Persistence of abnormal electrophysiological findings after carpal tunnel release

Antonio Merolli, Marco Luigetti, Anna Modoni, Marcella Masciullo, Maria Lucia Mereu, Mauro Lo Monaco

Research output: Contribution to journalArticle

Abstract

Practitioners may refer to experienced hand surgeons to differentiate a recurrence in carpal tunnel syndrome (CTS) from a failed carpal tunnel release. The patient may complain about the reappearance of symptoms, whatever is the cause. Nerve conduction studies (NCS) are often required by the practitioner to assist the final diagnosis. We observed abnormal values in NCS in patients who were clinically healed from CTS. We evaluated the changes preoperatively and, then, at 1, 3, 6, 9, and 12 month postoperatively. At the same time, we performed a retrospective study on a group of 37 clinically healed patients. Follow-up ranged from 2 to 20 years. Surgical treatment let the electrophysiological parameters to improve toward physiological values; however, normality is hardly ever reached. This sort of "electrophysiological scar" is true for all the parameters measured. In presence of CTS, the latency difference between the radial and median sensory nerve action potentials, recorded following thumb stimulation, produces a double peak shift. The "double peak shift" best described this "electrophysiological scar," being a parameter that should measure about zero in the normal population. In conclusion, abnormal postoperative electrophysiological findings cannot substantiate the diagnosis of a poor outcome of a carpal tunnel release nor a recurrence of CTS.

Original languageEnglish
Pages (from-to)511-516
Number of pages6
JournalJournal of Reconstructive Microsurgery
Volume29
Issue number8
DOIs
Publication statusPublished - 2013

Keywords

  • carpal tunnel syndrome
  • nerve conduction studies
  • prospective study
  • retrospective study

ASJC Scopus subject areas

  • Surgery

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    Merolli, A., Luigetti, M., Modoni, A., Masciullo, M., Lucia Mereu, M., & Lo Monaco, M. (2013). Persistence of abnormal electrophysiological findings after carpal tunnel release. Journal of Reconstructive Microsurgery, 29(8), 511-516. https://doi.org/10.1055/s-0033-1348038