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Egyptian Rheumatology and Rehabilitation
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Relation of anthropometric hand measurements to idiopathic carpal tunnel syndrome

Egyptian Rheumatology and Rehabilitation volume 44, pages 69–76 (2017)Cite this article

Abstract

Context

Certain individuals are more prone to developing idiopathic carpal tunnel syndrome (ICTS) than others, suggesting that certain personal factors can be implicated in its occurrence.

Aim

The aim of this work was to study anthropometric hand and wrist measurements in ICTS patients, and to correlate them with median nerve electrophysiologic study.

Patients and methods

The study included 50 patients with clinically diagnosed and electrophysiologically confirmed ICTS and 50 age-matched and sex-matched healthy volunteers as the control group. Both groups performed sensory and motor conduction studies of the median nerve. External hand and wrist anthropometric measurements were taken for both groups including wrist depth and width, wrist ratio (WR), palm length and width, third digit length, and hand ratio (HR).

Results

Patients had significantly higher wrist depth (P=0.000), higher WR (P=0.000), shorter palm length (P=0.002), shorter hand length (P=0.001), and lower HR (P=0.000). Patients had more square wrists and shorter hands. Some of these measurements correlated well with median nerve conduction study parameters. Wrist depth and WR were positively correlated with median motor and sensory latencies (P=0.000) and negatively correlated with median motor and sensory amplitudes (P=0.000), and sensory conduction velocity (P=0.000). HR was negatively correlated to median motor and sensory latencies (P=0.01) and positively correlated to median motor (P=0.001) and sensory amplitudes (P=0.039), and sensory conduction velocity (P=0.001). Palm width was negatively correlated with median motor amplitude (P=0.043).

Conclusion

Certain hand anthropometric characteristics predispose to ICTS. Short hand and square wrist configurations could predict the development of ICTS.

References

  1. Hlebs S, Majhenic K, Vidmar G. Body mass index and anthropometric characteristics of the hand as risk factor for carpal tunnel syndrome. Coll Anthropol 2014; 38:219–226.

    Google Scholar 

  2. Gelfman R, Melton LJ, Yawn BP, Wollan PC, Amadio PC, Stevens JC. Long-term trends in carpal tunnel syndrome. Neurology 2009; 72:33–41.

    CAS  PubMed  PubMed Central  Google Scholar 

  3. Chammas M, Boretto J, Burmann LM, Ramos RM, Dos Santos Neto FC, Silva JB. Carpal tunnel syndrome – Part I (anatomy, physiology, etiology and diagnosis). Rev Bras Ortop 2014; 49:429–436.

    PubMed  PubMed Central  Google Scholar 

  4. Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosén I. Prevalence of carpal tunnel syndrome in a general population. JAMA 1999; 282:153–158.

    CAS  Google Scholar 

  5. Aroori S, Spence RA. Carpal tunnel syndrome. Ulster Med J 2008; 77: 6–17.

    PubMed  PubMed Central  Google Scholar 

  6. Karpitskaya Y, Novak CB, Mackinnon SE. Prevalence of smoking, obesity, diabetes mellitus, and thyroid disease in patients with carpal tunnel syndrome. Ann Plast Surg 2002; 48:269–273.

    PubMed  Google Scholar 

  7. Geoghegan JM, Clark DI, Bainbridge LC, Smith C, Hubbard R. Risk factors in carpal tunnel syndrome. J Hand Surg Br 2004; 29:315–320.

    CAS  PubMed  Google Scholar 

  8. Mattioli S, Baldasseroni A, Bovenzi M, Curti S, Cooke RM, Campo G, et al. Risk factors for operated carpal tunnel syndrome: a multicenter population-based case-control study. BMC Public Health 2009; 9:343.

    PubMed  PubMed Central  Google Scholar 

  9. Barcenilla A, March LM, Chen JS, Sambrook PN. Carpal tunnel syndrome and its relationship to occupation: a meta-analysis. Rheumatology (Oxford) 2012; 51:250–261.

    Google Scholar 

  10. De Krom MC, Kester AD, Knipschild PG, Spaans F. Risk factors for carpal tunnel syndrome. Am J Epidemiol 1990; 132:1102–1110.

    PubMed  Google Scholar 

  11. Nordstrom DL, Vierkant RA, DeStefano F, Layde PM. Risk factors for carpal tunnel syndrome in a general population. Occup Environ Med 1997; 54:734–740.

