The Anatomical Site of Constriction of the Median Nerve in Patients with Severe Idiopathic Carpal Tunnel Syndrome

2006 ◽  
Vol 31 (6) ◽  
pp. 608-610 ◽  
Author(s):  
M. M AL-QATTAN
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Anatomical Site ◽  
Idiopathic Carpal Tunnel Syndrome ◽  
Tunnel Syndrome ◽  
A Prospective Study ◽  
Open Carpal Tunnel Release ◽  
Radiological Studies

During open carpal tunnel release in patients with severe idiopathic carpal tunnel syndrome, an area of constriction in the substance of the median nerve is frequently noted. In a prospective study of 30 patients, the central point of the constricted part of the nerve was determined intraoperatively and found to be, on average, 2.5 (range 2.2–2.8) cm from the distal wrist crease. This point always corresponded to the location of the hook of the hamate bone. These intraoperative findings were compared with the “narrowest” point of the carpal canal as determined by anatomical and radiological studies in the literature.

ENDOSCOPIC CARPAL TUNNEL RELEASE FOR RECURRENT CARPAL TUNNEL SYNDROME AFTER PREVIOUS OPEN RELEASE

Hand Surgery ◽  
2004 ◽  
Vol 09 (02) ◽  
pp. 235-239 ◽  
Author(s):  
Lam Chuan Teoh ◽  
Puay Ling Tan
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Open Release ◽  
Endoscopic Carpal Tunnel Release ◽  
Endoscopic Release ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release ◽  
Surgical Release

Recurrent carpal tunnel syndrome from various causes has been shown to occur in up to 19% of patients. Endoscopic carpal tunnel release has been used to decompress the median nerve in carpal tunnel syndrome for many years. However, endoscopic release for recurrent carpal tunnel syndrome after previous surgical release has not been reported. Nine hands in six patients had recurrent carpal tunnel syndrome five to 20 years after previous open carpal tunnel release. All the cases were successfully treated with endoscopic release.

A Prospective Study of Outcome Following Mini-open Carpal Tunnel Release

Hand Surgery ◽  
2003 ◽  
Vol 08 (01) ◽  
pp. 59-63 ◽  
Author(s):  
Michael P. Bradley ◽  
Edward P. Hayes ◽  
Arnold-Peter C. Weiss ◽  
Edward Akelman
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Historical Cohort ◽  
Endoscopic Release ◽  
Severity Scores ◽  
Tunnel Syndrome ◽  
A Prospective Study ◽  
Open Carpal Tunnel Release ◽  
Mini Open

Mini-open carpal tunnel release has been the focus of recent attention for surgical decompression of carpal tunnel syndrome. Other techniques such as standard open carpal tunnel release and endoscopic release have been well established, and outcomes, complications and results for these operations have been published widely. Our study uses the validated Levine Katz questionnaire for carpal tunnel syndrome to measure patient subjective outcomes at one year follow-up after mini-open carpal tunnel release. Thirty-four consecutive hands were enrolled prospectively with preoperative and postoperative questionnaires. Mean symptom severity scores per question improved from 2.8 to 1.3 and mean function severity scores per question improved from 2.6 to 1.3. Comparing our data to the historical cohort of Levine et al., there was a statistically significant improvement in postoperative outcomes in our population (p < 0.0001).

scholarly journals Carpal Tunnel Syndrome with Wrist Trigger Caused by Hypertrophied Lumbrical Muscle and Tenosynovitis

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Ayuko Shimizu ◽  
Masayoshi Ikeda ◽  
Yuka Kobayashi ◽  
Ikuo Saito ◽  
Joji Mochida
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Synovial Proliferation ◽  
Flexor Tendons ◽  
Active Flexion ◽  
Tunnel Syndrome ◽  
Lumbrical Muscle ◽  
Open Carpal Tunnel Release

