American Society for Peripheral Nerve

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Recovery of Monofilaments Testing in the Ring and Small Fingers
after Surgical Decompression of Carpal Tunnel Syndrome
Carlos Henrique Fernandes, MD; Giuseppe De Luca Jr, MD; Giselly Veríssimo de Miranda, MD; Luiz Guilherme de Saboia Lenzi, MD; Lia Meirelles, OT; João Baptista Santos, MD
Universidade Federal de São Paulo, Sao Paulo, Brazil

Introduction: Carpal Tunnel Syndrome is the most frequent upper extremity compression pathology. Monofilament testing diminishes occur in the median never trajectory in the patients with carpal tunnel syndrome. However, some patients present this sensitivity alteration in the ulnar border of the ring finger and throughout the small finger. Some hypothesize that these patients some degree of associated ulnar compression, justifying such an abnormality.

Objective: Compare the evolution of abnormal sensibility evaluated through monofilaments testing in the ring and small fingers in patients with carpal tunnel syndrome, both in the pre- and post-operative follow-up.

Material and Methods: Out of 340 patients with carpal tunnel syndrome, 41 fingers of 24 patients (7%) presented diminished sensibility of the ring and small fingers through monofilament testing. 84% of patients were women with an average of 52.1 years old. In 80% of cases, the right hand was affected. Patients follow-up were evaluated in the pre and post-operative in the first, third, and sixth months.

Results: After surgical treatment, improvement of the monofilament testing in the ring and small fingers was observed in 14 fingers (34.1%) in the first month, in 21 fingers (51.2%) in the third month, and in 32 fingers (78%) in the sixth month.

Discussion: Clinical occurrences of concomitant compressions of the ulnar and median nerves are not frequent. However, some literature shows this sensibility alteration in carpal tunnel syndrome. The different sensibility improvement percentages may result from different neurological compression periods, causing differing ischemic consequences.

Conclusion: During the follow-up, there was a gradual sensibility return in the ring and small fingers after carpal tunnel syndrome surgical treatment, as measured by monofilament testing.

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