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Prevalence Study of Anomaly of Linburg - Comstock in patients with Carpal Tunnel Syndrome
Saulo Rodrigues Moreira, MD; Carlos Henrique Fernandes, MD; Jorge Raduan Neto, MD; Joo Baptista G Santos, MD; Flavio Faloppa, PhD, MD
Universidade Federal de So Paulo, Sao Paulo, Brazil

Introduction: In 1979, Linburg and Comstock described an abnormal connection between the Flexor Pollicis Longus and Flexor Digitorus profundus to the index finger in the forearm.The presence of this connection is considered to be one cause of Carpal Tunnel Syndrome (CTS).
Objectives: To evaluate the prevalence of the presence of Linburg Comstock anomaly in patients with Carpal Tunnel Syndrome and without Carpal Tunnel Syndrome. Also to compare the prevalence in both cases.
Methods: The test for diagnosing the presence of the anomaly (concomitant flexion test) was done asking the patient to perform flexion of the thumb, and considered positive when concomitant index finger flexion was observed. Another test (pain in extension test) was considered positive when, during flexion of the thumb, the patient reported pain in the distal radial forearm, when performing passive extension of the index finger. The tests were performed on both hands of 171 patients with clinical diagnosis of CTS (group1) totaling 342 hands. A control group, where the same tests were performed, consisted of 400 hands of 200 volunteers, all female, over the age of 40 years (group 2).
Results: In group 1, the concomitant flexion test was positive in 271 (79.2%) hands and the pain test in 221 (64.6%) of the examined hands. In group 2, the concomitant flexion test was positive in 244 (61%) hands and the pain test in 110 (27.5%) of the examined hands.
Conclusion: The prevalence of positive tests for the presence of Linburg Comstock anomaly is higher in patients with carpal tunnel syndrome than in non Carpal Tunnel Syndrome volunteers. Comparing both groups, the difference in the prevalence of pain test is greater than the concomitant flexion test.


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