Value of Modified Duran’s Test in Clinical Diagnosis of Carpal Tunnel Syndrome

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DOI:

https://doi.org/10.25156/ptj.v11n1y2021.pp1-6

Keywords:

Carpal tunnel syndrome, Diagnosis, Provoking test

Abstract

Background: Carpal tunnel syndrome (CTS) is a medical condition, the most common, most important, and best defined, and the most carefully studied of all nerve entrapment syndromes. Objective: Our study aims to evaluate clinical tests in the diagnosis of CTS with special reference to modified Duran’s test regarding specificity and sensitivity. Patients and Methods: A prospective study carried out on 300 hands in 240 patients with symptomatic CTS was taken, from August 2015 to February 2017, at Erbil Teaching hospital (Orthopedic department). History, clinical examination, and Electrophysiological by Electromyography and Nerve conduction study and 250 persons without symptoms on 300 hands were taken as a controlling group. We applied the five clinical provocative tests on each group, Phalen’s test, Tinal’s test, original Duran’s test, arm Tourniquet test, and Reversed Phalen’s test. In this research, we compared former tests by our test modification (Duran’s test), considering specificity, accuracy, and sensitivity. Results: Findings show that the modified Duran’s test was the most specific (94%), accurate (94%), and sensitive (94%) in comparison with the other provocative tests. The modified Duran test had the highest positivity rate, according to the cases in less than 1-month history of symptoms it reached: 81.8% which was higher than the result of the previous tests in comparison to the previous clinical tests. Its mean time was 11.5 s. Conclusions: Modified Duran’s test was simple, noninvasive, most sensitive, and most specific in comparison to other clinical tests. Furthermore, the reaction time of Modified Duran’s test was the shortest,

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References

Al-Mukhtar, A. W. 2004. Evaluation of clinical tests in diagnosis of carpal tunnel syndrome with special reference to modified Duran’s test regarding specificity and sensitivity. Basrah J. Surg. 10: 78-86.

Andrews, B. 1972. Experiment of Physiology. Chirchill Livingstone, London.

Boland, R. A. and R. D. Adams. 1999. Sphygmomanometer-induced increases in forearm and hand volume. J. Hand Ther. 12: 275- 283.

Bozek, M. and T. S. Gaździk. 2001. The value of clinical examination in the diagnosis of carpal tunnel syndrome. Ortop. Traumatol. Rehabil. 3(3): 357-360.

De-La-Llave-Rincón, A. I., E. J. Puentedura and C. Fernández- De-Las-Peñas. 2012. New advances in the mechanisms and etiology of carpal tunnel syndrome. Discov. Med. 13: 343-348.

Douglas, G., Tompkins MD., Larosse, et al. Median nerve neuropathy in the CTS caused by tumor like condition. J Bone and Joint Surg 1981;21:373-83.

Durkan, J. A. 1991. A new diagnostic test for carpal tunnel syndrome. J. Bone Joint Surg. Am. 73: 535-538.

Gellman, H., R. H. Gelberman, A. M. Tan and M. J. Botte. 1986. Carpal tunnel syndrome. An evaluation of the provocative diagnostic tests. J. Bone Joint Surg. Am. 68: 735-737.

Kang, S., H. K. Kwon, K. H. Kim and H. S. Yun. 2012. Ultrasonography of median nerve and electrophysiologic severity in carpal tunnel syndrome. Ann. Rehabil. Med. 36: 72-79.

Kuschner, S. H. 1999. Reliability and validity of physical examination tests used to examine the upper extremity. J. Hand Surg. Am. 24: 868-869.

Louis, D. S. and F. M. Hankin. 1987. Symptomatic relief following carpal tunnel decompression with normal electroneuromyographic studies. Orthopedics. 10: 434-436.

Macdermid, J. C. and J. Wessel. 2004. Clinical diagnosis of carpal tunnel syndrome: A systematic review. J. Hand Ther. 17: 309- 319.

Parisdm, T. T. 2005. Wrist and hand reconstruction. In: AAOS Orthopaedic Knowledge Update 8.

Phalen, G. S. 1972. The carpal-tunnel syndrome. Clinical evaluation of 598 hands. Clin. Orthop. Relat. Res. 83: 29-40.

Rahmani, M., A. R. Ghasemi Esfe, S. M. Vaziri-Bozorg, M. Mazloumi, O. Khalilzadeh and H. Kahnouji. 2011. The ultrasonographic correlates of carpal tunnel syndrome in patients with normal electrodiagnostic tests. Radiol. Med. 116: 489-496.

Rickter, M. and P. Brüser. 1999. The value of clinical diagnosis in CTS. Handchir. Mikrochir. Plast. Chir. 31: 373-377.

Sorlie, D. E. 1995. Medical Biostatistics and Epidemiology: Examination and Board Review. Appleton and Lange, Norwalk, Connecticut.

Susan Ferry, P. H. and M. Warasky. 2000. CTs risk factors in women. AJE. 151(6): 566-573.

Szabo, R. M., R. R. Jr. Slater, T. B. Farver, D. B. Stanton and W. K. Sharman. 1999. The value of diagnostic testing in carpal tunnel syndrome. J Hand Surg. Am. 24: 704-714.

Tetro, A. M., B. A. Evanoff, S. B. Hollstien and R. H. Gelberman. 1998. A new provocative test for carpal tunnel syndrome. Assessment of wrist flexion and nerve compression. J. Bone Joint Surg. Br. 80(3): 493-498.

Trumble, T. E., E. Diao, R. A. Abrams and M. M. Gilbert-Anderson. 2002. Single-portal endoscopic carpal tunnel release compared with open release: A prospective, randomized trial. J. Bone Joint Surg. Am. 84: 1107-1115.

Wanitwattanarumlug, B. and V. Varavithya. 2012. Evaluating the mean cross-sectional area (CSA) of median nerve by use of ultrasound in Thai population. J. Med. Assoc. Thai. 95: 21-5.

Werner, R. A. and M. Andary. 2011. Electrodiagnostic evaluation of carpal tunnel syndrome. Muscle Nerve. 44: 597-607.

Williams, T. M., S. E. Mackinnon, C. B. Novak, S. McCabe and L. Kelly. 1992. Verification of the pressure provocative test in carpal tunnel syndrome. Ann. Plast. Surg. 29(1): 8-11.

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Published

2021-06-30

How to Cite

Qadir, M. K., & Hasan Kalwuri, S. K. (2021). Value of Modified Duran’s Test in Clinical Diagnosis of Carpal Tunnel Syndrome. Polytechnic Journal, 11(1), 1-6. https://doi.org/10.25156/ptj.v11n1y2021.pp1-6

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Vol. 11 No. 1 (2021):

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Research Articles

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Copyright (c) 2021 Mahdi Kh. Qadir, Samih K. Hasan Kalwuri

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