Syed Dil Bagh Ali Shah, Syeda Umm-e habiba Gillani, Khaliq-ur Rehman.
To Evaluate the Diagnostic Efficacy of Provocative tests in Carpal Tunnel Syndrome.
Ophthalmol Update Jan ;13(1):34-7.

Objective: To evaluate effectiveness and validity of the Phalen, Tinnel and Torniquet tests in diagnosing Carpal Tunnel Syndrome. Methodology: This descriptive interventional study was conducted in the department of Orthopaedic Rehman Medical Institute (R.M.I), Peshawar over a period of nine months May, 2009 to January, 2010. All Patients were more than 20 years and less than 70 years with Carpal Tunnel Syndrome who were not responding to non-operative measures, were included in the study. Phalen, tinnel and Tourniquet tests were performed in these patients. Moreover, electrophysiological studies (Nerve Conduction Studies) were also performed in these patients and all observations noted. Results of these tests and observations compared with per-operative findings which were taken as a gold standard. Results: The wrist flexion test (phalen) was found to be the most sensitive followed by the nerve percussion test (Tinnel). The tornique test was quite insensitive and not very specific and should not be used as a routine screening test in diagnosis of Carpal tunnel syndrome. Conclusion: wrist-flexion test (Phalen) is more sensitive among the provocative tests of Carpal tunnel syndrome. However, combination of all the provocative tests can give a better outcome in order to reach the diagnosis of Carpal Tunnel Syndrome.

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