Application of preoperative needle electromyography in patients with severe carpal tunnel syndrome / 中国医师进修杂志

ABSTRACT

Objective To investigate the relationship between the results of preoperative needle electromyography and the recovery of abductor pollicis brevis (APB) function in patients with severe carpal tunnel syndrome. Methods The clinical data of 68 patients (76 hands) with severe carpal tunnel syndrome were retrospectively analyzed. According to the results of preoperative needle electromyography, the patients were divided into the motor unit potential (MUP) positive group (46 cases, 52 hands), and MUP negative group (22 cases, 24 hands). The patients were followed up 1 year after operation, and the manual muscle testing (MMT) grade of abductor pollicis brevis muscle, functional assessment of thumb and patient satisfaction was recorded. Results The MMT grade ≥ 3 rate and satisfaction rate 1 year after operation in MUP positive group were significantly higher than those in MUP negative group 100.0% (52/52) vs. 75.0% (18/24) and 100.0% (52/52) vs. 66.7% (16/24), and there were statistical differences (P＜0.05). The patient′s thumb function 1 year after operation was evaluated by coin pickup test, button fastening test and sewing needle clamp test. The results showed that the thumb function in MUP positive group was significantly better than that in MUP negative group, and there was statistical difference (P＜0.05). Conclusions The recovery of postoperative thumb function is related with the evocation MUP of postoperative abductor pollicis brevis needle electromyography. For MUP positive patients, there is no need for secondary thumb opponensplasty 1 year after operation. Needle electromyography has a certain reference value for thumb opponensplasty.