الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Carpal tunnel syndrome is a clinical syndrome of numbness, tingling, burning and/or pain in the parts of the hand supplied by the median nerve associated with localized compression of the median nerve at the wrist. Women are almost 3 times more likely than men to develop CTS. The mean ages ranges from 40 to 60 years, only 10% of the reported cases are younger than 30 years.
Although several medical conditions such as diabetes, rheumatoid arthritis, pregnancy and renal failure are predisposing factors to this syndrome, the majority of cases are idiopathic CTS. Several studies have implicated some body, wrist and hand anthropometric measurements as risk factors for development of idiopathic CTS.
This work was carried out to identify cut off values for body, wrist and hand measurements in order to correctly identify individuals with increased risk of CTS.
Thirty patients with clinically diagnosed and electrophysiologically confirmed idiopathic CTS were enrolled as patients group and 30 age, sex and occupationally matched healthy volunteers as a control group.
Sensory and motor conduction studies of the median nerve were performed for both groups. These studies were performed to confirm presence of CTS in clinically diagnosed patients, to assess the severity of the disorder and to exclude presence of subclinical CTS in healthy subjects who were included as a control group.
Body, wrist and hand anthropometric measurements (weight, height, waist circumference, hip circumferences, wrist depth/width, third digit length, palm length/width and hand length) were measured from both groups. Thereafter, obesity indicators (body mass index, waist to hip ratio) and wrist/hand ratios (wrist ratio, hand ratio, shape index, wrist to palm ratio) were calculated. Area under the ROC curve (AUC), confidence intervals (CI), cutoff values, sensitivity and specificity were statistically calculated separately for each measured parameter.
There were statistically significant differences between patient and control groups regarding all obesity indices, wrist and hand anthropometric measurements. All studied patients were overweight and obese having more squarer wrists with shorter and wider hands in comparison to the control group.
The AUC of the cutoff values for all studied body, wrist and hand measurements showed high level of accuracy (AUC<95) except for hip circumference, waist to hip ratio, palm length, third digit length and digit index which showed moderate level of accuracy (AUC= 0.75–0.95). The cutoff value of wrist ratio (> 0.46) was the only value that had the highest level of accuracy (AUC= 1.000) compared with the other measured anthropometric parameters.
Also, there were significant positive correlations between BMI, wrist depth, wrist ratio and shape index with electrophysiological severity grading of CTS of the studied patients. On the other hand, palm length, hand length and hand ratio had significant negative correlations.
Finally, it was concluded that certain personal anthropometric measurements are associated with the development and severity of CTS.
Therefore, the cutoff values for body, wrist and hand anthropometric measurements (especially wrist ratio) can be used as assistive clinical predictive tools to identify individuals with increased risk of CTS