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. 2022 Jun 27;12(7):1045.
doi: 10.3390/jpm12071045.

The Correlation of Carpal Tunnel Pressure with Clinical Outcomes following Ultrasonographically-Guided Percutaneous Carpal Tunnel Release

Jui-Chien Wang  1 , Chung-Yi Li  2   3   4 , Po-Yen Ko  5   6 , Tung-Tai Wu  6   7 , Kuo-Chen Wu  8 , Fong-Chin Su  6   9 , I-Ming Jou  7   9   10   11 , Po-Ting Wu  5   6   9   12   13
Affiliations

The Correlation of Carpal Tunnel Pressure with Clinical Outcomes following Ultrasonographically-Guided Percutaneous Carpal Tunnel Release

Jui-Chien Wang et al. J Pers Med. .

Abstract

Background: To evaluate the correlation between carpal tunnel pressure (CTP) and the clinical presentations, and to explore the possible predictors for the postoperative recovery pattern in patients with carpal tunnel syndrome (CTS). Materials and Methods: Consecutive patients with idiopathic CTS following percutaneous ultrasound-guided carpal tunnel release (UCTR) were enrolled. CTP was measured preoperatively and immediately after operation. The Boston Carpal Tunnel Questionnaire (BCTQ) and the cross-sectional area (CSA) of median nerve were recorded preoperatively and at 1, 3, and 12 months postoperatively. Results: 37 patients (37 hands; 8 men and 29 females; median age, 59.0 years) were enrolled. CTP significantly decreased immediately from 40.0 (28.0−58.0) to 13.0 (8.0−20.0) mmHg after UCTR. BCTQ scores significantly improved at 1 month postoperatively, and the improvement trend persisted until 12 months postoperatively (p < 0.001). Preoperative CTP was positively correlated with preoperative CSA and preoperative BCTQ scores (p < 0.05, all). Using group-based trajectory modeling, all patients were categorized into the “gradual recovery” or “fast recovery” group. Higher preoperative CTP was significantly associated with a faster recovery pattern (odds ratio: 1.32). Conclusions: Preoperative CTP was well correlated with the clinical presentations and might be a useful predictor for the postoperative clinical recovery pattern.

Keywords: carpal tunnel pressure; carpal tunnel syndrome; surgery; treatment outcome; ultrasound.

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Conflict of interest statement

The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
The step-by-step procedure of the carpal tunnel pressure (CTP) measurement and carpal tunnel release (CTR) under ultrasonographical guidance. First, the median nerve, transverse carpal ligament, and hamate hook were quickly examined using ultrasound (US). The hamate hook was aimed at the center of the region of interest (ROI) in the sagittal view (a). The transducer was transversely moved towards the radial side until the full view of the median nerve (b), and then moved back a little toward the ulnar side to make ROI next to the median nerve. The needle of the CTP measurement gauge was percutaneously inserted into the carpal tunnel, and the tip of the needle was placed in the center of ROI in the sagittal view to align the hamate hook in the transverse direction (c). The transducer was turned transversely to make sure again that the tip of the CTP measurement gauge was next to the median nerve, within the carpal tunnel, and at the same level as the hamate hook (d). The percutaneous CTR was done under ultrasonographic guidance (e). After the surgical release, the CTP was measured again and recorded (f). H, hamate hook; asterisk, median nerve; arrowhead, the tip of the needle of the CTP measurement gauge.
Figure 2
Figure 2
The trajectories and 95% confidence intervals of the perioperative recovery pattern of the Boston Carpal Tunnel Questionnaire (BCTQ)-Total scores after percutaneous ultrasound-guided carpal tunnel release.
See this image and copyright information in PMC

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