b Starting from abduction through full palmar abduction to flexion. The Kapandji score (Kapandji, 1986) is. AAOHN J. Most of these were about 0.05–0.06 using the gyroscope, optical motion capture, and goniometer [41,42,43], and almost all the results of our study were similar values. Disclaimer. We were able to measure the thumb pronation and palmar abduction angles using the three-axis gyroscope, and this tool was able to detect impairments of thumb opposition due to carpal tunnel syndrome. Article  All patients were evaluated by one of four hand surgeons at our hospital taking a medical history and performing physical examination, including assessment of the Tinel-like sign, Phalen test, presence/absence of thenar muscle atrophy, grip strength (grasp power), Kapandji score, visual analog scale (VAS), and Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) score. First, by miniaturization of gyroscopes, we succeeded in measuring the thumb pronation angle, which had not been previously measured with a gyroscope. Acta Neurol Scand. Methods Fifteen patients (10 male and 5 female patients with an average age of 40 years old) were treated by the modified Sauve-Kapandji procedure from January 2014 to April 2016. Therefore, we demonstrated that MRI is particularly useful in assessment of the thenar muscles, and information regarding the correlation between thenar muscle thinness on MRI and electrodiagnostic studies may help in diagnosing and evaluating the severity of CTS, particularly if the clinical findings are equivocal. J Hand Surg Asian Pac Vol. The physical examination showed moderate or severe thenar atrophy in 15 hands, and muscle strength less than good in 13 hands. P<0.05 was considered to indicate a statistically significant difference. The https:// ensures that you are connecting to the Your privacy choices/Manage cookies we use in the preference centre. reported that the pronation angles were 56° and 57° respectively [36, 37]. The most significant factor contributor to the hand’s function is opposition [6, 7]. Bourrel's angle between the tip of the thumb and the fourth digit decreased from 75.75 ± 3.45 degrees to 36.96 ± 3.68 degree. 1Department of Orthopaedics, Juntendo University School of Medicine, Tokyo 113-8421, Japan, 2Department of Orthopaedics, Srinakharinwirot University, Nakhon Nayok 26120, Thailand, 3Department of Orthopaedic Surgery, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo 136-0075, Japan. The improvement of pronation is often used as one of the evaluation items of the opponensplasty method for severe carpal tunnel syndrome. Further prospective research is needed to better understand the correlations of MRI thenar muscle parameters with postoperative outcomes and such information may be useful for predicting functional recovery of the thenar muscles after decompression surgery and aid in deciding on surgical intervention, because some authors have reported that the thenar muscles show satisfactory recovery after carpal tunnel decompression alone even in severe CTS (2), but others have reported unsatisfactory postoperative recovery in patients with severe CTS and recommend single-stage tendon transfer (25–27). The Kapandji score is a tool useful for assessing the opposition of the thumb, based on where on their hand the patient is able to touch with the tip of their thumb. Q-DASH, Quick Disabilities of the Arm, Shoulder and Hand; APB, abductor pollicis brevis; DML, distal motor latency; SCV, sensory conduction velocity; CTS, carpal tunnel syndrome. Download scientific diagram | Kapandji thumb opposition scores. The mean grasp power, Kapandji score, VAS, and Q-DASH score were 20.6±7.4, 9.5±0.5, 4.6±2.3 and 37.8±20.5 kg, respectively (Table I). J Hand Surg Am. 2). Brain atrophy and trunk stability during dual-task walking among older adults. 2014;26:997–1002. Convergent and divergent validity were assessed with the Spearman correlation coefficient. All of the patients had clinical evidence of CTS (Tinel-like sign positive/negative in 15/2, Phalen test positive/negative in 11/6, thenar muscle atrophy present/absent in 15/2). Previous studies of CTS and rotator cuff disorders have shown that muscle atrophy and decreased muscle volume on MRI may indicate irreversible damage (9,12,13), but there have been no investigations of the correlations between muscle morphology, clinical findings, and electrodiagnostic studies. Correspondence to Individual changes in the score had the best correlation (r(s)=.51) with overall patient satisfaction. Provided by the Springer Nature SharedIt content-sharing initiative. Hence, we considered that our method to measure the thumb pronation three-dimensionally using a gyroscope is sufficiently reliable. 2016;41:632–7. Moreover, it seem to be associated with better results at MRI like absence of I ray decalage and minor scaphoid subchondral oedema at final follow-up. statement and It was easy, quick, and non-invasive. Participants were instructed to oppose their thumb by drawing as large a semicircle as possible and to move their thumb five times in 45 s. The angles of rotation and inclination of each bone axis were measured during five continuous reciprocating opposition movements, which were from the position of full radial abduction through full palmar abduction to full flexion of the MP and interphalangeal joints (Fig. The mean age was 68.8±8.7 years (range, 52–80) and the mean body mass index (BMI) was 23.1±3.3 kg/m2. Kapandji scores are widely used to evaluate thumb opposition in clinical practice [20, 45,46,47,48,49,50,51,52]. 