The Comparative Effectiveness of Combined Lumbrical Muscle Splints and Stretches on Symptoms and Function in Carpal Tunnel Syndrome

2012 ◽  
Vol 93 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Nancy A. Baker ◽  
Krissy K. Moehling ◽  
Elaine N. Rubinstein ◽  
Ronit Wollstein ◽  
Norman P. Gustafson ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Comparative Effectiveness ◽  
Tunnel Syndrome ◽  
Lumbrical Muscle ◽  
And Function

scholarly journals First Lumbrical Muscle Flap for Recurrence of Carpal Tunnel Syndrome: Anatomical Study and Surgical Technique

2021 ◽  
Vol 49 (01) ◽  
pp. 079-087
Author(s):  
Esther Fernández Tormos ◽  
Fernando Corella Montoya ◽  
Blanca Del Campo Cereceda ◽  
Montserrat Ocampos Hernández ◽  
Teresa Vázquez Osorio ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Revision Surgery ◽  
Muscle Flap ◽  
Anatomical Study ◽  
Physical Barrier ◽  
Adjacent Structures ◽  
Tunnel Syndrome ◽  
Lumbrical Muscle

AbstractRecurrence of carpal tunnel syndrome implies the reappearance of symptoms after release surgery. If the cause of recurrence is not an incomplete release, but a traction neuritis, the tendency is to add to the revision surgery of the carpal tunnel the use of flaps to cover the median nerve. These flaps establish a physical barrier between the nerve and the rest of the adjacent structures, preventing adhesions, and providing neovascularization and better nerve sliding.In the present work, we detail a revision surgery in which the first lumbrical muscle is used as a covering flap. This flap has two benefits. Firstly, it acts as a vascularized coverage for the median nerve (avoiding the formation of fibrosis and favoring its sliding); secondly, a structure that takes up space is removed from the carpal tunnel, thus reducing the pressure within it.Along with the explanation of the technique, the present article provides a detailed description of the anatomical variability of the first lumbrical muscle and its vascularization, as well as the results of a cadaveric study on the location of the vascular pedicle of the first lumbrical muscle.

Carpal Tunnel Syndrome Produced by an Organising Haematoma Within the Anomalous Second Lumbrical Muscle

HAND ◽  
1981 ◽  
Vol os-13 (1) ◽  
pp. 87-91 ◽  
Author(s):  
A. Nather ◽  
R. W. H. Pho
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Rare Case ◽  
Complete Relief ◽  
Anomalous Muscle ◽  
Tunnel Syndrome ◽  
Lumbrical Muscle

A rare case of carpal tunnel syndrome due to an anomalous second lumbrical muscle passing through the carpal tunnel is described. Its presentation as an organising haematoma in the anomalous muscle due to trauma precipitating the syndrome has not been reported in the literature previously. The anomalous muscle with its contained haematoma was excised with complete relief of symptom.

The Comparative Effectiveness of Tendon and Nerve Gliding Exercises in Patients with Carpal Tunnel Syndrome

2011 ◽  
Vol 90 (6) ◽  
pp. 435-442 ◽  
Author(s):  
Yi-Shiung Horng ◽  
Shih-Fu Hsieh ◽  
Yu-Kang Tu ◽  
Ming-Chuan Lin ◽  
Yu-Shiow Horng ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Comparative Effectiveness ◽  
Tunnel Syndrome ◽  
Nerve Gliding Exercises

scholarly journals Function of Microscopic Carpal Tunnel Release in Cases Resistant to Conservative Therapy

2021 ◽  
Vol 6 (4) ◽  
pp. 89-96
Author(s):  
Jehan Zeb ◽  
Muhammad Ullah ◽  
Muhammad Shoaib ◽  
Syed Shah ◽  
Walayat Shah ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Conservative Treatment ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Carpal Tunnel Release ◽  
P Value ◽  
Symptom Severity Score ◽  
Tunnel Syndrome ◽  
The Mean ◽  
And Function

Purpose: To determine the outcome of microscopic carpal tunnel release in patients with carpal tunnel syndrome who failed to respond to conservative treatment. Methodology: This descriptive case series was carried at Department of Neurosurgery, D.H.Q Hosptial Charsadda over 1 year from Jan 2019 to Dec 2020, indicate the sampling method used to select the study participants involving 94 patients; both men and women with ages in the range 30-70 years diagnosed of carpal tunnel syndrome who failed to respond to conservative treatment and were planned for surgical release. Microscopic CTS release was performed and outcomes were assessed in terms of improvement in VAS score for wrist pain, symptom severity score and function status scale 3 and 6 months after the surgery. Recurrence of symptoms was also noted. A written informed consent was obtained from every patient. Indicate the method of data collection and data analysis Findings: The mean age of the patients with carpal tunnel syndrome was 41.6±7.9 years. There was slight female predominance with male to female ratio of 1:2.1. History of diabetes was recorded in 29 (31.0%) patients while 34 (37.0%) patients were obese. Right hand was more frequently involved (53.0%) than the left hand (47.0%). The mean VAS score for wrist pain reduced from 7.9±1.2 at baseline to 1.8±0.7 3 months after the surgery (p- value<0.001). Similar improvements were also noted in symptom severity score (3.8±0.8 to 1.6±0.8; p- value<0.001) and function status scale (2.7±0.8 to 1.5±0.8; p-value<0.001) at the end of 3 months after the surgery. Recurrence was not observed in any patient at the end of 6 months follow-up. Recommendation: Microscopic carpal tunnel release was found to relieve patient’s symptoms and improve wrist function yet with minimal scarring and without recurrence which advocates its preferred use in future practice provided necessary surgical skills and hardware are available.

