Đánh giá giá trị chẩn đoán sớm hội chứng ống cổ tay của nghiệm pháp ngón 4

Abstract

Objective: (1) To describe the clinical characteristics and the positive rate of the digit 4 test in patients with mild carpal tunnel syndrome (CTS) according to the Boston Carpal Tunnel Questionnaire (BCTQ). (2) To analyze the relationship between clinical symptoms and the results of the digit 4 test in the study group. Subject and method: The study included 63 patients (81 hands) with mild CTS according to the BCTQ, all of whom had normal median nerve conduction studies. Patients were examined at the 108 Military Central Hospital between February 2025 and June 2025. Result: The age group 40-59 years accounted for the highest proportion (55.6%); females were more common than males (73%). The most frequent occupation was housework (34.9%). The majority had symptom duration of 1-3 months (76.2%). Right-hand symptoms were present in 41.3% of cases. Clinical features included numbness of digits 1, 2, and 3 (60.49%), numbness while riding a motorbike or using a phone (62.96%), nocturnal numbness (55.56%), tingling or “ants crawling” sensation in the hand (58.02%), but no muscle weakness (0%) or thenar atrophy (0%). Tinel’s sign was positive in 35.8% and Phalen’s test in 59.26%. The digit 4 test was positive in 66.7%. A significant association was found between positive digit 4 test and clinical symptoms (p<0.05). Conclusion: A high rate of positive digit 4 test indicates that this technique has potential in detecting early median nerve lesions, even when standard median nerve conduction remains normal. Therefore, the digit 4 test should be considered for routine application in the early diagnosis of carpal tunnel syndrome. This method is simple, non-invasive, low-cost, yet provides valuable diagnostic utility.