臨床整形外科55巻10号

2020年10月発行

臨床経験

電気生理学的重症度別での手根管開放術後1年におけるCTSI-JSSHの変化

著者： 金谷貴子¹ 原田義文¹ 高瀬史明¹ 名倉一成²

所属機関： ¹神戸労災病院整形外科 ²赤穂市民病院整形外科

ページ範囲：P.1155 - P.1159

背景：手根管開放術後の手根管症候群自記式質問表日本手外科学会版CTSI-JSSHの変化を検討した．

対象と方法：238手を電気生理学的重症度に分類し(Stage1〜5)，重症度スコア(SS)と機能的状態のスケール(FS)回復を術前・術後1年で比較した．

結果：全StageでSS，FSは術後改善し，Stage2〜5では有意であった．Stage間の比較では術前の差はなかったが，術後Stage3，4-Stage5間にSS，FSの有意差を認めた．

まとめ：術後1年にCTSI-JSSHの改善がみられ，手根管開放術による治療効果が確認できた．

参考文献

1) 金谷貴子，藤岡宏幸，山崎京子・他．手根管症候群における短母指外転筋終末潜時と感覚神経伝導速度の関係について．末梢神経2006；17(2)：280-2．

2) 金谷貴子，藤岡宏幸，黒坂昌弘・他．手根管開放術後における電気生理学的回復について．末梢神経2007；18(2)：225-7．

3) 金谷貴子，藤岡宏幸，黒坂昌弘・他．手根管開放術後における電気生理学的回復および臨床症状改善との関連について．臨整外2011；46(7)：637-41．

4) Kanatani T, Nagura I, Kurosaka M et al. Electrophysiological assessment of carpal tunnel syndrome in elderly patients:one year follow-up study. J Hand Surg Am 2014;39(11):2188-91.

5) 手の機能評価表第4版．日本手外科学会．2006．p.14-5．http://www.jssh.or.jp/doctor/jp/publication/kinouhyouka4th.html

6) Fajardo M, Kim SH, Szabo RM. Incidence of carpal tunnel release:Trends and implications within the united states ambulatory care setting. J Hand Surg Am 2012;37(8):1599-605.

7) Phalen GS. The carpal-tunnel syndrome. Clinical evaluation of 598 hands. Clin Orthop Relat Res 1972;83:29-40.

8) Bickel KD. Carpal tunnel syndrome. J Hand Surg Am 2010;35(1):147-52.

9) Graham B. The value added by electrodiagnostic testing in the diagnosis of carpal tunnel syndrome. J Bone Joint Surg Am 2008;90(12):2587-93.

10) Bland JD. Do nerve conduction studies predict the outcome of carpal tunnel decompression? Muscle Nerve 2001;24(7):935-40.

11) Chan L, Turner JA, Comstock BA, et al. The relationship between electrodiagnostic findings and patient symptoms and function in carpal tunnel syndrome. Arch Phys Med Rehabil 2007;88(1):19-24.

12) Levine DW, Simmons BP, Koris MJ, et al. A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am 1993;75(11):1585-92.

13) Imaeda T, Uchiyama S, Toh S, et al. Validation of the Japanese Society for Surgery of the Hand version of the Carpal Tunnel Syndrome Instrument. J Orthop Sci 2007;12(1):14-21.

14) Kim JK, Jeon SH. Minimal clinically important differences in the Carpal Tunnel Questionnaire after carpal tunnel release. J Hand Surg Eur Vol 2013;38(1):75-9.

15) 栗本　秀．手根管症候群の臨床評価法と身体所見．MB Orthopaedics 2020；33(4)：13-22．

16) Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure:the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med 1996;29(6):602-8.

17) ￥Beaton DE, Wright JG, Katz JN, et al. Development of the QuickDASH:comparison of three item-reduction approaches. J Bone Joint Surg Am 2005;87(5):1038-46.

18) Imaeda T, Toh S, Nakao Y, et al. Validation of the Japanese Society for Surgery of the Hand version of the Disability of the Arm, Shoulder, and Hand questionnaire. J Orthop Sci 2005;10(4):353-9.

19) Imaeda T, Toh S, Wada T, et al. Validation of the Japanese Society for Surgery of the Hand Version of the Quick Disability of the Arm, Shoulder, and Hand (QuickDASH-JSSH) questionnaire. J Orthop Sci 2006;11(3):248-53.

20) Uchiyama S, Imaeda T, Toh S, et al. Comparison of responsiveness of the Japanese Society for Surgery of the Hand version of the carpal tunnel syndrome instrument to surgical treatment with DASH, SF-36, and physical findings. J Orthop Sci 2007;12(3):249-53.