Highlights
- •Certain anatomic variations such as body mass index (BMI), wrist ratio (WR), wrist to palm ratio (WPR), shape index (SI) may be accounted for as CTS risk factors.
- •BMI & WPR was significantly higher in patients with CTS than controls for both genders.
- •WR was significantly higher in both CTS males and females when compared to the healthy male and female controls.
- •No significant difference was found in the SI between CTS male patients and control male groups.
Abstract
Study design
Systematic literature review of case-controlled studies.
Introduction
Carpal tunnel syndrome (CTS) is one of the most common tubular neuropathies where
certain anatomical variations may be accounted for as risk factors for CTS, including
body mass index (BMI), wrist ratio (WR), wrist to palm ratio (WPR), shape index (SI),
and digit length.
Purpose of the Study
To assess case-control studies examining the association between specific anatomical
variations of the wrist as risk factors for developing CTS and whether this effect
is the same for both genders.
Methods
The literature search was conducted between February-June 2020 through PubMed, Cochrane
Library, CINAHL Plus and PEDro. The literature search yielded 149 potential publications,
fifteen of which were filtered in accordance with eligibility criteria. The methodological
quality was assessed by using the Newcastle-Ottawa Quality Assessment Form for Case-Control
Studies (NOS).
Results
The total number of subjects included in this review was n=4299. The largest sample
was n=1117 participants and the smallest n=54. All studies included patients who had
a clinical diagnosis of CTS confirmed with nerve conduction studies and or ultrasonography.
CTS was significantly higher in patients with higher BMI, WR, WPR compared to control
groups. BMI and WR were the only indicators that can be considered as strong risk
factors.
Conclusions
Discussion: Despite the general patterns on the association of BMI, WPR, WR and SI as risk factors
for the development of CTS, there were exceptions to the accepted results and conclusions.
Conclusion: Clinicians are recommended to conduct more research to confirm anthropometric measurements
as risk factors for the development of CTS, mainly SI and WPR. When determining the
cut-off values for BMI and WR, it is recommended to take into account additional risk
factors such as occupation.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Hand TherapyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Entrapment neuropathies: a contemporary approach to pathophysiology, clinical assessment, and management.Pain Rep. 2020; 5: e829https://doi.org/10.1097/PR9.0000000000000829
- Carpal tunnel syndrome: clinical features, diagnosis, and management.Lancet Neurol. 2016; 15: 1273-1284https://doi.org/10.1016/S1474-4422(16)30231-9
- Prevalence of carpal tunnel syndrome in a general population.JAMA. 1999; 282: 153-158https://doi.org/10.1001/jama.282.2.153
- Carpal tunnel syndrome: diagnosis and management.Am Fam Physician. 2016; 94: 993-999
- https://doi.org/10.1016/B978-0-7216-9491-7.50062-4.
- Carpal Tunnel Syndrome.Pain Management. 2nd. WB Saunders, Elsevier, Philadelphia2007
- The prevalence of pronator teres among patients with carpal tunnel syndrome: cross-sectional study.Int J Biomed Sci: IJBS. 2016; 12: 89-94
- Pronator teres syndrome.StatPearls. 2021;
- Focal peripheral neuropathies.Electrodiagnostic medicine. 2nd. Hanley & Belfus, Philadelphia2002
- Occupational risk factors for carpal tunnel syndrome.MOJ Orthop Rheumatol. 2016; 4: 00131
- Mutations in COMP cause familial carpal tunnel syndrome.Nat Commun. 2020; 11: 3642https://doi.org/10.1038/s41467-020-17378-z
- Prevalence and incidence of carpal tunnel syndrome in US working populations: pooled analysis of six prospective studies.Scand J Work Environ Health. 2013; 39: 495-505https://doi.org/10.5271/sjweh.3351
- Sex-related differences in carpal arch morphology.PLoS One. 2019; 14e0217425https://doi.org/10.1371/journal.pone.0217425
- Attributable risk of carpal tunnel syndrome according to industry and occupation in a general population.Arthritis Rheum. 2008; 59: 1341-1348https://doi.org/10.1002/art.24002
- Physiotherapy evidence database (PEDro).J Med Libr Assoc. 2006; 94: 477-478
- PEDro scale.Neurosci Res Australia. 2021;
- Accessed from https://pedro.org.au/ [Accessed 18 March 2020].
