HAND

, Volume 8, Issue 1, pp 60–63 | Cite as

Carpal tunnel syndrome with thenar atrophy: evaluation of the pinch and grip strength in patients undergoing surgical treatment

  • Carlos H. Fernandes
  • Lia M. Meirelles
  • Jorge Raduan Neto
  • Luis R. Nakachima
  • João B. G. dos Santos
  • Flavio Faloppa
Surgery Articles

Abstract

This aim of this study was to evaluate the progression of grip, tip pinch, key (lateral) pinch, and tripod pinch strengths in patients suffering from carpal tunnel syndrome with thenar atrophy following surgery. Between October 2008 and May 2010, 46 patients (49 hands) with carpal tunnel syndrome associated with thenar atrophy underwent surgery. Thenar atrophy was assessed by clinical inspection. Evaluations for grip strength and for tip, key, and tripod pinch strengths were made using a hydraulic hand dynamometer grip and a hydraulic pinch gauge, respectively. These measurements were taken before surgery and at 3 and 6 months after the procedure. When we compared the averages of all forces measured in the affected hand before the surgery with all forces measured at 3 months postoperative, we found no significant differences. However, after 6 months, we found significant differences for all four strength tests as compared with those measurements taken preoperatively and at the 3 month time point. Our results suggest that patients with thenar atrophy show increased grip strength and pinch strength by the sixth month after surgical treatment.

Keywords

Carpal tunnel syndrome Thenar atrophy Hand strength Grip Pinch 

References

  1. 1.
    Brown RA, Gelberman RH, Seiler 3rd JG, et al. Carpal tunnel release. A prospective, randomized assessment of open and endoscopic methods. Carpal tunnel release: a prospective, randomized assessment of open and endoscopic methods. J Bone Joint Surg Am. 1993;75(9):1265–75.PubMedGoogle Scholar
  2. 2.
    Eversmann Jr WW. Compression and entrapment neuropathies of the upper extremity. J Hand Surg. 1983;8:759–66.Google Scholar
  3. 3.
    Eversmann Jr WW. Entraptament and compression neuropathies. In: Green DP, editor. Operative hand surgery. New York: Churchill Livingstone; 1988. p. 1336–66.Google Scholar
  4. 4.
    Fernandes CH, Meirelles LM, Carneiro RS, et al. Tratamento cirúrgico da síndrome do canal do carpo por incisão palmar e utilização do instrumento de Paine. Rev Bras Ortop. 1999;34:260–70.Google Scholar
  5. 5.
    Geere J, Chester R, Kale S, et al. Power grip, pinch grip, manual muscle testing or thenar atrophy—which should be assessed as a motor outcome after carpal tunnel decompression? A systematic review. BMC Musculoskelet Disord. 2007;8:114–23.PubMedCrossRefGoogle Scholar
  6. 6.
    Gelberman RH, Pfeffer GB, Galbraith RT, et al. Results of treatment of severe carpal-tunnel syndrome without internal neurolysis of the median nerve. J Bone Joint Surg Am. 1987;69(6):896–903.PubMedGoogle Scholar
  7. 7.
    Gellman H, Kan D, Gee V, et al. Analysis of pinch and grip strength after carpal tunnel release. J Hand Surg Am. 1989;14(5):863–4.PubMedCrossRefGoogle Scholar
  8. 8.
    Gomes I, Becker J, Ehlers JA, et al. Prediction of the neurophysiological diagnosis of carpal tunnel syndrome from the demographic and clinical data. Clin Neurophysiol. 2006;117(5):964–71.PubMedCrossRefGoogle Scholar
  9. 9.
    Graham B, Regehr G, Naglie G, et al. Development and validation of diagnostic criteria for carpal tunnel syndrome. J Hand Surg Am. 2006;31(6):919–24.PubMedGoogle Scholar
  10. 10.
    Keith MW, Masear V, Chung KC, et al. American Academy of Orthopaedic Surgeons clinical practice guideline on diagnosis of carpal tunnel syndrome. J Bone Joint Surg Am. 2009;91(10):2478–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Leit ME, Weiser RW, Tomaino MM. Patient reported outcome after carpal tunnel release for advanced disease: a prospective and longitudinal assessment in patients older than age 70. J Hand Surg Am. 2004;29(3):379–83.PubMedCrossRefGoogle Scholar
  12. 12.
    Mathiowetz V, Kashman N, Volland G, et al. Grip and pinch strength: normative data for adults. Arch Phys Med Rehabil. 1985;66(2):69–74.PubMedGoogle Scholar
  13. 13.
    Meirelles LM, Santos JBG, Santos LL, et al. Evaluation of the Boston questionnaire applied at late post-operative period of carpal tunnel syndrome operated with the Paine retinaculotome through palmar port. Acta Ortop Bras. 2006;14:126–32.CrossRefGoogle Scholar
  14. 14.
    Nagaoka M, Nagao S, Matsuzaki H. Endoscopic release for carpal tunnel syndrome accompanied by thenar muscle atrophy. Arthroscopy. 2004;20(8):848–50.PubMedGoogle Scholar
  15. 15.
    Paula SEC, Meirelles LM, Santos JBG, et al. Long-term clinical evaluation—by Phalen, Tinel sign and night paresthesia—of patients submitted to carpal tunnel release surgery with Paine retinaculotome. Acta Ortop Bras. 2006;14:213–6.Google Scholar
  16. 16.
    Phalen GS. Reflections on 21 years’ experience with the carpal-tunnel syndrome. JAMA. 1970;212:1365–7.PubMedCrossRefGoogle Scholar
  17. 17.
    Santos LL, Meirelles LM, Santos JBG, et al. Carpal tunnel syndrome: reassessment of long-term outcomes with the use of Paine retinaculotome during surgery through a palmar incision. Acta Ortop Bras. 2005;13:225–8.CrossRefGoogle Scholar

Copyright information

© American Association for Hand Surgery 2012

Authors and Affiliations

  • Carlos H. Fernandes
    • 1
  • Lia M. Meirelles
    • 1
  • Jorge Raduan Neto
    • 1
  • Luis R. Nakachima
    • 1
  • João B. G. dos Santos
    • 1
  • Flavio Faloppa
    • 1
  1. 1.Hand Surgery Group, Department of Orthopedic SurgeryUniversidade Federal de São PauloSão PauloBrazil

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