch strength by 0,8 kg. Throughout the postoperative period the level of satisfaction was high in both groups (8,8 VAS points).

Based on our results we can conclude that our hypothesis was wrong thus thenar atrophy does not influence the outcome of carpal tunnel release.