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A Békésy audiometer was modified for use in analysis of vibrotactile sensibility of
the hand at frequencies ranging from 8 to 500 Hz. In control subjects the “digital
vibrogram” has a typical shape, which differs characteristically in patients with
carpal tunnel syndrome (CTS). Changes in digital vibrogram usually parallel or precede
abnormalities in neurophysiologic tests, and appear long before changes in two-point
discrimination (2PD). One-hundred-thirty-two hands of 76 patients diagnosed as having
CTS were tested with a vibrometer. Of 113 hands with normal 2PD, the digital vibrogram
showed abnormal in 86 cases. Of 19 hands with abnormal 2PD, the digital vibrogram
showed abnormal in all but three cases. Twenty-six hands with neurophysiologically
normal appearance had abnormal digital vibrogram in 14 cases, while 53 hands neurophysiologically
classified as CTS showed abnormal digital vibrogram in 44 cases. It is concluded that
the digital vibrogram is a useful tool for early diagnosis of CTS.
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References
- Objective methods for determining the functional value of sensibility in the hand.J Bone Joint Surg [Br]. 1958; 40: 454-476
- Critisism and study of methods for examining sensibility in the hand.Neurology. 1962; 12: 8-19
- Methods for examining sensibility of the hand.in: Flynn SE Hand surgery. Williams & Wilkins, Baltimore1966: 435-449
- Clinical use of vibratory stimuli to evaluate peripheral nerve injury and compression neuropathy.Plast Reconstr Surg. 1980; 65: 466-476
- Carpal tunnel syndrome.Results of a prospective trial of steroid injection and splinting. J Bone Joint Surg [Am]. 1980; 62: 1181-1184
- Sensibility testing in patients with carpal tunnel syndrome.J Bone Joint Surg [Am]. 1984; 66: 60-64
- Sensibility testing in peripheral nerve compression syndromes.An experimental study in humans. J Bone Joint Surg [Am]. 1983; 65: 632-638
- Spontaneous compression of the median nerve at the wrist.JAMA. 1951; 145: 1128-1133
- The carpal tunnel syndrome.Seventeen years' experience in diagnosis and treatment of six hundred fifty-four hands. J Bone Joint Surg [Am]. 1966; 48: 211-228
- The carpal tunnel syndrome.Clinical evaluation of 598 hands. Clin Orthop. 1972; 83: 29-40
- Carpal tunnel syndrome and its variants.Surg Clin North Am. 1968; 48: 1097-1112
- Clinical and electrodiagnostic features of carpal tunnel syndrome.Arch Phys Med. 1968; 49: 371-375
- Chronic nerve compression and entrapment.in: Sumner AJ The physiology of peripheral nerve disease. WB Saunders Co, Philadelphia1980: 316-339
- Nerve fiber pathology in acute and chronic compression.in: Omer JE Spinner M Management of peripheral nerve problems. WB Saunders Co, Philadelphia1980: 487-501
- The nerve lesion in the carpal tunnel syndrome.J Neurol Neurosurg and Psych. 1976; 39: 615-626
- The intrinsic vascularization of human peripheral nerves.Structural and functional aspects. J Hand Surg. 1979; 4: 34-41
- Median nerve compression in the carpal tunnel - functional response to experimentally induced controlled pressure.J Hand Surg. 1982; 7: 252-259
- Effects of graded compression on intraneural blood flow.J Hand Surg. 1981; 6: 3-12
- Nerve compression injury and increase in endoneurial fluid pressure: A “miniature compartment syndrome”.J Neurol Neurosurg Psychiatry. 1983; 46: 1119-1124
- The carpal tunnel syndrome.A study of carpal canal pressures. J Bone Joint Surg [Am]. 1981; 63: 380-383
- Evaluation of sensibility and reeducation of sensation in the hand. Williams & Wilkins, Baltimore1981
- Vibratory sensory testing in acute peripheral nerve compression.J Hand Surg. 1985; 9A: 104-109
- Response of rapidly and slowlyadapting mechanoreceptors and vibratory sensitivity in human hairy skin.Pfluegers Arch. 1977; 368: 39-44
- A neural base for the sense of flutter-vibration.Science. 1967; 155: 597-600
- Physiology of sensory receptors: Introduction to sensory processes.in: Mountcastle VB Medical physiology. ed 12. The CV Mosby Co, St Louis1968: 1345-1371
- The vibratory sensation in diseases of the nervous system.Am J Med Sci. 1922; 164: 715-727
- Tactile sensory coding in the glabrous skin of the human hand.TINS. 1983; 6: 27-32
- Neural basis of the sense of flutter-vibration.Science. 1967; 155: 597-600
- Spatial properties of the population of mechanoreceptive units in the glabrous skin of the human hand.Brain Res. 1980; 184: 353-366
- Detection of tactile stimuli.Thresholds of afferent units related to psychophysical thresholds in the human hand. J Physiol (London). 1979; 297: 405-422
- Sensitivity to edges of mechanoreceptive afferent units innervating the glabrous skin of the human hand.Brain Res. 1982; 244: 27-32
- Cortical neuronal mechanisms in flutter-vibration studied in unanesthetized monkeys.Neuronal periodicity and frequency discrimination. J Neurophysiol. 1969; 32: 452-484
- Sensory recovery after nerve repair.Hand. 1970; 2: 7-9
- Sensory evaluation after median nerve repair.Hand. 1971; 3: 101-111
- Neurographic studies before, after and during operation for median nerve compression in the carpal tunnel.Scand J Plast Reconstr Surg. 1971; 5: 103-109
- Intraoperative changes in motor nerve conduction latency in carpal tunnel syndrome.J Hand Surg. 1978; 3: 77-81
Article info
Publication history
Accepted:
January 10,
1986
Received:
November 15,
1985
Footnotes
+Supported by grants from the Swedish Medical Research Council, No. 5188, the Swedish Work Environmental Fund, and the University of Lund.
++Presented at the Fortieth Annual Meeting of the American Society for Surgery of the Hand, Las Vegas, Nevada, January, 1985.
Identification
Copyright
© 1986 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
