Abstract
Background
Carpal tunnel syndrome (CTS) is a prevalent condition characterized by median nerve compression, impacting a significant portion of the population worldwide. While neurophysiological testing has been traditionally employed for diagnosis, recent advancements in ultrasonography have shown promise in offering a non-invasive alternative. In this study, we aimed to (1) evaluate the postoperative statistical changes of the median nerve and flexor retinaculum, (2) share our ultrasonographic measurement methodologies for standardized reporting, and (3) suggest a set of ultrasonographic parameters for postoperative tracking.
Methods
A prospective cohort of 18 patients with 24 CTS-affected hands underwent comprehensive evaluations including ultrasonography, nerve conduction studies, and functional assessments before and six months after surgical intervention. Various ultrasonographic parameters such as cross-sectional area (CSA), bowing of the flexor retinaculum, displacement of median nerve, and flattening ratio were measured at inlet and outlet levels of the carpal tunnel. Additionally, functional outcomes including grip strength, pinch strength, Disabilities of the Arm, Shoulder, and Hand score (DASH), visual analog scale (VAS), and World Health Organization Quality of Life score (WHOQOL) were assessed.
Results
A total of 18 patients (24 wrists) with CTS were included in this study. In this study, there were 15 females and 3 males, with 18 single-sided surgeries and 6 double-sided surgeries. The mean age was 45 years old with a mean duration of symptoms of 26 months. There were no complications and no reoperations during the follow-up period. Improvements in all postoperative parameters were recorded, with statistically significant improvements noted in CSA (outlet), bowing (outlet), displacement (inlet and outlet), and functional scores.
Conclusions
In this study, we reported on the postoperative statistical changes after carpal tunnel release. In addition, we shared detailed descriptions of our ultrasonographic methodologies for standardized reporting in the future. After cross-referencing with other publications, we also proposed a set of postoperative ultrasonographic parameters for determining successful release of carpal tunnel. In conclusion, we recommended that ultrasonography could be used as a reliable tool for postoperative tracking and could act as a tool for patient communication.
Trial registration
This study was approved by the ethics committee of China Medical University Hospital, Taichung, Taiwan and conducted in accordance with the Helsinki Declaration (IRB approval number CMUH109-REC2-184).