    CAS  PubMed  PubMed Central  Google Scholar 

  12. Kouyoumdjian JA, Zanetta DM, Morita MP. Evaluation of age, body mass index, and wrist index as risk factors for carpal tunnel syndrome severity. Muscle Nerve 2002; 25:93–97.

    PubMed  Google Scholar 

  13. Kouyoumdjian JA, Morita MD, Rocha PR, Miranda RC, Gouveia GM. Body mass index and carpal tunnel syndrome. Arq Neuropsiquiatr 2000; 58: 252–256.

    CAS  PubMed  Google Scholar 

  14. Kouyoumdjian JA, Morita MP, Rocha PR, Miranda RC, Gouveia GM. Wrist and palm indexes in carpal tunnel syndrome. Arq Neuropsiquiatr 2000; 58:625–629.

    CAS  PubMed  Google Scholar 

  15. Chroni E, Paschalis C, Arvaniti C, Zotou K, Nikolakopoulou A, Papapetropoulos T. Carpal tunnel syndrome and hand configuration. Muscle Nerve 2001; 24:1607–1611.

    CAS  PubMed  Google Scholar 

  16. Boz C, Ozmenoglu M, Altunayoglu V, Velioglu S, Alioglu Z. Individual risk factors for carpal tunnel syndrome: an evaluation of body mass index, wrist index and hand anthropometric measurements. Clin Neurol Neurosurg 2004; 106:294–299.

    PubMed  Google Scholar 

  17. American Association of Electrodiagnostic Medicine, American Academy of Neurology, American Academy of Physical Medicine and Rehabilitation. Practice parameter for electrodiagnostic studies in carpal tunnel syndrome: summary statement. Muscle Nerve 2002; 25: 918–922.

    Google Scholar 

  18. Farmer JE, Davis TR. Carpal tunnel syndrome: a case control study evaluating its relationship with body mass index and hand and wrist measurements. J Hand Surg Eur 2008; 33:445–448.

    CAS  Google Scholar 

  19. Stallings SP, Kasdan ML, Soergel TM, Corwin HM. A case-control study of obesity as a risk factor for carpal tunnel syndrome in a population of 600 patients presenting for independent medical examination. J Hand Surg Am 1997; 22:211–215.

    CAS  PubMed  Google Scholar 

  20. Bleecker ML, Bohlman M, Moreland R, Tipton A. Carpal tunnel syndrome: role of carpal tunnel size. Neurology 1985; 35:1599–1604.

    CAS  PubMed  Google Scholar 

  21. Edwards KS. Square wrists and carpal tunnel syndrome. Ohio Med 1990; 86:432–433.

    CAS  PubMed  Google Scholar 

  22. Robinson LR, Rubner DE, Wahl PW, Fujimoto WY, Stolov WC. Influences of height and gender on normal nerve conduction studies. Arch Phys Med Rehabil 1993; 74:1134–1138.

    CAS  PubMed  Google Scholar 

  23. Fujimaki Y, Kuwabara S, Sato Y, Isose S, Shibuya K, Sekiguchi Y, et al. The effects of age, gender, and body mass index on amplitude of sensory nerve action potentials: multivariate analyses. Clin Neurophysiol 2009; 120: 1683–1686.

    Google Scholar 

  24. Mondelli M, Curti S, Farioli A, Aretini A, Ginanneschi F, Greco G, Mattioli S. Anthropometric measurements as a screening test for carpal tunnel syndrome: receiver operating characteristic curves and accuracy. Arthritis Care Res (Hoboken) 2015; 67:691–700.

    Google Scholar 

  25. Kamolz LP, Beck H, Haslik W, Hogler R, Rab M, Schrögendorfer KF, Frey M. Carpal tunnel syndrome: a question of hand and wrist configurations? J Hand Surg Br 2004; 29:321–324.

    PubMed  Google Scholar 

  26. Chiotis K, Dimisianos N, Rigopoulou A, Chrysanthopoulou A, Chroni E. Role of anthropometric characteristics in idiopathic carpal tunnel syndrome. Arch Phys Med Rehabil 2013; 94:737–744.

    PubMed  Google Scholar 

  27. Johnson EW, Gatens T, Poindexter D, Bowers D. Wrist dimensions: correlation with median sensory latencies. Arch Phys Med Rehabil 1983; 64:556–557.

