Camitz Tendon Transfer Using Flexor Retinaculum as a Pulley in Advanced Carpal Tunnel Syndrome

Hattori, Yasunori; Doi, Kazuteru; Sakamoto, Sotetsu; Kumar, Kannan Karuppiah; Koide, Satomi

doi:10.1016/j.jhsa.2014.09.008

Cited by 22 publications

(49 citation statements)

References 19 publications

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“…Loss of grasp power in patients with CTS could be due to a variety of causes that may not primarily or exclusively be related to muscles affected by CTS, but we did not distinguish other causes of weakness and we did not assess pinch strength (lateral and palmar). Further prospective research is needed to better understand the correlations of MRI thenar muscle parameters with postoperative outcomes and such information may be useful for predicting functional recovery of the thenar muscles after decompression surgery and aid in deciding on surgical intervention, because some authors have reported that the thenar muscles show satisfactory recovery after carpal tunnel decompression alone even in severe CTS ( 2 ), but others have reported unsatisfactory postoperative recovery in patients with severe CTS and recommend single-stage tendon transfer ( 25 – 27 ).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of thenar muscles by MRI in carpal tunnel syndrome

Dilokhuttakarn¹,

Naïto²,

Kinoshita³

et al. 2017

Experimental and Therapeutic Medicine

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In the present study, the thenar muscles were evaluated using magnetic resonance imaging (MRI), in addition, the correlations between thenar muscle changes, clinical findings and electrodiagnostic results from patients with carpal tunnel syndrome were investigated. The subjects were 13 patients (17 wrists) who were clinically diagnosed with carpal tunnel syndrome. In all patients, a medical history was obtained and physical examination was performed, in addition to assessment using the Kapandji scoring system, visual analogue scale (VAS), quick-disabilities of the arm, shoulder and hand (Q-DASH) score, electrodiagnostic results of the median nerve, and MRI of the thenar muscles. Thenar muscle volume was not significantly correlated with clinical data or the electrodiagnostic results. The thenar muscle major axis was significantly correlated with grasp power (P<0.05) and the Kapandji score (P<0.05), while the thenar muscle minor axis was significantly correlated with abductor pollicis brevis distal motor latency (APB DML) (P<0.01). In addition, the thenar muscle minor axis/thenar muscle major axis ratio was significantly correlated with APB DML and Kanatani's stage. Notably, thenar muscle thinness was significantly correlated with the severity of electrodiagnostic changes, while the grasp power and Kapandji score were correlated with thenar muscle thickness. Furthermore, it was demonstrated that thenar muscle thinness was significantly correlated with the severity of electrodiagnostic changes; in addition, there was a significant correlation between the thenar muscle major axis and the grasp power or Kapandji score. Taken together, these results revealed that thenar muscle atrophy did not affect patient-based assessments, including VAS and Q-DASH, but reflected electrodiagnostic results, particularly DML and severity. The results of the present study suggest that thenar muscle atrophy can be used to estimate the severity of carpal tunnel syndrome.

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Section: Discussionmentioning

confidence: 99%

Evaluation of thenar muscles by MRI in carpal tunnel syndrome

Dilokhuttakarn¹,

Naïto²,

Kinoshita³

et al. 2017

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

show abstract

“…The comparison between the MRC scale and the post APB‐Amp is shown in Figure . If the tentative cut‐off value for APB‐Amp was set at 2 mV, as in a previous study, good recovery, defined as 4 or 5 on the MRC scale, was achieved in 9 of 11 hands with APB‐Amp of 2 mV or more, but in only 5 of 14 hands with APB‐Amp of less than 2 mV ( P = 0.03). Therefore, the 2 mV cut‐off value for APB‐Amp as an index of good recovery seemed appropriate.…”

Section: Resultsmentioning

confidence: 91%

“…Opponensplasty (Camitz tendon transfer) may be considered for severe CTS patients who present with thenar atrophy and motor dysfunction . However, there is uncertainty as to whether opponensplasty should be performed simultaneously with carpal tunnel release . Some authors have reported that even severe CTS patients with absent compound muscle action potential (CMAP) of the abductor pollicis brevis (APB) muscle have satisfactory recovery after carpal tunnel release alone, and do not recommend simultaneous tendon transfer .…”

mentioning

confidence: 99%

“…Some authors have reported that even severe CTS patients with absent compound muscle action potential (CMAP) of the abductor pollicis brevis (APB) muscle have satisfactory recovery after carpal tunnel release alone, and do not recommend simultaneous tendon transfer . Others have underscored the unsatisfactory postoperative recovery of severe CTS patients and recommend single‐stage opponensplasty . It would be helpful if the prognosis of a severe CTS patient is known preoperatively, although only a few studies have investigated the prognostic factors of such severe CTS patients …”

mentioning

confidence: 99%

“…Others have underscored the unsatisfactory postoperative recovery of severe CTS patients and recommend single‐stage opponensplasty . It would be helpful if the prognosis of a severe CTS patient is known preoperatively, although only a few studies have investigated the prognostic factors of such severe CTS patients …”

mentioning

confidence: 99%

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