Evaluation of the Incidence of Double Crush Syndrome in Patients with Carpal Tunnel Syndrome

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, School of Medicine AND Student Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: This study aimed to determine the incidence of double crush syndrome in patients with carpal tunnel syndrome and evaluate the association of the severity of carpal tunnel syndrome, onset to diagnosis interval of carpal tunnel syndrome, gender and body mass index (BMI) with double crush syndrome.Methods: In this descriptive cross-sectional study, 105 patients (71 women) with carpal tunnel syndrome diagnosed via clinical manifestations and electrophysiologic criteria were selected randomly. The presence of cervical radiculopathy (C5, C6, C7 roots involvement) was characterized using electromyography-nerve conduction velocity (EMG-NCV) as double crush syndrome in these patients. The risk factors of double crush syndrome were evaluated.Findings: The incidence of double crush syndrome in patients with carpal tunnel syndrome was 41.9% (44 patients) which 9 of them (20.45%) were men and 35 (79.55%) were women. Among the men, 26.5%, and among the women, 49.3% showed double crush syndrome. None of the patients with body mass index of less than 20 kg/m2 had signs of double crush syndrome since 47.3% of patients with body mass index of more than 25 kg/m2 had double crush syndrome.Conclusion: Our study confirms that severe carpal tunnel syndrome and constant physical activity in involved limb increase the incidence of double crush syndrome. It also shows that the incidence of double crush syndrome in women is higher than men and higher body mass index could be a risk factor for double crush syndrome.

Keywords

References

  1. Calandruccio JH. Carpal tunnel syndrome, ulnar tunnel syndrome, and stenosing tenosynovitis. In: Canale T, Beaty JH, editors. Campbell's operative orthopaedics. 12th ed. Philadelphia, PA; Mosby: 2013. p. 3637-60.
  2. Page MJ, O'Connor D, Pitt V, Massy-Westropp N. Therapeutic ultrasound for carpal tunnel syndrome. Cochrane Database Syst Rev 2012; 1: CD009601.
  3. Wilbourn AJ, Gilliatt RW. Double-crush syndrome: a critical analysis. Neurology 1997; 49(1): 21-9.
  4. Trail IA, Fleming A. Disorders of the hand: vol. 2: Hand reconstruction and nerve compression. New York, NY: Springer; 2014.
  5. Lo SF, Chou LW, Meng NH, Chen FF, Juan TT, Ho WC, et al. Clinical characteristics and electrodiagnostic features in patients with carpal tunnel syndrome, double crush syndrome, and cervical radiculopathy. Rheumatol Int 2012; 32(5): 1257-63.
  6. Schmid AB, Coppieters MW. The double crush syndrome revisited--a Delphi study to reveal current expert views on mechanisms underlying dual nerve disorders. Man Ther 2011; 16(6): 557-62.
  7. Pierre-Jerome C, Bekkelund SI. Magnetic resonance assessment of the double-crush phenomenon in patients with carpal tunnel syndrome: a bilateral quantitative study. Scand J Plast Reconstr Surg Hand Surg 2003; 37(1): 46-53.
  8. Herczeg E, Otto A, Vass A, Piza-Katzer H. Significance of double crush in carpal tunnel syndrome. Handchir Mikrochir Plast Chir 1997; 29(3): 144-6. [In German].
  9. Moghtaderi A, Izadi S. Double crush syndrome: an analysis of age, gender and body mass index. Clin Neurol Neurosurg 2008; 110(1): 25-9.
Journal of Isfahan Medical School
Volume 33, Issue 358 - Serial Number 358
September and October 2016
Pages 1912-1917

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History

  • Receive Date: 06 July 2015
  • Revise Date: 03 May 2024
  • Accept Date: 06 April 2022

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