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Background: Carpal tunnel syndrome (CTS) is now one of the most common workplace injuries, with nearly 50% of patients eventually requiring CTS release surgery as a permanent solution. With a concern of a younger incidence of CTS developing in a technology dependent society, some patients may fear even a minimal loss of function. To our knowledge there has been no study comparing forearm grip strength before symptoms develop to grip strength after the procedure has been performed.
Objectives: The aim of this study was to determine if there was a significant change in strength of the flexor digitorum superficialis and profundus tendons before and after a carpal tunnel release procedure as a proxy for change in grip strength.
Methodology: Four cadavers were selected based on thickness of flexor tendons and general composition; one cadaver was excluded due to inadequacy of tendon durability. The flexor digitorum superficialis and profundus of digits 2,3, and 4 were tested for strength at 0 and 15 degrees, before and after cutting of the flexor retinaculum. Strength was replicated by loading of the tendons with 2,4, and 6kg weights and measuring the voltage output on a Single Tract pressure sensor.
Results: Over 60 points of data were collected across the four cadavers; however, a significance in pre- and post-retinaculum release trials was only achieved in the superficialis muscle of the 4th digit at a 4kg and 6 kg weight. The remaining results displayed no significant pattern or trend in regard to pre and post release strength.
Conclusion: The evidence gathered in this experiment does not allow us to make an accurate conclusion due to its equivocal nature. Recommendation is for further testing to increase the data size, expansion to include soft cure cadavers, improve replication/isolation of mimicking the carpal tunnel release surgery, and reduce variability in the data collection. In evaluation of surgical treatment of CTS, our recommendation currently is to follow current surgical guidelines.
Mosier T, White E. Risking the Wrist. 2021
Available for download on Friday, December 13, 2024
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