Journal of wrist surgery · 2025
Natural History of Constant Preoperative Fingertip Numbness and Thenar Atrophy Following Carpal Tunnel Release: A Prospective Study.
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Nadeem Maheen, Got Christopher C, DaSilva Manuel F, Katarincic Julia A, Akelman Edward, Weiss Arnold-Peter C
Аннотация
BACKGROUND: It is not well known whether constant fingertip numbness (CN) or thenar muscle atrophy in advanced carpal tunnel syndrome (CTS) improves following carpal tunnel release (CTR).
MATERIALS AND METHODS: A total of 41 hands from 36 patients were enrolled in this prospective study. Patients endorsed CN ( n = 38) and/or presented on physical exam with thenar atrophy (TA; n = 18); 12 patients had both. After undergoing open CTR, patients were evaluated at 8 days, 3, 6, and 12 months following surgery. Outcomes assessed included Semmes-Weinstein sensibility, grip strength, key-pinch strength, QuickDash scores, and atrophy via direct quantitative measurement.
RESULTS: Six months postoperative, 83% of CN patients showed improved sensibility in any digit versus 40% of TA patients. Pinch strength was worse at baseline in TA patients (8.9 ± 3.7 vs. 10.8 ± 5.0) and returned to baseline in 72 and 80% of CN and TA patients at 6 months and 93.3 and 100% of CN and TA patients at 12 months. Hand function dissatisfaction improved to 100% satisfaction at 3 months. Tingling severity was characterized as "none" from zero patients at baseline to 42, 72, and 62% of all patients at 3, 6, and 12 months. Atrophy patients presented with 1.4 ± 0.8 mm of atrophy at baseline that improved by 1.2 mm at 12 months.
CONCLUSION: Patients with TA showed weaker pinch strengths at baseline but improved more rapidly than CN patients. Hand function significantly improved by 3 months and constant tip numbness resolved in roughly 2/3 of all patients at 6 months.
MATERIALS AND METHODS: A total of 41 hands from 36 patients were enrolled in this prospective study. Patients endorsed CN ( n = 38) and/or presented on physical exam with thenar atrophy (TA; n = 18); 12 patients had both. After undergoing open CTR, patients were evaluated at 8 days, 3, 6, and 12 months following surgery. Outcomes assessed included Semmes-Weinstein sensibility, grip strength, key-pinch strength, QuickDash scores, and atrophy via direct quantitative measurement.
RESULTS: Six months postoperative, 83% of CN patients showed improved sensibility in any digit versus 40% of TA patients. Pinch strength was worse at baseline in TA patients (8.9 ± 3.7 vs. 10.8 ± 5.0) and returned to baseline in 72 and 80% of CN and TA patients at 6 months and 93.3 and 100% of CN and TA patients at 12 months. Hand function dissatisfaction improved to 100% satisfaction at 3 months. Tingling severity was characterized as "none" from zero patients at baseline to 42, 72, and 62% of all patients at 3, 6, and 12 months. Atrophy patients presented with 1.4 ± 0.8 mm of atrophy at baseline that improved by 1.2 mm at 12 months.
CONCLUSION: Patients with TA showed weaker pinch strengths at baseline but improved more rapidly than CN patients. Hand function significantly improved by 3 months and constant tip numbness resolved in roughly 2/3 of all patients at 6 months.