The Role of Electrophysiological Examination in the Diagnosis of Carpal Tunnel Syndrome: Analysis of 2516 Patients

Abstract

Objective: The aim of the present study was to assess the correlation between patient history, physical examination, and electrophysiological method of assessment in patients with clinical suspicion of carpal tunnel syndrome ( CTS). Patients and Methods: Results of electrophysiological examinations performed from 2009 to 2016 on 3151 hands of 2516 patients who had symptoms that clinically suggested CTS were examined retrospectively. Patients were assessed in terms of age, gender, direction of nerve compression, and presence and degree of CTS as determined electrophysiologically. Kolmogorov-Smirnov test, Levene's test, and Chi-square test were used for statistical analyses. Level of significance was accepted as P < 0.05. Results: Of the 2516 patients, 1838 ( 73.1%) were female and 678 ( 26.9%) were male. Average age was 48.60 +/- 14.83 years, and 1858 ( 73.8%) of the patients had complaints in only 1 hand, whereas 658 ( 26.2%) had complaints in bilateral hands. CTS was detected in 1383 patients ( 54.9%; female/ male: 1019/ 364) and average age was 52.16 +/- 13.84 years. No statistically significant association was found between CTS and gender. Nerve compression was found in 1 hand of 71.5% ( 1328) of females and 28.5% ( 530) of males, and this result was found to be statistically significant. No significant association was found between degree and direction of nerve compression. Conclusion: Only 54.9% of the patients with clinical suspicion were found to have CTS. Given complexity of the hand and a large number of potential pathologies, electrophysiological examination is necessary for definitive diagnosis to avoid unnecessary surgical interventions.