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Thenar Atrophy in Carpal Tunnel Syndrome. Evolution of Grip Strength and Finger Pinch in Pre-and Postoperatively
Carlos Henrique Fernandes, MD; L. M. Meirelles, Phisioterapist; Jorge Raduan Neto, MD; João Baptista Gomes dos Santos, MD; Flávio Faloppa, MD; Walter Manna Albertoni, MD
Orthopaedic Sugery / Hand Surgery Group, Universidade Federal de São Paulo, São Paulo, Brazil

Introduction: The objective of this study was to evaluate an improvement of strength and the muscle atrophy in patients treated surgically with carpal tunnel syndrome accompanied by thenar muscle atrophy.

Methods: Between october 2008 and may 2010 a total of 49 patients and 46 hands with carpal tunnel syndrome were treated surgically. Entry criteria included a thenar muscle atrophy. There were 3 men and 46 women at age of 55 years old (range, 37-85 years). It was evaluated with the presence or absence of  the thenar muscle atrophy, three and six months followed up. It was evaluated a grip, tip pinch, key pinch and palmar pinch with Jamar dynamometer and pinch gauge respectively

Results: Twenty three (47%) of the forty nine (100%)  hands that had thenar atrophy regained normal muscle bulk in the sixth mouth of follow up. Studying to the strength of the operated hand in time, comparing the values obtained preoperatively with the third month, there were no differences between the average. The preoperative with the sixth month there were differences between the average. The third through the sixth was also differences between the average, or whether there was an improvement in strength in the sixth month postoperative follow-up .

Conclusion: We concluded that  the strength in patients with thenar atrophy caused  by carpal tunnel syndrome has its  recovery from  three months after the surgery.

TABLES 

Analysis of the operated hand in pre and follow-up times(Average)

Pre X 3 months PO

 

pre

3 months

% Increase

p-test

interpretation to the level of 5%

Grip strength

12,98

12,56

-3

0,57

no differences

Tip pinch

2,11

2,29

9

0,07

no differences

Key pinch

4,35

4,27

-2

0,713

no differences

Palmar pinch

2,74

2,75

0

0,962

no differences

Pre X 6 months PO

 

pre

 6 months

% Increase

p-test

interpretation to the level of 5%

Grip strength

12,98

15,71

21

0,007

differences

Tip pinch

2,11

2,74

30

0,000

differences

Key pinch

4,35

5,09

17

0,000

differences

Palmar pinch

2,74

3,41

24

0,000

differences

3 months PO X 6 months PO

 

pre

 6 months

% Increase

p-test

interpretation to the level of 5%

Grip strength

12,56

15,71

25

0,007

differences

Tip pinch

2,29

2,74

20

0,000

differences

Key pinch

4,27

5,09

19

0,000

differences

Palmar pinch

2,75

3,41

24

0,000

differences


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