Carpal tunnel syndrome – current controversies

Raja, Senthooran; Carlos, Adrian

doi:10.1016/j.mporth.2015.08.001

Cited by 7 publications

(10 citation statements)

References 32 publications

(26 reference statements)

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“…Carpal tunnel syndrome (CTS) is the entrapment neuropathy of the median nerve due to the increased pressure in the carpal tunnel. It is the most common chronic compression neuropathy of the peripheral nerves, with a prevalence of 4% in the general population (1). Increasing pain at nights and paraesthesia in the area of the hand innervated by the median nerve are the most characteristic complaints (2).…”

Section: Introductionmentioning

confidence: 99%

“…Conventional surgical treatment of CTS is usually performed with standard open technique, limited incision and endoscopic procedures (4). Surgical decompression of the carpal tunnel with a longitudinal incision results in a minimal rate of complications (1). However, carpal tunnel release via standard open surgery has been reported to result in delayed wound healing, scar tissue sensitivity, pillar pain and late return to work (1,(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

“…Surgical decompression of the carpal tunnel with a longitudinal incision results in a minimal rate of complications (1). However, carpal tunnel release via standard open surgery has been reported to result in delayed wound healing, scar tissue sensitivity, pillar pain and late return to work (1,(5)(6)(7). Mini open palmar incisions, mini open transverse wrist incisions and endoscopic procedures allow for faster wound healing and return to work whereas scar tissue sensitivity and pillar pain will be still present (5,7,8,9) and endoscopic procedures have led to incomplete release of the flexor retinaculum and iatrogenic nerve injuries (10)(11)(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

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Carpal Tunnel Release with a Minimally Invasive Surgical Approach at the Proximal of the Distal Wrist Crease: The Evaluation of the Efficacy of the Technique with Clinical and Magnetic Resonance Imaging

Yılmaz¹

2019

btd

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Amaç: Karpal tünel sendromunun cerrahi tedavisi çoğunlukla palmar bölgede standart açık teknik, sınırlı insizyon ve endoskopik işlemler ile yapılmaktadır. Bu prospektif çalışmada, karpal tünel gevşetmesi için distal el bileği kırışıklığı proksimalinde minimal invasiv cerrahi tekniğin etkinliğini klinik ve pre ve postoperatif manyetik resonans görüntüleme (MRG) bulguları ile değerlendirmeyi amaçladık.Yöntemler: Klinik ve elektrofizyolojik çalışmalar ile karpal tünel sendromu tanısı konan 65 hastanın 102 eline, distal el bileği kırışıklığı proksimalinde yapılan mini insizyon ile karpal tünel gevşetmesi uygulandı. Olguların klinik değerlendirilmesi ameliyat öncesi ve ameliyat sonrası 3., 6. ve 12. ayda Boston Karpal Tünel Anketi ile yapıldı. Pre-ve postoperatif MRG değerlendirmesinde median sinir sinyal yoğunluğunda artış, fleksör retinakulumda palmar bowing ve sinirde yassılaşmanın varlığı araştırıldı.Bulgular: Klinik değerlendirmede ameliyat öncesi ve ameliyat sonrası 3. ay değerleri arasında anlamlı fark vardı (p<0.001). Preoperatif MRG'de tesbit edilen bulgular postoperatif MRG'de anlamlı oranda azaldı (p<0.001). Hastalar fizyolojik ihtiyaçlarını postoperatif 2 gün içinde karşıladılar. Hiçbir hastada pillar ağrısı ve skar dokusu hassasiyeti görülmedi. Yeniden ameliyat gerekmedi. Sonuç: Distal el bileği kırışıklığı proksimalinde, mini invasiv yaklaşımla uygulanan karpal tünel gevşetmesi etkin bir yöntemdir. Hastaların fizyolojik aktivitelerini erken başarmaları yaşam konforlarını artırmıştır. Anahtar Kelimeler: Karpal tünel sendomu, dekompresyon, minimal invasiv cerrahi işlemler, el bileği, manyetik rezonans görüntüleme Objective: The surgical treatment of carpal tunnel syndrome is usually performed via standard open technique, limited incision and endoscopic procedures in the palmar region.In this prospective study, we aimed to evaluate the efficacy of minimally invasive surgical technique at the proximal of the distal wrist crease for carpal tunnel release with clinical and pre-and postoperative magnetic resonance imaging (MRI) findings. Methods:Following the diagnosis of carpal tunnel syndrome via clinical and electrophysiological examinations, carpal tunnel release was performed on 102 wrists of 65 patients with a mini-incision at the proximal of the distal wrist crease. Clinical assessment of the patients was made with the Boston Carpal Tunnel Questionnaire before surgery and at the third, sixth and twelfth months after surgery. Preoperative and postoperative third month MRIs were examined for presence of an increase in the signal intensity of the median nerve, palmar bowing of the flexor retinaculum or nerve flattening. Results:There was a clinically significant difference between the preoperative and postoperative third month results (p<0.001). The findings from the preoperative MRIs have significantly declined in the postoperative MRIs (p<0.001). Patients were able to meet their physiological needs by the postoperative second day. None of the patients experienced pillar pain or scar tissue sensitivity. No...