    CAS  PubMed  Google Scholar 

  28. Moghtaderi A, Izadi S, Sharafadinzadeh N. An evaluation of gender, body mass index, wrist circumference and wrist ratio as independent risk factors for carpal tunnel syndrome. Acta Neurol Scand 2005; 112:375–379.

    CAS  PubMed  Google Scholar 

  29. Sharifi-Mollayousefi A, Yazdchi-Marandi M, Ayramlou H, Heidari P, Salavati A, Zarrintan S, Sharifi-Mollayousefi A. Assessment of body mass index and hand anthropometric measurements as independent risk factors for carpal tunnel syndrome. Folia Morphol (Warsz) 2008; 67: 36–42.

    CAS  Google Scholar 

  30. Radecki P. Variability in the median and ulnar nerve latencies: implications for diagnosing entrapment. J Occup Environ Med 1995; 37:1293–1299.

    CAS  PubMed  Google Scholar 

  31. Lim PG, Tan S, Ahmad TS. The role of wrist anthropometric measurement in idiopathic carpal tunnel syndrome. J Hand Surg Eur Vol 2008; 33: 645–647.

    CAS  PubMed  Google Scholar 

  32. Gordon C, Johnson EW, Gatens PF, Ashton JJ. Wrist ratio correlation with carpal tunnel syndrome in industry. Am J Phys Med Rehabil 1988; 67:270–272.

    CAS  PubMed  Google Scholar 

  33. Radecki P. A gender specific wrist ratio and the likelihood of a median nerve abnormality at the carpal tunnel. Am J Phys Med Rehabil 1994; 73: 157–162.

    CAS  PubMed  Google Scholar 

  34. Kuhlman KA, Hennessey WJ. Sensitivity and specificity of carpal tunnel syndrome signs. Am J Phys Med Rehabil 1997; 76:451–457.

    CAS  PubMed  Google Scholar 

  35. Sposato RC, Riley MW, Ballard JL, Stentz TL, Glismann CL. Wrist squareness and median nerve impairment. J Occup Environ Med 1995; 37:1122–1126.

    CAS  PubMed  Google Scholar 

  36. Stetson DS, Albers JW, Silverstein BA, Wolfe RA. Effects of age, sex, and anthropometric factors on nerve conduction measures. Muscle Nerve 1992; 15:1095–1104.

    CAS  PubMed  Google Scholar 

  37. Armstrong TJ, Chaffin DB. Carpal tunnel syndrome and selected personal attributes. J Occup Med 1997; 21:481–486.

    Google Scholar 

  38. Kiernan MC, Mogyoros I, Burke D. Conduction block in carpal tunnel syndrome. Brain 1999; 122:933–941.

    PubMed  Google Scholar 

  39. Galea LA, Gatt R, Sciberras C. Hand and wrist configurations in patients with carpal tunnel syndrome. Malta Med J 2007; 19:32–34.

    Google Scholar 

  40. Steinberg DR, Szabo RM. Anatomy of the median nerve at the wrist: open carpal tunnel release, classic. Hand Clin 1996; 12:259–269.

    CAS  PubMed  Google Scholar 

  41. Szabo RM. Carpal tunnel syndrome as a repetitive motion disorder. Clin Orthop Relat Res 1998; 351:78–89.

    Google Scholar 

  42. Werner R, Armstrong TJ, Bir C, Aylard MK. Intracarpal canal pressures: the role of finger, hand, wrist and forearm position. Clin Biomech Bristol Avon 1997; 12:44–51.

    CAS  Google Scholar 

  43. Werner RA, Andary M. Carpal tunnel syndrome: pathophysiology and clinical neurophysiology. Clin Neurophysiol 2002; 113:1373–1381.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Physical Medicine, Rheumatology and Rehabilitation Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Wafaa S. El-Emary MD

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  1. Wafaa S. El-Emary MD
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Correspondence to Wafaa S. El-Emary MD.

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El-Emary, W.S. Relation of anthropometric hand measurements to idiopathic carpal tunnel syndrome. Egypt Rheumatol Rehabil 44, 69–76 (2017). https://doi.org/10.4103/1110-161X.198426

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  • DOI: https://doi.org/10.4103/1110-161X.198426

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