Serial Overnight Recordings of Intracarpal Canal Pressure in Carpal Tunnel Syndrome Patients with and without Wrist Splinting

1994 ◽  
Vol 19 (1) ◽  
pp. 35-37 ◽  
Author(s):  
R. LUCHETTI ◽  
R. SCHOENHUBER ◽  
M. ALFARANO ◽  
S. DELUCA ◽  
G. DE CICCO ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Critical Pressure ◽  
Constant Infusion ◽  
Tunnel Syndrome ◽  
The Difference ◽  
Infusion Technique

In 15 carpal tunnel syndrome patients pressure was measured during the day and at 2-hourly intervals from midnight to 6 a.m., via a catheter introduced into the carpal canal, using the constant infusion technique. Intracarpal tunnel pressure of the patients always exceeded the critical pressure of 30 mmHg and the highest values were found at 6 a.m. Slightly lower pressures were found when the wrist was splinted, but the difference was not significant, nor were critical pressure levels prevented by splinting.

scholarly journals Comparison between Carpal Tunnel Syndrome and Individuals with Symptoms of Obsessive- Compulsive Disorder

2020 ◽  
Author(s):  
Meliha GÜNDAĞ PAPAKER ◽  
Anas ABDALLAH ◽  
Mehmet Hakan SEYİTHANOĞLU ◽  
Engin CAN ◽  
Aygül TANTİK PAK ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Patient Group ◽  
Carpal Tunnel ◽  
Significant Relationship ◽  
Control Group ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Tunnel Syndrome ◽  
Anxiety Levels ◽  
The Difference

Abstract Objective: Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment neuropathy and is seen in 3 % of the general population. The aim to this study was examine the relationship between the symptoms of cleaning compulsion with using Moudsley obsessive compulsive inventory ( MOCI ) and patients with CTS. Methods: Sixty patients with CTS and 60 healty controls were evaluated in Bezmialem Vakif University Faculty of Medicine Neurosurgery Clinic. Neurological examination, Electrophysiological findings, the presence of neuropathic pain evaluated by the Leeds assessment of neuropathic symptoms and signs (LANSS) , the symptoms of obsessive- compulsive disorder using with MOCI and anxiety levels assessed by the Beck Anxiety Inventory (BAI) were evaluated. Results: No statistically significant relationship was observed between anxiety levels and CTS (p › 0.005). No statistically significant relationship was found MOCI rumination, control and doubting subscale scores (p › 0.005). Patient group had higher MOCI cleaning subscale scores than the control group and the difference was statistically significant (p=0.008). Patient group had higher MOCI slowness subscale scores than the control group and the difference was statistically significant (p=0.004). Conclusion: Increased wrist movement in people that have the symptoms of compulsive cleaning is associated with the risk of CTS. Our study show that a reduction of high level of wrist flexion-extansion movements may decrease the new CTS cases.

TRIGGER DIGITS-ASSOCIATED CARPAL TUNNEL SYNDROME: RELATIONSHIP BETWEEN CARPAL TUNNEL RELEASE AND TRIGGER DIGITS

Hand Surgery ◽  
2005 ◽  
Vol 10 (02n03) ◽  
pp. 205-208 ◽  
Author(s):  
K. Harada ◽  
H. Nakashima ◽  
K. Teramoto ◽  
T. Nagai ◽  
S. Hoshino ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Flexor Tendon ◽  
Carpal Tunnel Release ◽  
Tendon Sheath ◽  
Flexor Tendon Sheath ◽  
Idiopathic Carpal Tunnel Syndrome ◽  
Tunnel Syndrome ◽  
The Difference ◽  
Performance Rate

Of 875 idiopathic carpal tunnel syndrome (CTS) cases, 101 (11.5%) required trigger digit release operations within three years before and/or after carpal tunnel release (CTR); these 101 cases were investigated, retrospectively. Trigger digit release (TDR) was performed most often after the CTR, especially within three months. Next most common was at the same time as the CTR. The TDR performance rate after CTR was 5.9%. The nerve conduction study (NCS) comparison between trigger digits-associated CTS and isolated CTS showed that pre-operative distal motor latency was significantly more delayed in trigger digits-associated CTS, while there was no evidence of any difference due to age or gender. The difference of operative method (open or endoscopic procedure) did not influence the incidence rate of trigger digits after the CTR. This study suggested that trigger digits-associated CTS has a previously developed wide-ranging narrowing of the flexor tendon sheath.