scholarly journals Improvement of Sleep Quality after Surgical Decompression in Carpal Tunnel Syndrome

2021 ◽  
Author(s):  
Nguyen Le Trung Hieu ◽  
Nguyen Anh Sang ◽  
Nguyen Lam Vuong
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Sleep Quality ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Surgical Decompression ◽  
Poor Sleep ◽  
Tunnel Syndrome ◽  
And Function ◽  
Hand Symptoms ◽  
The Impact

Abstract Background Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy which can cause severe sleep disturbance. Carpal tunnel release (CTR) is a choice for severe cases, which has shown to improve sleep quality, but the available evidence is limited. This study aimed to investigate the impact of CTR on sleep quality and hand symptoms and functions in patients with CTS. Methods This was a prospective study in 2019–2020 on patients with CTS and poor sleep quality undergoing CTR. Patients were evaluated before and at 1, 3, and 12 months after CTR by the Pittsburgh sleep quality index (PSQI) and Boston carpal tunnel syndrome questionnaires. Results There were 33 patients with 27 females (82%) and a median age of 51 years. The median time of CTS diagnosis and having sleep disorder before CTR were 12 and 6 months, respectively. The outcomes significantly improved after CTR, with the median PSQI and Boston symptom and function scores reduced from 12, 33, and 23 before CTR to 9, 14, and 11 at 1 month; 7, 13, and 9 at 3 months; and 1, 11, and 8 at 12 months postoperatively, respectively. The correlations between the PSQI and Boston symptom and function scores were > 0.6 at all time-points. Conclusions Surgical decompression significantly improves sleep quality and the hand symptoms and functions in patients with CTS. Long-term evaluations are lacking and thus are required in future studies.

scholarly journals Mathematical Modeling for Neuropathic Pain: Bayesian Linear Regression and Self-Organizing Maps Applied to Carpal Tunnel Syndrome

Symmetry ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 1581
Author(s):  
Oscar J. Pellicer-Valero ◽  
José D. Martín-Guerrero ◽  
Margarita I. Cigarán-Méndez ◽  
Carmen Écija-Gallardo ◽  
César Fernández-de-las-Peñas ◽  
...  
Keyword(s):  
Mathematical Modeling ◽  
Neuropathic Pain ◽  
Carpal Tunnel Syndrome ◽  
Pain Intensity ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Grip Force ◽  
Self Organizing Maps ◽  
Tunnel Syndrome ◽  
And Function

A better understanding of the connection between risk factors associated with pain and function may assist therapists in optimizing therapeutic programs. This study applied mathematical modeling to analyze the relationship of psychological, psychophysical, and motor variables with pain, function, and symptom severity using Bayesian linear regressions (BLR) and self-organizing maps (SOMs) in carpal tunnel syndrome (CTS). The novelty of this work was a transfer of the symmetry mathematical background to a neuropathic pain condition, whose symptoms can be either unilateral or bilateral. Duration of symptoms, pain intensity, function, symptom severity, depressive levels, pinch tip grip force, and pressure pain thresholds (PPTs) over the ulnar, radial, and median nerve trunks, the cervical spine, the carpal tunnel, and the tibialis anterior were collected in 208 women suffering from CTS. The first BLR model revealed that symptom severity, PPTs over the radial nerve, and function had significant correlations with pain intensity. The second BLR showed that symptom severity, depressive levels, pain intensity, and years with pain were associated with function. The third model demonstrated that pain intensity and function were associated with symptom severity. The SOMs visualized these correlations among variables, i.e., clinical, psychophysical, and physical, and identified a subgroup of women with CTS exhibiting worse clinical features, higher pressure sensitivity, and lower pinch tip grip force. Therefore, the application of mathematical modeling identified some interactions among the intensity of pain, function, and symptom severity in women with CTS.

Relationship between the Self-Administered Boston Questionnaire and Electrophysiological Findings in Follow-Up of Surgically-Treated Carpal Tunnel Syndrome

2000 ◽  
Vol 25 (2) ◽  
pp. 128-134 ◽  
Author(s):  
M. MONDELLI ◽  
F. REALE ◽  
F. SICURELLI ◽  
L. PADUA
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Conduction Velocities ◽  
Electrophysiological Findings ◽  
Tunnel Syndrome ◽  
Electrophysiological Examination ◽  
A Prospective Study ◽  
And Function

A prospective study of electrophysiological examination and the Boston self-administered questionnaire (BQ) was carried out in patients with surgically-treated carpal tunnel syndrome. There were 104 hands in 93 patients (13 men and 80 women, mean age 56 years). The BQ was used to assess the severity of symptoms and function, and nerve conduction studies were done before surgical release by short incision at the palm, and at follow-ups 1 and 6 months after surgery. The BQ severity score improved or became normal in 98% of hands. The mean BQ scores and distal sensory and motor conduction velocities in the median nerve showed significant improvement at the 1 month follow-up. Further significant improvement was found at 6 months. There was no relationship between the improvements in BQ scores and the distal conduction in the median nerve. The degree of improvement in sensory and motor distal conduction velocities could be forecast from presurgical values, whereas the degree of improvement in the symptoms and the functional status after release could not be predicted from the presurgical BQ scores.

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