Hand anthropometry in patients with carpal tunnel syndrome: a case-control study with a matched control group of healthy volunteers
Abstract
Background: The aim of this study was to perform anthropometrical measure- ments of patients’ hands with carpal tunnel syndrome (CTS) in order to evaluate if there is a correlation between CTS occurrence and hand features regarding sexual dimorphism, age and physical activity.
Materials and methods: Study sample consisted of 48 patients (33 females) and control group included 80 healthy volunteers (58 females) with no history of CTS. The following measurements were performed: the wrist circumference, length of the hand, the hand’s width, width of the wrist, thickness of the wrist, height of the hypothenar and thenar, length of the arm and forearm, circumference of the proximal phalanges and width of the digits; as well as several indexes were calculated i.e.: body mass index (BMI), shape index, digit index, wrist index, hand length/height ratio (HLH-ratio) and hand length/upper limb length ratio (HLULL-ratio).
Results: Correlation coincidences were analysed between circumferences within the hand, palm and body weight. All parameters except fingers were correlated with body weight in either gender in both groups (p < 0.05; r = 0.40–0.80); Furthermore, width of the hand was correlated with body height (p < 0.001; r = 0.56–0.71). Mean values of wrist index for CTS patients were: males: 0.8, females: 0.74 (significantly higher than in healthy individuals and indicating square shape); shape index: males 76.5, females 75.8; digit index: males 55.7, females 56.5. The calculated HLH-ratio in CTS group was: males 10.6, females 10.9; HLULL-ratio: males 23.6, females 24.9 and they did not differ significantly from healthy volunteers. Almost 90.0% of females with diagnosed CTS have BMI > 25.0 kg/m2.
Conclusions: There are significant differences in morphometrical features of the upper limbs between CTS patients and healthy individuals. Hands of patients with CTS are more massive and with ‘plumb’ fingers and square shape of the wrist. Furthermore, higher BMI values were confirmed to be predisposing factors in CTS occurrence.
Keywords: carpal tunnel syndromeanthropometryrisk factorshape indexwristhand measurements
References
- Alford JW, Weiss APC, Akelman E. The familial incidence of carpal tunnel syndrome in patients with unilateral and bilateral disease. Am J Orthop (Belle Mead NJ). 2004; 33(8): 397–400.
- Becker J, Nora DB, Gomes I, et al. An evaluation of gender, obesity, age and diabetes mellitus as risk factors for carpal tunnel syndrome. Clin Neurophysiol. 2002; 113(9): 1429–1434.
- Bongers FJM, Schellevis FG, van den Bosch WJ, et al. Carpal tunnel syndrome in general practice (1987 and 2001): incidence and the role of occupational and non-occupational factors. Br J Gen Pract. 2007; 57(534): 36–39.
- Boz C, Ozmenoglu M, Altunayoglu V, et al. Individual risk factors for carpal tunnel syndrome: an evaluation of body mass index, wrist index and hand anthropometric measurements. Clin Neurol Neurosurg. 2004; 106(4): 294–299.
- Chiotis K, Dimisianos N, Rigopoulou A, et al. Role of anthropometric characteristics in idiopathic carpal tunnel syndrome. Arch Phys Med Rehabil. 2013; 94(4): 737–744.
- Fernandes CH, Meirelles LM, Raduan Neto J, et al. Carpal tunnel syndrome with thenar atrophy: evaluation of the pinch and grip strength in patients undergoing surgical treatment. Hand (N Y). 2013; 8(1): 60–63.
- Frankenfield DC, Rowe WA, Cooney RN, et al. Limits of body mass index to detect obesity and predict body composition. Nutrition. 2001; 17(1): 26–30.
- Fujimaki Y, Kuwabara S, Sato 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(9): 1683–1686.
- Gordon C, Johnson EW, Gatens PF, et al. Wrist ratio correlation with carpal tunnel syndrome in industry. Am J Phys Med Rehabil. 1988; 67(6): 270–272.
- Hlebs S, Majhenic K, Vidmar G. Body mass index and anthropometric characteristics of the hand as risk factors for carpal tunnel syndrome. Coll Antropol. 2014; 38(1): 219–226.
- Hortobágyi T, Israel RG, O'Brien KF. Sensitivity and specificity of the Quetelet index to assess obesity in men and women. Eur J Clin Nutr. 1994; 48(5): 369–375.