2009;95:63–9. Tech Hand Up Extrem Surg. 2021 Sep;16(5):686-693. doi: 10.1177/1558944719878846. Previous studies of CTS have shown that thenar muscle atrophy on MRI may indicate irreversible muscle damage (9,11), but the prior investigations did not assess the correlations between MRI thenar muscle parameters and clinical findings or the results of elctrodiagnostic studies. Thumb function and electromyography result after modified Camitz tendon transfer. Guzzini, M., Perugia, D., Proietti, L. et al. Correlation of the thenar muscle major axis with clinical data (grasp power, Kapandji score, and Q-DASH score) and electrodiagnostic variables (APB-DML, SCV, and Kanatani's stage) in CTS patients. In group B, six hands (17.6%) reported a Kapandji score of 8 and 28 patients (82.4%), a Kapandji score of 10 (p < 0.05). Kanatani T, Fujioka H, Kurosaka M, Nagura I, Sumi M. Delayed electrophysiological recovery after carpal tunnel release for advanced carpal tunnel syndrome: A two-year follow-up study. The thumb is vitally important for hand function and accounts for 40–50% of hand function [1,2,3,4,5]. Article  The reason for recruiting patients who underwent total hip arthroplasty for the control group was that these patients underwent routine X-ray of the hand preoperatively to assess the effect on T cane use; therefore, additional radiation exposure was unnecessary. MRI of the wrist. Inclusion in an NLM database does not imply endorsement of, or agreement with, Setting: Correspondence to However, this effect should have reduced the measured angle, thereby making it more difficult to obtain any significant outcome. Medical Research Council Special Report Series. We recruited 16 patients with CTS and thenar atrophy before surgery (CTS group, 27 hands) and 16 healthy volunteers (control group, 32 hands) between June 2017 and June 2018. 2003 Aug;19(3):471-81. doi: 10.1016/s0749-0712(03)00004-0. J Biomech. Previous studies have evaluated the pronation angle of the first metacarpal bone using CT in healthy volunteers and yielded various values for the average pronation angle. 2014;39:632–6. The 50 patients in the validity study were evaluated twice, before and after surgery, at a mean interval +/- standard deviation of 7.16+/-2.10 months (range, 6-15mo). J Burns Wounds. 2014;472:2526–33. volume 43, pages 647–651 (2019)Cite this article. MRI demonstrated that the thenar muscles volume, thenar muscle major axis, and thenar muscle minor axis were 8.3±3.9 cm3, 50.8±4.5, and 10.0±3.0 mm, respectively. This study was approved by the medical research ethics committee of our university and informed consent was obtained from all patients. Hand strengths in carpal tunnel syndrome. J Phys Ther Sci. A new method of measuring the thumb pronation and palmar abduction angles during opposition movement using a three-axis gyroscope. Goubier JN, Teboul F. Management of hand palsies in isolated C7 to T1 or C8, T1 root avulsions. During measurement, the examiner maintained the participant’s wrist and MP joint of fingers in a stationary position. The MKI has excellent validity and reliability. and responsiveness of the modified Kapandji index for assessment of functional mobility of the rheumatoid hand Arch Phys Med Rehabil. The Kapandji score (Kapandji, 1986) is used to measure thumb opposition by referring to points on the hand itself rather than measuring angles. 1987;69:896–903. Your US state privacy rights, PubMed Google Scholar. We attached a small gyroscope to the thumb metacarpal and measured the pronation and palmar abduction angles at each position of the Kapandji score in both groups. As the CTS group, patients were included if they were primarily diagnosed with CTS and planned to undergo carpal tunnel release. This article about Orthopedic surgery is a stub. Four representative examples of transition graphs. TK performed all experiments and analyses and prepared the first draft of the paper. PubMed  Lewis E, Fors L, Tharion WJ. First, we investigated the clinical profile of the patients with CTS. 2000 Oct;13(5):296-303. doi: 10.1002/1529-0131(200010)13:5<296::aid-anr9>3.0.co;2-f. J Hand Surg Am. Quantifying thumb rotation during circumduction utilizing a video technique. Abb. After excluding the first and last opposition movements from the five repeated measurements, we considered the average of these values as the range of motion during one opposition movement. Baker NA, Moehling KK, Desai AR, Gustafson NP. First, we investigated the reliability of measuring the thumb pronation and palmar abduction angles using a small sensor with a three-axis gyroscope and accelerometer. Bookshelf https://doi.org/10.1016/j.jhsa.2016.07.089, Article  By mounting the full hand assist system on the dummy hand, it is possible to perform the Kapandji Test to evaluate position control of the assisted thumb. Unable to load your collection due to an error, Unable to load your delegates due to an error. Holl S, Blum A, Gosheger G, Dieckmann R, Winter C, Rosenbaum D. Clinical outcome and physical activity measured with StepWatch 3 Activity Monitor after minimally invasive total hip arthroplasty. Data regarding age and the motion angle are presented as the median with an interquartile range. Intra-articular botulinum toxin A for base-of-thumb osteoarthritis: protocol for a randomised trial (RHIBOT). PLoS One. 2018;43:8–15. All the participants were female. J Biomech. 1993;75:1585–92. The mean age was 51 years (range, 31 to 71 years, SD=12.8) and