IMPLICATION OF NERVE CONDUCTION STUDY FOR CARPAL TUNNEL SYNDROME AT DISTRICT GENERAL HOSPITAL SETTING

Abstract

Aim: To assess the implications of nerve conduction study for carpal tunnel syndrome.

Methods and Materials: A retrospective audit of the patients who underwent carpal tunnel release at the district general hospital from July 2000 till June 2005. Due to the un-availability of facility for nerve conduction study at our district general hospital, the patients had to be referred to other hospitals in the region for the same. A total of 263 carpal tunnel releases were performed during the study period in 206 patients (57 were bilateral). 61 patients were males and 145 were females.

Results: Of the classical presentation group, the nerve conduction study was requested in 76 of the 172 patients while in the atypical presentation group 53 of the 91 patients had a nerve conduction study prior to the operative treatment. The intra-operative findings of thickened flexor retinaculum and thinned median nerve were statistically similar in the 2 groups: Nerve conduction not performed and Nerve conduction study performed.

Discussion: The average duration between the first consultation and the operative treatment was 72 days in the patients who did not undergo the nerve conduction study, whereas the average duration between the first clinic appointment and the operative treatment for the patients who had the nerve conduction study was 180.5 days. The request for nerve conduction study in cases with classical presentation leads to an average 108.5 days delay in the final management of the patient’s problem. It also causes a significant loss of time and finances.