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.

MR imaging of the wrist in carpal tunnel syndrome

1997 ◽  
Vol 38 (6) ◽  
pp. 1050-1052 ◽  
Author(s):  
L. Bak ◽  
S. Bak ◽  
P. Gaster ◽  
F. Mathiesen ◽  
K. Ellemann ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Mr Imaging ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Entrapment ◽  
Mr Images ◽  
Electrophysiological Findings ◽  
Tunnel Syndrome ◽  
Electrophysiological Examination

Purpose: to determine whether specific parameters measured on MR images correlated to electrophysiological changes in carpal tunnel syndrome (CTS) Material and Methods: Prospective clinical examinations were made of 20 patients with suspected CTS. We performed bilateral electrophysiological examinations of the median nerve and bilateral MR imaging of the wrists Results: the electrophysiological examination suggested median nerve entrapment in 18 wrists. These wrists were compared to the remaining 22 electrophysiologically normal wrists. in addition, we compared both wrists in 12 patients with unilateral symptoms of CTS without reference to the electrophysiological findings. We found no difference in specific MR parameters between the 2 groups Conclusion: Neither symptoms nor electrophysiological findings in CTS were related to specific MR parameters

Kinesio taping as an alternative treatment for manual laborers with carpal tunnel syndrome: A double-blind randomized clinical trial

2021 ◽  
pp. 1-9
Author(s):  
Atefeh Aminian-Far ◽  
Dariush Pahlavan ◽  
Fatemeh Maleki Kohnegi
Keyword(s):  
Clinical Trial ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Control Group ◽  
Double Blind ◽  
Kinesio Taping ◽  
Tunnel Syndrome ◽  
Electrophysiological Examination

BACKGROUND: Carpal tunnel syndrome (CTS) is one of the most common forms of peripheral neuropathies due to median nerve compression. Occupational factors, such as repetitive hand motions are believed to be associated with this condition. OBJECTIVE: This clinical trial assessed the effect of Kinesio taping (KT) of hand flexor muscles on the management of mild to moderate CTS in Iranian manual laborers. METHODS: Thirty manual laborers with mild to moderate CTS participated in this clinical trial. They were assigned to an intervention or a control group. The treatment consisted of a 2-week KT followed by a 4-week follow-up. The control group received sham KT without tension applied. Boston Carpal Tunnel Questionnaire scores, pinch and grip force tests, and electrophysiological examination of the median nerve were performed for each participant at baseline, 24 to 48 hours, and two to four weeks of follow-up. The statistical analysis of variance was performed five times for all participants, comparing differences in the data within and between the two groups. RESULTS: The baseline assessment revealed no inter-group differences in the clinical outcomes (P⩽ 0.05). Comparisons of the changes in the electro-physiological and functional variables indicated significantly greater improvement in the KT group than in the sham counterpart (P< 0.05). No statically significant improvement was evident by the electrodiagnostic criteria in the sham-KT group (P⩽ 0.05). CONCLUSIONS: KT is an effective, safe, reliable, and conservative therapeutic choice for the management of patients with CTS. The treatment does not restrict the daily activities of patients nor has it any side effects.

scholarly journals Efficacy of Hyalase Hydrodissection in the Treatment of Carpal Tunnel Syndrome: A Randomized, Double-Blind, Controlled, Clinical Trial

2020 ◽  
Vol 2;23 (4;2) ◽  
pp. E175-E183
Author(s):  
Emad Zarief Kamel
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Saline Solution ◽  
Controlled Clinical Trial ◽  
Tunnel Syndrome ◽  
Group 2 ◽  
Group 1

Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, which results from median nerve compression. A lot of nonsurgical modalities are available for the management of mild to moderate situations. Local Hyalase hydrodissection (HD) of the entrapped median nerve could offer a desirable sustained symptom alleviation. Objectives: To evaluate the clinical efficacy of Hyalase/saline solution carpal tunnel HD on pain, functional status, and nerve conduction in patients with CTS. Study Design: A randomized, double-blinded trial. Setting: Anesthesia, pain, and rheumatology clinics in a university hospital. Methods: Patients: 60 patients with CTS (> 6 months’ duration). Intervention: patients were allocated equally into either group 1 (HD with Hyalase + 10 mL saline solution injection), or group 2 (HD with 10 mL saline solution only). Measurements: assessment of pain using Visual Analog Scale (VAS), functional disability (FD) score, and nerve conduction studies before injection, and over 6 months after injection. Nerve conduction parameters before injection and postinjection by the end of 3 and 6 months were evaluated as well. Results: Statistically significant lower postinjection values of VAS (1 ± 1.8, 2 ± 1.1, 2 ± 1.2, 2 ± 1.1) in group 1 versus (2 ± 1.2, 3 ± 1.7, 4 ± 1.5, 5 ± 2.6) in group 2 by the end of the first week, and the first, third, and sixth months, and significantly lower FD scores (15.3 ± 1.2, 13 ± 1.3, 10.2 ± 1.3, 10.2 ± 1.3) in group 1 versus (17.5 ± 1.8, 16.6 ± 2.8, 19.4 ± 3.2, 21.2 ± 2.5) in group 2 during the same time intervals. Nerve conduction study parameters have shown significantly higher velocity and lower latency in the Hyalase group than in the saline solution group by the 3 and 6 month follow-up. Limitation: We suggest a longer period could be reasonable. Conclusions: Carpal tunnel HD with Hyalase with saline solution is considered as an efficient technique offering a rapid onset of pain relief and functional improvements, and better median nerve conduction in patients with CTS over 6 months follow-up duration. Key words: Carpal tunnel syndrome, Hyalase, median nerve hydrodissection

Experimentally and Theoretically Narrowing Carpal Arch Width to Increase the Area Formed by the Transverse Carpal Ligament

2011 ◽  
Author(s):  
Suk H. Yu ◽  
Tracy A. Mondello ◽  
Zong-Ming Li
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Transverse Carpal Ligament ◽  
Cross Sectional ◽  
Arch Width ◽  
Endoscopic Release ◽  
Volar Aspect ◽  
Tunnel Syndrome

Carpal tunnel syndrome is conventionally treated by open and endoscopic release surgeries in which transecting the transverse carpal ligament (TCL) relieves mechanical insults around the median nerve. The TCL release surgeries yield an increase in the tunnel cross-sectional area particularly within the volar aspect of the tunnel, the arch area, where the median nerve is located. As a result of increased arch area, post-operative follow-up studies using MRI confirmed a significant volar migration of the median nerve [1]. However, transecting the TCL compromises critical biomechanical roles of the carpal tunnel [2], and therefore, it is imperative to investigate an alternative method for treating carpal tunnel syndrome patients while preserving the TCL. Li et al. suggested that increasing the TCL length and narrowing the carpal arch width (CAW) as potential alternatives for increasing the arch area [3]. However, the data from their application of palmarly directed forces to the TCL from inside of the tunnel showed that the TCL length remained relatively constant while the carpal bones were mobilized to increase the arch area [3]. The purpose of this study was to investigate the relationship between CAW narrowing and the TCL-formed arch area by experimental and geometrical modeling.

No correlation between sonographic and electrophysiological parameters in carpal tunnel syndrome

2013 ◽  
Vol 39 (2) ◽  
pp. 161-166 ◽  
Author(s):  
A. Żyluk ◽  
I. Walaszek ◽  
Z. Szlosser
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Prospective Study ◽  
Carpal Tunnel ◽  
Sectional Area ◽  
Cross Sectional ◽  
Conduction Disturbances ◽  
Tunnel Syndrome ◽  
The Mean ◽  
Electrophysiological Examination ◽  
A Prospective Study

A prospective study was carried out to investigate any correlation between electrophysiological and sonographic findings in patients with a clinical diagnosis of carpal tunnel syndrome. A total of 113 patients (113 wrists) in 90 women and 23 men, with a mean age of 60 years, underwent sonographic and electrophysiological examination. Fifty-five patients (48%) had mild, 43 (38%) moderate and 12 (11%) had severe conduction disturbances and three patients had normal conduction. Sonographic measurements showed a cross-sectional area of the median nerve of 9.9 mm2 at the forearm and 17.8 mm2 at the tunnel inlet. The mean anteroposterior diameter (height) of the nerve at the tunnel inlet was 2.7 mm, and the lowest height inside the tunnel was 1.8 mm. No correlation was found between sonographic and electrophysiological parameters.