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Carpal Tunnel Release with a Minimally Invasive Surgical Approach at the Proximal of the Distal Wrist Crease: The Evaluation of the Efficacy of the Technique with Clinical and Magnetic Resonance Imaging

Yılmaz¹

2019

btd

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“…The study found reasonable evidence that regular and prolonged use of handheld vibratory tools was associated with a more than double risk of carpal tunnel syndrome. 6 It is the most common form of nerve entrapment syndrome. It can be a debilitating condition with significant socioeconomic costs in the form of reduced productivity, wage reimbursement and compensation claims.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors of Carpal Tunnel Syndrome in Food-Packing Workers Karanganyar

Setyawan

2017

Kesmas: National Public Health Journal

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Carpal Tunnel Syndrome occurs when the median nerve, which runs from the forearm into the hand, suffers pressure or is squeezed in the wrist. The results may be pain, weakness, or numbness in the hand and wrist, radiating up to the arm. This study aimed to examine the risk factors i.e age, sex, work period and repetitive movements toward Carpal Tunnel Syndrome complaints among food-packing workers in Karanganyar. The study was conducted in October to December 2014 that used analytic observational design with cross sectional study. Samples were 50 of 67 food-packing workers in Jaten Karanganyar industrial area as taken by using simple random sampling technique. Data were analyzed using chi square and multivariate logistic regression. Results showed that age and sex had significant relation with Carpal Tunnel Syndrome and age was the most influential factor 24 times to increased risk of Carpal Tunnel Syndrome (p value = 0.057, Exp. β = 24.965). Keywords: Age, carpal tunnel syndrome, food-packing workers, repetitive movement, sex Abstrak Carpal Tunnel Syndrome terjadi ketika saraf median, yang membentang dari lengan bawah ke tangan, mengalami tekanan atau terpuntir di pergelangan tangan. Hasilnya mungkin sakit, kelemahan atau mati rasa di tangan dan pergelangan tangan, yang memancar ke lengan tangan. Penelitian ini bertujuan untuk mengkaji faktor risiko usia, jenis kelamin, masa kerja dan gerakan repetitif terhadap keluhan Carpal Tunnel Syndrome pada pekerja pengepakan makanan di Karanganyar. Penelitian ini dilaksanakan pada bulan Oktober -Desember 2014 menggunakan desain observasional analitik dengan penelitian potong lintang. Sampel terdiri dari 50 orang dari total 67 pekerja pengepak makanan di kawasan industri Jaten Karanganyar yang diambil dengan menggunakan teknik simple random sampling. Data penelitian diolah menggunakan uji kai kuadrat dan regresi logistik multivariat. Hasil penelitian menunjukkan bahwa usia dan jenis kelamin signifikan berhubungan dengan keluhan Carpal Tunnel Syndrome, dan usia merupakan faktor yang paling berpengaruh 24 kali lipat untuk meningkatkan risiko terjadinya Carpal Tunnel Syndrome (nilai p = 0.057, Exp. β = 24.965). Kata kunci: Usia, carpal tunnel syndrome, pekerja pengepakan makanan, gerakan repetitif, jenis kelamin

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“…It is related to a focal compression of the median nerve in the carpal tunnel due to a local hypertension. Its clinical, paraclinical and therapeutic aspects were the subjects of many studies worldwide [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%