Carpal tunnel syndromeMuscle Atrophy at Diagnosis of Carpal and Cubital Tunnel Syndrome
Section snippets
Materials and Methods
A list of patients presenting to the office of a single hand surgeon from January 2000 through June 2005 was generated from billing records. Inclusion criteria included (1) patients with an initial diagnosis of carpal tunnel or cubital tunnel syndrome; (2) the compressive neuropathy was idiopathic; (3) this was the only diagnosis made—it was an isolated problem (eg, no cervical radiculopathy, elbow arthrosis, etc.).
Fifty-eight patients with cubital tunnel syndrome and 370 patients with carpal
Results
In univariate analysis, age, diabetes, and diagnosis (carpal tunnel vs cubital tunnel syndrome) were significantly associated with atrophy and gender showed a non-significant trend for association with atrophy (Table 2). Twenty-three of 58 (40%) patients with cubital tunnel syndrome and 62 of 370 (17%) patients with carpal tunnel syndrome presented with muscle atrophy (p < .0001).
Multivariate logistic regression revealed that older age (odds ratio, 1.06; 95% CI, 1.04–1.08) and diagnosis
Discussion
This study is limited by the fact that it represents a single surgeon’s practice and practice style, and electrophysiologic testing was not used routinely to confirm the diagnosis. Use of the neurophysiologist’s overall rating, although practical in a retrospective study, is also somewhat subjective. It is possible that the patients presenting to this surgeon and the diagnostic criteria used by this surgeon and neurophysiologist cannot be generalized to the average practice. An additional
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Supported by unrestricted research grants from AO Foundation, Wright Medical, Joint Active Systems, Smith and Nephew Richards, and Small Bone Innovations.