Chan Y, Selvaratnam V, Manickavasagar T, Shetty V, Sahni V. Liverpool carpal tunnel scoring system to predict nerve conduction study results: A prospective correlation study. World J Orthop 2022; 13(2): 171-177 [PMID: 35317399 DOI: 10.5312/wjo.v13.i2.171]
Corresponding Author of This Article
Yuen Chan, FRCS, MBChB, MSc, Surgeon, Department of Trauma and Orthopaedics, Mersey Deanery, Warrington Rd, Rainfall, Prescot L35 5DR, Merseyside, United Kingdom. y.chan1@nhs.net
Research Domain of This Article
Surgery
Article-Type of This Article
Prospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yuen Chan, Department of Trauma and Orthopaedics, Mersey Deanery, Prescot L35 5DR, Merseyside, United Kingdom
Veenesh Selvaratnam, Department of Trauma and Orthopaedics, Manchester University Hospitals NHS Foundation Trust, Manchester M13 9WL, United Kingdom
Tharjan Manickavasagar, Vishwanath Shetty, Vishal Sahni, Department of Trauma and Orthopaedics, Southport and Ormskirk NHS Trust, Southport L39 2AZ, United Kingdom
Author contributions: Chan Y and Selvaratnam V wrote and edited the manuscript and were involved in the analysis of the study; Selvaratnam V, Manickavasagar T, Shetty V, and Sahni V were involved in the collection of data and editing of the manuscript.
Institutional review board statement: This study was approved by Southport and Ormskirk NHS Hospital.
Clinical trial registration statement: A clinical trial registration was not required.
Informed consent statement: The informed consent statement is not applicable for this study.
Conflict-of-interest statement: No conflict of interest.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuen Chan, FRCS, MBChB, MSc, Surgeon, Department of Trauma and Orthopaedics, Mersey Deanery, Warrington Rd, Rainfall, Prescot L35 5DR, Merseyside, United Kingdom. y.chan1@nhs.net
Received: March 25, 2021 Peer-review started: March 25, 2021 First decision: June 16, 2021 Revised: June 30, 2021 Accepted: January 18, 2022 Article in press: January 18, 2022 Published online: February 18, 2022 Processing time: 329 Days and 8 Hours
ARTICLE HIGHLIGHTS
Research background
There is still debate around what is the best approach for assessment of Carpal tunnel syndrome (CTS). Controversies do exist regarding the need for investigations such as the need for nerve conduction studies (NCS) to aid with management decisions.
Research motivation
We hypothesised that a scoring system combining symptoms, signs and risk factors can help with the diagnosis of carpal tunnel syndrome and whether nerve conduction studies would be required.
Research objectives
The aim of the study was to correlate the severity of nerve conduction study results to a scoring system which included symptoms, signs and risk factors.
Research methods
We scored patients’ signs and symptoms using our CTS scoring system. This was then correlated with the findings of the NCS. The scoring system included - four symptoms and four clinical signs and two risk factors. We classified the NCS results to normal, mild, moderate and severe.
Research results
All scores of 8 or more matched with NCS results of moderate and severe intensity apart from three scores which were greater than seven that had normal NCS. Eta score was 0.822 for the CTS score being the dependent value and the NCS category being the independent variable showing a strong association between the scoring system and the NCS group.
Research conclusions
Based on our study, we believe that patients who score less than 8 may require NCS to confirm the diagnosis of CTS. However, patients who score more than 7 have a 93% chance of having moderate to severe CTS on NCS. The use of our simple scoring methods can help determine patients with moderate and severe CTS. In this group of patients, we recommend not using NCS. Patients scoring less than 8 may have mild or moderate CTS and in this group of patients, we recommend the use of NCS.
Research perspectives
The use of our Liverpool carpal tunnel scoring system can have the potential to be used to help determine if NCS is required. Further studies looking into the validation of the scoring system is required.