Relationship of Carpal Canal Contents Volume to Carpal Canal Pressure in Carpal Tunnel Syndrome Patients

2004 ◽  
Vol 29 (3) ◽  
pp. 275-278 ◽  
Author(s):  
A. YOSHIDA ◽  
I. OKUTSU
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Clinical Symptoms ◽  
Flexor Digitorum Superficialis ◽  
Tunnel Syndrome ◽  
Finger Motion ◽  
Flexor Digitorum ◽  
Relationship Of ◽  
Infusion Technique

Forty patients long-term haemodialysis with a second recurrence of carpal tunnel syndrome and concomitant loss of flexor tendon function due to flexor adhesions were treated by excision of the flexor digitorum superficialis tendons. During the procedure the carpal canal pressure was measured using a continuous infusion technique. The preoperative mean carpal canal pressure was 81 (SD, 53) mmHg. After removal of all the flexor digitorum superficialis tendons, the carpal canal pressure decreased to 10 (SD, 8) mmHg. The clinical symptoms of carpal tunnel syndrome were relieved and hand strength and finger motion were improved in all patients.

Quantitative analysis of the variation in angles of the carpal arch after open and endoscopic carpal tunnel release

2009 ◽  
Vol 111 (2) ◽  
pp. 311-316 ◽  
Author(s):  
Leandro Pretto Flores ◽  
Thiago F. P. Cavalcante ◽  
Oswaldo R. M. Neto ◽  
Fabiano S. Alcântara
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Open Surgery ◽  
Carpal Tunnel Release ◽  
Statistical Significance ◽  
Mean Values ◽  
Endoscopic Carpal Tunnel Release ◽  
Tunnel Syndrome ◽  
The Mean ◽  
The Difference

Object Previous studies have demonstrated that the volume of the carpal canal increases after open and endoscopic surgery in patients with carpal tunnel syndrome. There is some controversy regarding the contribution of the postoperative widening of the carpal arch to the increment in carpal canal volume. The objectives of this study were to: 1) evaluate the degree of variation in the angles formed by the borders of the carpal arch following the surgical division of the transverse carpal ligament; and 2) determine if there are differences in the variation of these angles after the classical open surgery versus endoscopic carpal tunnel release. Methods The authors prospectively studied 20 patients undergoing carpal tunnel syndrome surgery: 10 patients were treated via the standard open technique, and 10 underwent endoscopic carpal tunnel release. The angles of the carpal arch were measured on CT scans of the affected hand obtained before and immediately after the surgical procedures. Measurements were performed at the level of the pisiform-scaphoid hiatus and at the level of the hook of the hamate-trapezium hiatus. Results There was widening of the postoperative angles of the carpal arch after open and endoscopic division of the flexor retinaculum; however, the difference between pre- and postoperative angulations reached statistical significance only in those patients treated by means of the open procedure. The mean (± SD) values for the postoperative increase in the angles at the level of the pisiform-scaphoid hiatus were 5.1 ± 0.4° after open surgery and 2.5 ± 0.3° after the endoscopically assisted procedure (p < 0.05). At the level of the hook of the hamate-trapezium hiatus, the mean values for the widening of the angles were 6.2 ± 0.6° for the open surgery group and 1.2 ± 0.4° for those patients treated by means of the endoscopic technique (p < 0.05). Conclusions The widening of the postoperative angles of the carpal arch is a phenomenon observed at the proximal and distal levels of the carpal canal, and it can be noted after both open and endoscopically assisted carpal tunnel release. The endoscopic procedure yielded less increase in these angles than the open surgery.

scholarly journals Diagnosis Accuracy of Carpal Tunnel Syndrome in Diabetic Neuropathy

Medicina ◽  
2020 ◽  
Vol 56 (6) ◽  
pp. 279
Author(s):  
Nicu Cătălin Drăghici ◽  
Maria Magdalena Tămaș ◽  
Daniel Corneliu Leucuța ◽  
Tudor Dimitrie Lupescu ◽  
Ștefan Strilciuc ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Diabetic Neuropathy ◽  
Carpal Tunnel ◽  
Compound Muscle Action Potential ◽  
Ring Finger ◽  
Cross Sectional ◽  
Muscle Action Potential ◽  
The Us ◽  
Tunnel Syndrome ◽  
The Difference

Background and objectives: Carpal tunnel syndrome (CTS) is a common pathology, but sometimes the diagnosis is delayed in patients with diabetic neuropathy (DN). The aim of the study is twofold: first, to compare the accuracy of ultrasound (US) with that of electroneurography (ENG) in the diagnosis of CTS associated with DN, using the clinical diagnosis as a reference standard, and second, to investigate the correlation between morphological US parameters and electrodiagnosis (EDX) measurements in patients with CTS and DN. Materials and Methods: This study included patients with DN. They were divided into two groups: Control (patients without CTS) and Cases (patients with CTS). We performed US and ENG in both hands, totaling 56 wrists, with 28 wrists in each group. Results: We found that the difference in the sensory distal latencies between the median and the ulnar nerves (ring finger) exhibited the highest diagnostic accuracy of all the US and ENG parameters, areas under the receiver operating characteristic (AUC) = 0.99 (95% CI 0.97–1), and it was significantly different from the best US diagnostic method. The wrist cross-sectional area (CSA) had the most accurate US diagnosis, while the wrist-to-forearm ratio had the worst AUC. Moreover, in the group of CTS and DN patients, the wrist CSA enlargement was statistically directly proportional to the median compound muscle action potential (CMAP) distal latency and inversely proportional to the antidromic median nerve conduction study (NCS) and the orthodromic median palm–wrist NCS. Conclusions: Both examinations can be used with confidence in the diagnosis of CTS overlapping with DN, but the EDX examination seems to be more accurate. Furthermore, we found a positive correlation between the US and EDX parameters.

