电诊断测试预测腓骨隧道综合征患者减压后的疗效

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2024-11-01 DOI:10.1016/j.jhsg.2024.08.013

Kevin R. Cuneo BS , Thomas J. McQuillan MD , Constance M. Sullivan BS, BA , Hayden L. Cooke BS , Sabryn A. Kapp BS , Eric R. Wagner MD, MSc , Michael B. Gottschalk MD

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引用次数: 0

摘要

目的电诊断（EDX）测试通常与症状和体格检查结果相结合，用于诊断肘隧道综合征（CuTS）。本研究旨在调查术前 EDX 诊断与 CuTS 患者术后手臂、肩部和手部残疾（QuickDASH）改善程度之间的关系。术前进行过 EDX 检测以及术前和术后 3 个月进行过 QuickDASH 评分的患者均符合纳入条件。根据 CuTS EDX 检测结果，这些患者被分为 EDX 阳性和 EDX 阴性两组。两组患者的人口统计学、术前 QuickDASH、术后 QuickDASH 和 QuickDASH 变化情况进行了比较。EDX阴性组的术前QuickDASH评分较高，接近但未达到显著性（P = .06）。肘隧道松解术后，两组患者的 QuickDASH 均有明显改善（P = .021, P < .01）。结论无论EDX诊断结果如何，接受肘隧道松解术的患者的QuickDASH评分在短期内都有明显改善。然而，在临床强烈怀疑 CuTS 的情况下，术前 EDX 检查结果呈阴性并不能排除诊断，事实上，这可能是术后短期功能改善的一个积极而非消极的预测因素。

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Electrodiagnostic Testing Predicts Postdecompression Outcomes in Patients With Cubital Tunnel Syndrome

Purpose

Electrodiagnostic (EDX) testing is commonly used in conjunction with symptoms and physical examination findings to diagnose cubital tunnel syndrome (CuTS). The purpose of this study was to investigate the relationship between preoperative EDX diagnosis and the degree of Disabilities of the Arm, Shoulder, and Hand (QuickDASH) improvement after surgery within the CuTS patient population.

Methods

A retrospective review was designed to analyze patients from a single institution who underwent a cubital tunnel release. Patients who had preoperative EDX testing, as well as preoperative and 3-month postoperative QuickDASH scores were eligible for inclusion. These patients were divided into two groups, EDX-positive or EDX-negative, based on the findings of their EDX testing for CuTS. Demographics, preoperative QuickDASH, postoperative QuickDASH, and changes in QuickDASH were compared between the two groups.

Results

Fifty-seven patients were included—34 EDX-positive and 23 EDX-negative. The EDX-negative cohort had higher preoperative QuickDASH scores, which approached but did not reach significance (P = .06). Both groups had significant improvement in QuickDASH following cubital tunnel release (P = .021, P < .01). Patients with EDX-negative testing had a significantly greater improvement in QuickDASH from before surgery to 3 months after surgery (25 points vs 11, P < .01).

Conclusions

Patients who underwent cubital tunnel release had a significant short-term improvement in their QuickDASH scores, regardless of EDX diagnosis. However, negative preoperative EDX studies in the setting of strong clinical suspicion of CuTS do not exclude diagnosis and may in fact be a positive, rather than a negative, predictive factor for short-term postoperative functional improvement.