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Med J Tabriz Uni Med Sciences Health Services. 2006;28(1): 13-15.
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  PDF Download: 113

Surgery

Research

Evaluation of Diagnostic Value of Two Point Discrimination (2PD) Test, Combined with Other Clinical Signs as an Indication in Surgery of Carpal Tunnel Syndrome

AFSHAR AR*, AHMADZADEH J, YEKTA Z, MIRZATOLOEI F
*Corresponding Author: Email: afshar@umsu.ac.ir

Abstract

Background and Objectives: Carpal tunnel syndrome (CTS) results from compression of median nerve within carpal tunnel. Unfortunately there is not standard test or tests for definitive diagnosis of CTS. CTS is presented with a constellation of symptoms and signs. Two point discrimination test is used for quantify the quality of sense in peripheral nerve injuries. The main purpose of this study is PD evaluation in patients with CTS and comparing with other clinical tests and electrodiagnostic study. Material and Methods: In a cross sectional study 77 patients (154 hands) with CTS diagnosis and consecutive sampling evaluated. 2 PD test, clinical tests and electrodiagnostic study performed. Montecarlo test was used for statistical analysis. Results: Mean age of patients was 44.9 years (from25-79). Mean time of clinical symptoms was 19.44 months. 2PD was abnormal in 41.6% (64 from 154 hands). Meaningful statistical correlation was found between 2PD test and Tinel’s sign (p=0.007), and Phalen test (p=0.02). Also meaningful statistically correlation was found between 2PD abnormality and electrodiagnostic study (p=0.03). There was not meaningful statistical correlation between 2PD and duration of symptoms. Conclusion: PD test is not recommended as a screening and diagnostic test in CTS, but 2PD abnormality with other clinical sign of CTS reveals advanced nerve injury in CTS. Therefore; it is recommended that PD abnormality be considered as an indication for surgical release of CTS.
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Submitted: 21 Aug 2010
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