Nerve conduction studies in hand surgery

Abstract

The treatment of nerve disorders of the upper extremity has become a highly specialized area. There has been an evolution in the electrodiagnostic approach for evaluating patients with these disorders. Portable automated nerve conduction testing systems are becoming popular for limited nerve conduction testing in the office. Differential latency testing can aid in the diagnosis of dynamic nerve entrapment disorders such as radial tunnel syndrome. Comparative latency testing increases the test sensitivity in the diagnosis of carpal tunnel syndrome, cubital tunnel syndrome, and ulnar tunnel syndrome. Digital nerve conduction testing can detect isolated digital nerve lesions and can be used to monitor the adequacy of reinnervation after a nerve repair. Because of the inherent pitfalls of testing, it is not safe to rely on machine-generated reports. Hand surgeons who perform or supervise nerve conduction studies must be aware of the methodology and the limitations of the electrodiagnostic test.