Efficiency of ultrasound parameters in diagnosis posttraumatic carpal tunnel syndrome (TCTS)

Abstract

The aim of our study was retro and prospective analysis of ultrasonographic parameters in the diagnosis of carpal tunnel syndrome. Preoperative median nerve was examined by ultrasonography being taken the following parameters - the length in the transverse plane (T) and thickness in the sagittal plane at the level of proximal entrances (D) of the median nerve in the carpal tunnel, the smallest thickness in the sagittal plane at channel or at the distal outlet (d). Were used the following indices: cross-sectional area of the median nerve (AT norm to 7 mm2 ), AT = 3.14xTxD/4, the ratio of R = T/D (norm up to 3.3), and IGP degree of compression index = 100 (1-d/D) (rule around 10%). In the Hand Surgery Department of IMSP CHTO in period 2011-2015 we present data of 202 patients with carpal tunnel syndrome. Report male - female is 2.74: 1. Mean age 55.6 ± 11.9. In 91 (45.05%) was determined PCTs. At 111 (54.95%) patients with CTS in association with traumatic factor the mean (md) mdAT = 15,06mm2 , mdTD = 2.12; mdIGP 52.00%. In TCTS mdAT = 13,81mm2 ; mdTD = 2.06; mdIGP = 52.43%. Following surgery, with amelioration of disease at 6 weeks in the group with CTS were examined by ultrasound to determine mdAT = 14,43mm2, mdTD = 2.12; mdIGP = 21.78%; the SCCT lot mdAT = 16,96mm2; mdTD = 2.17; mdIGP = 22.82%. At 3 months at 50 patients, of which 23 with CTS was determined mdAT = 13,52mm2, mdTD = 2.01; mdIGP = 13.13%; in group TCTS with 27 patients – mdAT = 14,96mm2; mdTD, 2.10; mdIGP, 10.82%. Conclusion · Problem diagnosis and treatment of these patients until now remains current, despite of successes in the treatment of orthopedic and experience in the treatment of CTS · In our study, the absolute majority of patients by ultrasound investigation has been determined that IGP is more demonstrative than AT and TD. · Because the compression is the primary factor in the pathogenesis of CTS, the appreciation of PGI allows the determination of treatment strategy.