Journal of hand therapy : official journal of the American Society of Hand Therapists
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Comparative Study
Sensory function assessment. A pilot comparison study of touch pressure threshold with texture and tactile discrimination.
The purpose of this study was to determine if a correlation exists between touch-pressure threshold testing and sensory discrimination function, specifically tactile gnosis for texture and object recognition. Twenty-nine patients diagnosed with carpal tunnel syndrome (CTS), as confirmed by electromyography or nerve conduction velocity tests, were administered three sensibility tests: the Semmes-Weinstein monofilament test, a texture discrimination test, and an object identification test. Norms were established for texture and object recognition tests using 100 subjects (50 females and 50 males) with normal touch-pressure thresholds as assessed by the Semmes-Weinstein monofilament test. ⋯ A significant difference (p < .05) in response times by those CTS patients with diminished light touch was detected in identification in four out of six objects. Subjects with diminished protective sensation had significantly longer response times (p < .05) for identification of the textures of cork, coarse and fine sandpaper, and rubber. Significantly longer response times were recorded by the same subjects for identification of such objects as a screw and a button, and for the shapes of a square, triangle, and oval.
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Endoscopic carpal tunnel release is one of the most controversial topics in hand surgery today. Many surgeons have reservations in doing carpal tunnel release endoscopically because its merits and demerits have not been clearly defined. ⋯ The anatomic basis for a single-portal technique using the Concept Carpal Tunnel Release Kit is described in detail. The results of 100 postoperative cases indicate that endoscopic carpal tunnel release was superior to the open technique in regard to postoperative morbidity and patient satisfaction in 92% of this patient group.