- The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: a systematic review.J Evid Based Med. 2015; 8: 2-10https://doi.org/10.1111/jebm.12141
- Benzodiazepine use and risk of dementia in the elderly population: a systematic review and meta-analysis.Neuroepidemiology. 2016; 47: 181-191https://doi.org/10.1159/000454881
- Individual risk factors for carpal tunnel syndrome: an evaluation of body mass index, wrist index and hand anthropometric measurements.Clin Neurol Neurosurg. 2004; 106: 294-299https://doi.org/10.1016/j.clineuro.2004.01.002
- Carpal tunnel syndrome: a question of hand and wrist configurations?.J Hand Surg Br. 2004; 29: 321-324https://doi.org/10.1016/j.jhsb.2003.09.010
- An evaluation of gender, body mass index, wrist circumference and wrist ratio as independent risk factors for carpal tunnel syndrome.Acta Neurol Scand. 2005; 112: 375-379https://doi.org/10.1111/j.1600-0404.2005.00528.x
- The role of wrist anthropometric measurement in idiopathic carpal tunnel syndrome.J Hand Surg Eur. 2008; 33: 645-647https://doi.org/10.1177/1753193408093326
- Assessment of body mass index and hand anthropometric measurements as independent risk factors for carpal tunnel syndrome.Folia Morphol. 2008; 67: 36-42
- Role of anthropometric characteristics in idiopathic carpal tunnel syndrome.Arch Phys Med Rehabil. 2013; 94: 737-744https://doi.org/10.1016/j.apmr.2012.11.017
- Body mass index and anthropometric characteristics of the hand as risk factors for carpal tunnel syndrome.Coll Antropol. 2014; 38: 219-226
- The relationship between waist circumference, wrist circumference, and body mass index in carpal tunnel syndrome.Journal of Turgut Ozal Medical Center. 2015; 22: 152-157
- Associations between body anthropometric measures and severity of carpal tunnel syndrome.Arch Phys Med Rehabil. 2016; 97: 1456-1464
- Hand anthropometry in patients with carpal tunnel syndrome: a case-control study with a matched control group of healthy volunteers.Folia Morphol (Warsz). 2019; 78: 182-190https://doi.org/10.5603/FM.a2018.0049
- High wrist ratio is a risk factor for carpal tunnel syndrome.Clin Anat. 2018; 31: 698-701https://doi.org/10.1002/ca.23198
- Physical ergonomic risk factors of carpal tunnel syndrome among rubber tappers.Arch Environ Occup Health. 2020; 75: 1-9https://doi.org/10.1080/19338244.2018.1507991
- Study of wrist ratio and wrist-to-palm index radio in individuals suffering from carpal tunnel syndrome.Ann Indian Acad Neurol. 2019; 22: 159-163https://doi.org/10.4103/aian.AIAN_343_18
- Prevalence and risk factors of carpal tunnel syndrome in japanese aged 50 to 89 years.J Hand Surg Asian Pac. 2020; 25: 320-327https://doi.org/10.1142/S2424835520500356
- Association of the role of personal variables and nonoccupational risk factors for work-related carpal tunnel syndrome.Cent Eur J Public Health. 2020; 28: 274-278https://doi.org/10.21101/cejph.a6109
- Is carpal tunnel syndrome caused by work with vibrating tools?.Occup Med (Lond). 2020; 70: 8-10https://doi.org/10.1093/occmed/kqz142
- Carpal tunnel syndrome: a review of literature.Cureus. 2020; 12: e7333https://doi.org/10.7759/cureus.7333
- Wrist dimensions: correlation with median sensory latencies.Arch Phys Med Rehabil. 1983; 64: 556-557
Article info
Publication history
Published online: July 08, 2022
Accepted:
March 10,
2022
Received in revised form:
December 3,
2021
Received:
May 23,
2021
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