- Islamov RR, Hendricks WA, Katwa LC, et al. Effect of 17 beta-estradiol on gene expression in lumbar spinal cord following sciatic nerve crush injury in ovariectomized mice. Brain Res. 2003; 966(1): 65–75.
- Jenkins PJ, Srikantharajah D, Duckworth AD, et al. Carpal tunnel syndrome: the association with occupation at a population level. J Hand Surg Eur Vol. 2013; 38(1): 67–72.
- Johnson EW, Gatens T, Poindexter D, et al. Wrist dimensions: correlation with median sensory latencies. Arch Phys Med Rehabil. 1983; 64(11): 556–557.
- Kamolz LP, Beck H, Haslik W, et al. Carpal tunnel syndrome: a question of hand and wrist configurations? J Hand Surg Br. 2004; 29(4): 321–324.
- Kaplan Y, Kurt SG, Karaer H. Carpal tunnel syndrome in postmenopausal women. J Neurol Sci. 2008; 270(1-2): 77–81.
- 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(3): 269–273.
- Komurcu HF, Kilic S, Anlar O. Relationship of age, body mass index, wrist and waist circumferences to carpal tunnel syndrome severity. Neurol Med Chir (Tokyo). 2014; 54(5): 395–400.
- Kouyoumdjian JA, Morita MP, Rocha PR, et al. Wrist and palm indexes in carpal tunnel syndrome. Arq Neuropsiquiatr. 2000; 58(3A): 625–629.
- Kouyoumdjian JA, Zanetta DMT, Morita MPA. Evaluation of age, body mass index, and wrist index as risk factors for carpal tunnel syndrome severity. Muscle Nerve. 2002; 25(1): 93–97.
- Lam N, Thurston A. Association of obesity, gender, age and occupation with carpal tunnel syndrome. Aust N Z J Surg. 1998; 68(3): 190–193.
- Loslever P, Ranaivosoa A. Biomechanical and epidemiological investigation of carpal tunnel syndrome at workplaces with high risk factors. Ergonomics. 1993; 36(5): 537–555.
- McDiarmid M, Oliver M, Ruser J, et al. Male and female rate differences in carpal tunnel syndrome injuries: personal attributes or job tasks? Environ Res. 2000; 83(1): 23–32.
- Mogk JPM, Keir PJ. Wrist and carpal tunnel size and shape measurements: effects of posture. Clin Biomech (Bristol, Avon). 2008; 23(9): 1112–1120.
- Mondelli M, Curti S, Farioli A, et al. Anthropometric measurements as a screening test for carpal tunnel syndrome: receiver operating characteristic curves and accuracy. Arthritis Care Res (Hoboken). 2015; 67(5): 691–700.
- Nathan PA, Keniston RC. Carpal tunnel syndrome and its relation to general physical condition. Hand Clin. 1993; 9(2): 253–261.
- Nathan PA, Meadows KD, Istvan JA. Predictors of carpal tunnel syndrome: an 11-year study of industrial workers. J Hand Surg Am. 2002; 27(4): 644–651.
- Papka RE, Hafemeister J, Puder BA, et al. Estrogen receptor-alpha and neural circuits to the spinal cord during pregnancy. J Neurosci Res. 2002; 70(6): 808–816.
- 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(3): 157–162.
- Sharifi-Mollayousefi A, Yazdchi-Marandi M, Ayramlou H, et al. Assessment of body mass index and hand anthropometric measurements as independent risk factors for carpal tunnel syndrome. Folia Morphol. 2008; 67(1): 36–42.
- Stevens JC, Sun S, Beard CM, et al. Carpal tunnel syndrome in Rochester, Minnesota, 1961 to 1980. Neurology. 1988; 38(1): 134–138.
- Tseng CH, Liao CC, Kuo CM, et al. Medical and non-medical correlates of carpal tunnel syndrome in a Taiwan cohort of one million. Eur J Neurol. 2012; 19(1): 91–97.
- Werner R, Armstrong TJ, Bir C, et al. Intracarpal canal pressures: the role of finger, hand, wrist and forearm position. Clin Biomech (Bristol, Avon). 1997; 12(1): 44–51.
- Werner RA, Albers JW, Franzblau A, et al. The relationship between body mass index and the diagnosis of carpal tunnel syndrome. Muscle Nerve. 1994; 17(6): 632–636.
- Zyluk A, Dabal L, Szlosser Z. [Association of anthropometric factors and predisposition to carpal tunnel syndrome]. Chir Narzadow Ruchu Ortop Pol. 2011; 76(4): 193–196.