Incidence of Bilateral Symptoms in Carpal Tunnel Syndrome

1998 ◽  
Vol 23 (5) ◽  
pp. 603-606 ◽  
Author(s):  
L. PADUA ◽  
R. PADUA ◽  
M. NAZZARO ◽  
P. TONALI
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Significant Positive Correlation ◽  
Duration Of Symptoms ◽  
Positive Correlation ◽  
Tunnel Syndrome ◽  
Contralateral Symptoms ◽  
Bilateral Impairment

We prospectively studied 266 hands in 133 patients with carpal tunnel syndrome (CTS) in order to evaluate: the incidence of bilateral CTS symptoms; correlation between severity, duration of symptoms and bilateral occurrence of CTS; agreement of clinical and neurophysiological findings; and the neurophysiological findings in asymptomatic hands in unilateral CTS, The incidence of bilateral clinical CTS in our population was 87%. Neurophysiological impairment of median nerve was observed in about half of the asymptomatic hands. Follow-up of patients with unilateral CTS showed that contralateral symptoms developed in most cases. We found a significant positive correlation of bilateral CTS with the duration of symptoms, whereas there was no correlation with the severity of symptoms. Our data suggest that bilateral impairment of median nerve is the rule in patients with CTS and probably it has been underestimated in previous studies.

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.

scholarly journals Volume Matters in Ultrasound-Guided Perineural Dextrose Injection for Carpal Tunnel Syndrome: A Randomized, Double-Blinded, Three-Arm Trial

2020 ◽  
Vol 11 ◽  
Author(s):  
Meng-Ting Lin ◽  
Chun-Li Liao ◽  
Ming-Yen Hsiao ◽  
Hsueh-Wen Hsueh ◽  
Chi-Chao Chao ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Group Analysis ◽  
Post Injection ◽  
Ultrasound Guided ◽  
Electrophysiological Studies ◽  
Tunnel Syndrome ◽  
Double Blinded

Ultrasound-guided perineural dextrose injection (PDI) has been reported effective for carpal tunnel syndrome (CTS). Higher volume of injectate may reduce adhesion of median nerve from other tissues, but volume-dependent effects of PDI in CTS remain unknown. We aimed to investigate whether PDI with different injectate volumes had different effects for CTS participants. In this randomized, double-blinded, three-arm trial, 63 wrists diagnosed with CTS were randomized into three groups that received ultrasound-guided PDI with either 1, 2 or 4 ml of 5% dextrose water. All participants finished this study. Primary outcome as visual analog scale (VAS) and secondary outcomes including Boston Carpal Tunnel Questionnaire (BCTQ), Disability of the Arm, Shoulder and Hand score (QuickDASH), electrophysiological studies and cross-sectional area (CSA) of the median nerve at carpal tunnel inlet were assessed before and after PDI at the 1st, 4th, 12th and 24th weeks. For within-group analysis, all three groups (21 participants, each) revealed significant improvement from baseline in VAS, BCTQ and QuickDASH at the 1st, 4th, 12th and 24th weeks. For between-group analysis, 4 ml-group yielded better VAS reduction at the 4th and 12th weeks as well as improvement of BCTQ and QuickDASH at the 1st, 4th, and 12th weeks, compared to other groups. No significant between-group differences were observed in electrophysiological studies or median nerve CSA at any follow-up time points. There were no severe complications in this trial, and transient minor adverse effects occurred equally in the three groups. In conclusion, ultrasound-guided PDI with 4 ml of 5% dextrose provided better efficacy than with 1 and 2 ml based on symptom relief and functional improvement for CTS at the 1st, 4th, and 12th week post-injection, with no reports of severe adverse effects. There was no significant difference between the three groups at the 24th-week post-injection follow-up.Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT03598322.

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