Evolution of clinical, electrophysiological, and radiological aspects of the carpal tunnel syndrome before and after surgery.

Abstract

The aim of the study was to analyze the evolution of the clinical, electrophysiological, and ultrasound aspects of carpal tunnel syndrome (CTS) before and 4 and 8weeks after surgery. A Boston Carpal Tunnel Questionnaire, an ultrasound scan, and an electrophysiological exam were performed in 14 patients the day of surgery, 4 and 8weeks after. The nerve conduction study included: median nerve sensory conduction stimulating digit 3 and 4, median motor conduction from the abductor pollicis brevis, ulnar nerve sensory, and motor conduction. A significant improvement of the symptoms and a significant decrease of the median nerve proximal cross-sectional area on the ultrasound scan were observed 4weeks after surgery. Distal motor latency (DML) was >4.2ms in six patients and decreased along the three visits. DML was ≤4.2ms in the eight others and stayed stable after surgery. We observed a significant increase of the sensory median nerve amplitude response at the wrist stimulating the third digit 8weeks after surgery. When operated patients are referred for control, we recommend to perform: (1) 4weeks after surgery, an ultrasonography, and a measure of the DML of the median nerve; (2) 8weeks after surgery, a measure of the sensory conduction velocity of the median nerve.