Atsuyuki Inui1, Hanako Nishimoto2, Yutaka Mifune2, Takeshi Kokubu2, Ryosuke Sakata2, Masahiro Kurosaka2. 1. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. ainui@med.kobe-u.ac.jp. 2. Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Abstract
INTRODUCTION: Ultrasound measurement of the cross-sectional area (CSA) of the median nerve can give information about regeneration of the nerve after carpal tunnel release (CTR), but the changes at selected follow-up points up to 1 year compared to electrodiagnostic findings are not known. We postoperatively measured the CSA of the median nerve with ultrasound and compared the measurements with electrophysiological findings over 12 months after open CTR. MATERIALS AND METHODS: In 21 hands that underwent open CTR, the CSA of the median nerve was measured at the inlet (proximal CSA) and outlet (distal CSA) of the carpal tunnel at 3- 6- and 12-month follow-up. The respective ratios [(CSA postoperatively/CSA preoperatively) × 100] were calculated and correlated with distal motor latency (DML) and sensory nerve conduction velocity (SCV). RESULTS: The proximal CSA ratio was 88.9, 84.5, and 78.4 % at 3-, 6-, and 12-month follow-up, respectively. Each value was significantly lower than that before surgery. The distal CSA ratio was 104.3, 99.1, and 91.8 % at 3-, 6-, and 12-month follow-up, respectively. The values were not significantly different compared to preoperative values. CONCLUSIONS: The proximal CSA of the median nerve decreased continuously over the time after CTR while the distal CSA increased up to 3 months before it decreased continuously, too.
INTRODUCTION: Ultrasound measurement of the cross-sectional area (CSA) of the median nerve can give information about regeneration of the nerve after carpal tunnel release (CTR), but the changes at selected follow-up points up to 1 year compared to electrodiagnostic findings are not known. We postoperatively measured the CSA of the median nerve with ultrasound and compared the measurements with electrophysiological findings over 12 months after open CTR. MATERIALS AND METHODS: In 21 hands that underwent open CTR, the CSA of the median nerve was measured at the inlet (proximal CSA) and outlet (distal CSA) of the carpal tunnel at 3- 6- and 12-month follow-up. The respective ratios [(CSA postoperatively/CSA preoperatively) × 100] were calculated and correlated with distal motor latency (DML) and sensory nerve conduction velocity (SCV). RESULTS: The proximal CSA ratio was 88.9, 84.5, and 78.4 % at 3-, 6-, and 12-month follow-up, respectively. Each value was significantly lower than that before surgery. The distal CSA ratio was 104.3, 99.1, and 91.8 % at 3-, 6-, and 12-month follow-up, respectively. The values were not significantly different compared to preoperative values. CONCLUSIONS: The proximal CSA of the median nerve decreased continuously over the time after CTR while the distal CSA increased up to 3 months before it decreased continuously, too.
Authors: Alex Wing Hung Ng; James Francis Griffith; Carita Tsoi; Raymond Chun Wing Fong; Michael Chu Kay Mak; Wing Lim Tse; Pak Cheong Ho Journal: Korean J Radiol Date: 2021-05-04 Impact factor: 3.500