We present a case of carpal tunnel syndrome involving wrist trigger caused by a hypertrophied lumbrical muscle with flexor synovitis. The case was a 40-year-old male heavy manual worker complaining of numbness and pain in the median nerve area. On active flexion of the fingers, snapping was observed at the carpal area, and forceful full grip was impossible. Tinel’s sign was positive and an electromyographic study revealed conduction disturbance of the median nerve at the carpal tunnel. Magnetic resonance imaging revealed edematous lumbrical muscle with synovial proliferation around the flexor tendons. Open carpal tunnel release was performed under local anesthesia. Synovial proliferation of the flexor tendons was found and when flexing the index and middle fingers, the lumbrical muscle was drawn into the carpal tunnel with a triggering phenomenon. After releasing the carpal tunnel, the triggering phenomenon and painful numbness improved.

LONGITUDINAL MEDIAN NERVE CONDUCTION STUDIES AFTER ENDOSCOPIC CARPAL TUNNEL RELEASE

Hand Surgery ◽  
1999 ◽  
Vol 04 (02) ◽  
pp. 145-149 ◽  
Author(s):  
Yukio Nakamura ◽  
Shigeharu Uchiyama ◽  
Hiroshi Toriumi ◽  
Hiroyuki Nakagawa ◽  
Tada-atsu Miyasaka
Keyword(s):  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Carpal Tunnel Release ◽  
Nerve Conduction Studies ◽  
Rapid Improvement ◽  
Endoscopic Carpal Tunnel Release ◽  
Idiopathic Carpal Tunnel Syndrome ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release

Forty hands of 36 patients who had undergone endoscopic carpal tunnel release (ECTR), utilising Chow's two-portal technique after being diagnosed with idiopathic carpal tunnel syndrome, were subjected to longitudinal median nerve conduction studies. The distal motor latency (DML) was examined pre-operatively on all the hands, which were re-examined at the post-operative 1st, 3rd, 6th and 12th months. Rapid improvement of DML was observed post-operatively in the first three months. These improvements patterns are not much different from those after open carpal tunnel release (OCTR) reported in the literatures. We consider that the data reported herein can be used as standards of DML course after ECTR.

scholarly journals Outcome of Carpal Tunnel Release: a prospective study

2013 ◽  
Vol 1 (1) ◽  
Author(s):  
NMS Pradhan ◽  
JA Khan ◽  
BM Acharya ◽  
P Devkota ◽  
A Rajbhandari
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Conservative Treatment ◽  
Prospective Study ◽  
Carpal Tunnel ◽  
Outcome Measurement ◽  
Carpal Tunnel Release ◽  
Signs And Symptoms ◽  
Tunnel Syndrome ◽  
A Prospective Study ◽  
Open Carpal Tunnel Release

BACKGROUND: Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy and is manifested by characteristic signs and symptoms resulting from median nerve compression at the carpal tunnel. The diagnosis is essentially clinical, which is further confirmed by nerve conduction studies. Surgical release of the transverse carpal ligament is advised when conservative treatment fails.  METHODS: This prospective study evaluates the outcome of standard open carpal tunnel release performed at our center* from June 2004 to July 2007. Thirty two patients with idiopathic carpal tunnel syndrome, with failed conservative treatments, either with NSAIDs and/or local infiltration with corticosteroid injections plus night splint, or recurrence after conservative treatment were subjected to open carpal tunnel release after getting approval from the local ethical committee and getting a written and informed consent from the patient. Clinical assessment was done preoperatively and at 6 weeks, 3 months and 6 months following the procedure and included the two-point discrimination test at the tip of the index finger and Boston questionnaires as an outcome measurement of symptoms severity. All the patients were followed up for a period of six months. RESULTS: All the patients presented improvement in the postoperative evaluations in all the analyzed parameters. CONCLUSION: Open carpal tunnel release is a safe and effective method for the treatment of CTS and can be carried out when the conservative means fail to relieve the symptoms. DOI: http://dx.doi.org/10.3126/noaj.v1i1.8129 Nepal Orthopaedic Association Journal Vol.1(1) 2010

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