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首页> 外文期刊>Hand >A Clinical Scoring System for Distinguishing Patients With Coincident Cubital Tunnel Syndrome Among Patients With Carpal Tunnel Syndrome
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A Clinical Scoring System for Distinguishing Patients With Coincident Cubital Tunnel Syndrome Among Patients With Carpal Tunnel Syndrome

机译：腕管综合征患者重合职核电综合征患者区分临床评分系统

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Background: Coincident carpal and cubital tunnel syndromes present a diagnostic challenge, exacerbated by the limitations of nerve conduction study (NCS) for confirming cubital tunnel syndrome. This study develops a diagnostic scoring system, the Koh-Benhaim (KB) score, to identify patients with coincident compression neuropathies. Methods: A retrospective review of 515 patients was performed from patients surgically treated for carpal and/or cubital tunnel release. These patients were divided as patients with isolated carpal tunnel syndrome (n = 337) or coincident carpal and cubital tunnel syndromes (n = 178), then characterized according to demographics, medical history, physical examination, and NCS results. Univariate and multivariate logistic regression identified predictors of coincident neuropathy. A clinical score was constructed by integerizing regression coefficients of predictive factors. Receiver operating characteristic (ROC) curves were generated for each iteration of the score. Sensitivities, specificities, and positive and negative predictive values were calculated to identify the best cutoff value. Results: Decreased intrinsic muscle strength, decreased ulnar sensation, positive elbow flexion test, positive cubital tunnel Tinel’s sign, and abnormal NCS result were selected. The cutoff value for high risk of coincident compression was 3 points: positive predictive value, 82.9% and specificity, 93.4%. Model performance was very good—ROC area under the curve of 0.917. Conclusions: A KB score of 3 or greater represents high risk of coincident cubital tunnel compression. The variables involved are routinely used to assess the cubital tunnel, and all component factors of the KB score were of equivalent clinical weight in assessing patients with potential coincident compression neuropathy.
机译：背景：重合的腕骨和肘管综合征提出了诊断挑战，通过神经传导研究（NCS）的局限性来确认职核综合征的局限性。本研究开发了诊断评分系统，KOH-BENHAIM（KB）得分，以鉴定患者重合压缩神经病患者。方法：对515名患者进行回顾性审查，从手术治疗腕管和/或秘隧释放。这些患者分为分离的腕管综合征（n = 337）或重合的腕管综合征（n = 178），然后根据人口统计，病史，体检和NCS结果表征。单变量和多变量逻辑回归鉴定了一致神经病变的预测因子。通过整理预测因子的回归系数构建临床评分。为每次迭代产生接收器操作特征（ROC）曲线。计算敏感性，特异性和正负预测值，以识别最佳截止值。结果：缩短了内在肌肉力量，尺寸下降，尺肘屈曲试验，正肘隧道癣和异常NCS结果。重合压缩的高风险的截止值为3点：阳性预测值，82.9％和特异性，93.4％。模型性能在0.917的曲线下非常好的ROC区域。结论：KB得分为3或更大代表巧合肘管压缩的高风险。所涉及的变量通常用于评估职隧道，KB评分的所有组分因子在评估潜在一致压缩神经病变的患者方面是等同的临床体重。

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