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American Association for Hand Surgery

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A New EMG Classification for CTS with Clinical Course Correlation
Carlos Abilio Sánchez-Mojica, M.A.1, Yonathan Omar Garfias, Dr.2, Verónica D. Durán, M.A.3, Beatriz Buentello, Dr.2, Martín J. Molina, Dr.4, Luis Enrique Sánchez-Mojica, Dr.3 and Omar Iván Sánchez-Mojica, Dr.3, (1)Hospital Juárez de México, Mexico City, DF, Mexico, (2)Conde de Valenciana, Mexico City, DF, Mexico, (3)UNAM, Mexico City, DF, Mexico, (4)Hospital General la Villa, Mexico City, DF, Mexico

Introduction: Different scales have been validated to measure the post-surgical improvement of the carpal tunnel syndrome (CTS), such as the HiOB, the Quick Dash and the BCTQ, which measure the severity of the syndrome based on clinical signs and symptoms, there are also different electromyographic severity scales, however there are not a correlation between these two types of scales, which reduces the use of electromyographic scales because they do not have a postoperative predictive value. In this study we evaluate the correlation between a new electrodiagnostic classification for CTS and the postoperative clinical symptoms measured with validated and standardized instruments.
Materials and Methods: Between January 2018 and August 2019, a cohort double-blind study was carried out with 47 patients diagnosed with CTS and treated with surgical carpal tunnel release. The patients underwent a pre-surgical electromyography and were followed-up with the QuickDASH, HiOb, functional and sensitive BCTQ scales at 15 days, one, three, six and twelve months after surgery.
Results: We found two EMG patterns: 1) patients only with sensory alterations and 2) patients with mixed alterations (sensory and motor). This finding was used to design the new classification and each pattern was subdivided according to the values of sensory nerve conduction velocity (SNCV) and motor latency (ML). A statistically significant correlation (p <0.05) was found between the classification and the improvement of clinical symptoms reported by the QuickDash and HiOb scales.
Conclusion(s): These results demonstrate the new electromyographic classification has a statistically significant correlation with long-term postsurgical clinical findings, in contrast with current scales accepted internationally. Thus, this classification will allow orienting patients of the expected postoperative clinical course, through an objective presurgical study.


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