Correlation of Vitamin D Level with Electrophysiological Findings and Clinical Grading in Carpal Tunnel Syndrome

2021 ◽  
Vol 19 (7) ◽  
pp. 149-155
Author(s):  
Shatha Mohammed Abdulmunem ◽  
Hanan L. Al-Omary
Keyword(s):  
Vitamin D ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Motor Nerve ◽  
Control Group ◽  
P Value ◽  
Electrophysiological Findings ◽  
Tunnel Syndrome ◽  
The Difference ◽  
Clinical Grading

Carpal tunnel syndrome is a neurological disease that presented with paresthesias, pain, and numbness in the hand's median nerve compression. Vitamin D was assumed to affect both electrophysiological &clinical gradings, the study aims to assess the correlation between the deficiency of vitamin D and both electrophysiological and clinical gradings. This study was conducted in Ghazi Alhariri Hospital during the period from the first of November/2020 to the twenty-eighth of February/2021, fifty five individuals were referred to as Carpal tunnel syndrome patients, and compared to (55) control individuals, blood samples were withdrawn from the patients (3ml), centrifuged and kept in the freezer (-20°C) until the time of analysis of vitamin D3, Sensory and motor nerve conduction studies of both median and ulnar nerve were done bilaterally. patients were classified electrophysiologically and clinically into two subgroups (mild to moderate) and (severe) groups. The result showed that the differences are not significant in the gender, BMI and vitamin D of the patients versus the control group (p>0.05), the difference of the electrophysiological parameters was not significant between patients with low vitamin D versus those with normal vitamin D (p value>0.05), there was a significant association between the electrophysiological and clinical grading in addition to a significant association between vitamin D level and the clinical grading. Vitamin D deficiency does not affect the electrophysiological parameters while the clinical grading becomes worse with the decrease in its level. The electrophysiological grading is associated with clinical grading.

The Possible Role of Vascular Congestion in Carpal Tunnel Syndrome

1988 ◽  
Vol 13 (4) ◽  
pp. 397-399
Author(s):  
A. J. THURSTON ◽  
B. L. KRAUSE
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Clinical Picture ◽  
Critical Pressure ◽  
Initial Rise ◽  
Vascular Congestion ◽  
Extension Force ◽  
Tunnel Syndrome ◽  
At Will

A study of interstitial pressures within the carpal tunnel using a slit catheter found that, in some patients, an initial rise in pressure is recorded when the wrist is passively extended a this continues to rise to a plateau if the position is maintained. A rise above a critical pressure brought about by congestion would explain the clinical picture of predominantly nocturnal symptoms and no electro-physiological evidence with the wrist in a neutral (resting) position. The results also bring into doubt published results of the pressure within the carpal tunnel wit the wrist flexed or extended, since the pressure can be changed at will, depending on the flexion or extension force used.

scholarly journals Analysis of Sonographic Measurement by Anatomical Area in Carpal Tunnel Syndrome and Correlation the Measurement with Electrodiagnostic Study

2020 ◽  
Vol 25 (1) ◽  
pp. 8-16
Author(s):  
JungWoo Park
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Pearson Correlation ◽  
Control Group ◽  
Cross Sectional ◽  
Pearson Correlation Test ◽  
Tunnel Syndrome ◽  
The Difference ◽  
Electrodiagnostic Study ◽  
Anatomical Area

Purpose: To evaluate effectiveness of ultrasonographic measurement of carpal tunnel by anatomical area and correlation with electrodiagnostic study in diagnosis of carpal tunnel syndrome.Methods: From September 2018 to March 2019, we performed the ultrasonography for 30 cases with carpal tunnel syndrome diagnosed with electrodiagnosis and 30 cases as control group. We measured median nerve diameter, cross-sectional area (CSA), and flattening ratio (FR) by area of carpal tunnel. We analyzed the difference of measurement between two groups and correlate the measurement with electrodiagnosis findings.Results: There was significant statistically differences in sonographic measurement between two groups by independent t-test (CSA zone 1, p=0.01; FR zone 2, p=0.000; FR zone 3; p=0.001). With Pearson correlation test, there was correlation between sonographic measurement and electrodiagnostic findings (terminal latency and nerve conduction velocity) statistically, but the Pearson coefficient was low (r<0.4). Conclusion: By anatomical area, the available value of sonographic measurement was different. But, as the values were has low power to diagnose the carpal tunnel syndrome, ultrasonography is proper to use as a complementary tool in diagnosis of carpal tunnel syndrome.

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