Grip Strength and Carpal Tunnel: What Interest in Management

Abstract

Introduction: Carpal tunnel syndrome (CTS) is one of the most common musculoskeletal disorders of the upper extremity. Strong evidence supports operative treatment, in motor forms, regardless of technique, as superior to nonoperative treatment. Severity of motor forms of CTS depend of clinicals, and Electroneuromyography aspects. According to ENMG aspects, therapeutics decisions are difficults. Hook grip strength could early diagnosed decreasy strenght, and classified patients.

Objectives: Our study aim to determine strenght grip characteristics in differents class of severity in CTS.Patients and Methods: We conducted a multicenter study including patients with unilateral CTS, on two phases. Weren’t included, patients with bilateral CTS and pre-existing functional limitations of upper limb. We classed patients in 3 groups of severity according to motor ENMG results. Hook grip strength measured in all patients by a dynamometer with a maximum strenght of 90 kg on both sides and Functional capacity evaluated by Functional dimension of Boston Crapal Tunel Questionary (FBCTQ). We classes strength grip on three groups of severity according to differences of both sides.

Results: We collected 33 patients. Median age was 48,33 ± 11,67 years. Sex-ratio was 0,27. CTS was severe in 54. 5% of patients. Grip strenght decreased in 81.8% of patients. Minor reduced grip strenght interested 45.5% of patients. FBCTQ score is less than 2/5 in 64% of patients. Functional prognosis factor in CTS were FBCTQS (P= 0.035), trans-carpal Tunel Velocity (p=0,025).

Conclusion: Therapeutics decisions in CTS must include evaluation of Hook Grip strength and FBCTQS.