Current concepts of carpal tunnel syndrome: pathophysiology, treatment, and evaluation

Uchiyama, Shigeharu; Itsubo, Toshirou; Nakamura, Kōichi; Kato, Hiroyuki; Yasutomi, Takashi; Momose, Toshimitsu

doi:10.1007/s00776-009-1416-x

Cited by 135 publications

(141 citation statements)

References 121 publications

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“…CTQ and DASH seems to have good correlation in 6 weeks follow up but SF36 does not [23] . Also Uchiyama show similar results [3] . These results are in line with those published by Amirfyez et al, who evaluated at 6 weeks after surgery using the DASH questionnaires, with significant improvement in their series [24] .…”

Section: Discussionsupporting

confidence: 61%

See 1 more Smart Citation

Short-Term Outcomes after Median Nerve Release for Carpal Tunnel Syndrome

Domínguez¹,

Mira

Sallent

et al. 2017

International Journal of Orthopaedics

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Section: Discussionsupporting

confidence: 61%

“…CTS is the most frequent compression peripheral neuropathy in the hand. It is estimated to affect 3.8% of the general population [3] with an incidence of 276: 100,000 a year [4] . It occurs more frequently in women, with a prevalence of 9.2% among women and 6% in men [2,5] .…”

Section: Introductionmentioning

confidence: 99%

Short-Term Outcomes after Median Nerve Release for Carpal Tunnel Syndrome

Domínguez¹,

Mira

Sallent

et al. 2017

International Journal of Orthopaedics

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“…CTS, a mononeuropathy of the median nerve, was superimposed on these classic FD manifestations in the three patients described. In the general population, CTS is proposed to result from increased pressure within the carpal tunnel, with subsequent median nerve ischaemia, epineural oedema and fibroblast invasion, culminating in the development of constrictive scar tissue around the nerve (Gelberman et al 1981;Werner and Andary 2002;Uchiyama et al 2010). While CTS is associated with a number of systemic diseases and some mechanical and occupational factors (Mattioli et al 2009;Uchiyama et al 2010), a genetic predisposition for CTS has also been shown (Hakim et al 2002;Lozano-Calderon et al 2008).…”

Section: Discussionmentioning

confidence: 99%

Carpal Tunnel Syndrome in Fabry Disease

et al. 2011

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Carpal tunnel syndrome (CTS) is a common peripheral mononeuropathy affecting up to 4% of the general population, typically women in late middle age. The incidence in patients with Fabry disease (FD) is unclear, but may affect 25% of patients with this X-linked lysosomal storage disease. We report three cases of CTS in young Caucasian male patients with classical FD, who developed CTS symptoms with supportive nerve conduction study (NCS) findings. Two patients had bilateral CTS and two had evidence of concurrent ulnar nerve neuropathy on NCS, suggesting a systemic process contributed to nerve compression. All were receiving enzyme replacement therapy (ERT) and had a moderate burden of FD complications. It is possible that an increase in connective tissue in the intracarpal canal in FD patients may be incited by injury to fibroblasts, via either accumulation of globotriaosylceramide (GL3) or local ischaemia through endothelial injury. The former hypothesis may be a more plausible explanation for the development of CTS, as histology of the flexor retinaculae from our patients has demonstrated fibroblasts with characteristic vacuolation and excessive myxomatous stroma, despite endothelial clearance of GL3 in these patients receiving ERT. CTS should not be overlooked in FD patients and young patients presenting with CTS should be evaluated for an underlying systemic or genetic disorder. Surgical carpal tunnel decompression was effective in our patients, already troubled by long-standing acroparesthesia, in providing sustained relief of symptoms.

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“…Carpal Tunnel Syndrome (CTS) is a common problem that is caused by pressure on a nerve in the wrist and is associated with various factors (Aboonq, 2015;Uchiyama et al, 2010). Fractures, dislocations, tumors, some chronic diseases, such as diabetes or thyroid disorders and repetitive movements of the wrist, are conditions that cause pressure on the median nerve at the wrist and ultimately cause CTS (De-La-Llave-Rincon et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy of Ultrasound Findings in Patients with Carpal Tunnel Syndrome

Dehdashti¹,

Kashipazha²,

Rahim³

et al. 2015

J. of Medical Sciences

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Carpal Tunnel Syndrome (CTS) is a common problem that is caused by pressure on a nerve in the wrist and is associated with various factors. We compared Cross-Sectional Area (CSA) of the inlet and outlet in CTS patients and healthy controls and define the best cut off point of CSA and assess the utility of US in the diagnosis of CTS patients as well. This cross-sectional, age-group-matched case-control study was performed on 39 patients aged 42-65 years with electro-physiologically confirmed idiopathic CTS and 35 healthy controls from Golestan Hospital, Ahvaz, Iran from Jan 2013 to Feb 2014. Neurological and electro-diagnostic tests for patients were performed by an expert neurologist as the gold standard diagnostic test for CTS cases. Hundred wrists were evaluated. Electromyography (EMG) showed that 16 (32%) cases were mild, 17 (34%) were moderate and 17 (34%) were severe. The results showed that the CSA of carpal tunnel inlet, carpal tunnel outlet and AP diameter were significantly different between the two groups (p<0.001, p = 0.009, respectively). The sensitivity and specificity of carpal tunnel inlet were 92 and 96%, for carpal tunnel outlet were 92 and 92%, for AP diameter were 64 and 58%. longitudinal evaluations are necessary to better know the utility of ultrasound for diagnosing CTS. The accuracy of diagnosis increases in parallel with the increase in the stages and severity of CTS. Therefore, patients with severe CTS would not need the more uncomfortable, costly and invasive techniques.

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Current concepts of carpal tunnel syndrome: pathophysiology, treatment, and evaluation

Cited by 135 publications

References 121 publications

Short-Term Outcomes after Median Nerve Release for Carpal Tunnel Syndrome

Short-Term Outcomes after Median Nerve Release for Carpal Tunnel Syndrome

Carpal Tunnel Syndrome in Fabry Disease

Diagnostic Accuracy of Ultrasound Findings in Patients with Carpal Tunnel Syndrome

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