Entrapment syndromes

2019 ◽  
pp. 839-846
Author(s):  
Grainne Bourke ◽  
Mobin Syed
Keyword(s):  
Peripheral Nerve ◽  
Effective Treatment ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Management Strategies ◽  
Treatment Strategies ◽  
Nerve Entrapment ◽  
Cubital Tunnel ◽  
Meralgia Paraesthetica ◽  
Entrapment Syndromes

Peripheral nerve entrapment is common. Patients present with tingling and pain in the distribution of the affected nerve. This will progress to altered sensation and weakness with prolonged and/or increasing pressure. The most common nerve entrapment syndromes are carpal tunnel affecting the median nerve at the wrist and cubital tunnel affecting the ulnar nerve at the elbow. They affect the working population, so time-efficient diagnosis and robust effective treatment strategies are important to minimize the financial implications to industry. Aetiology, diagnosis, and management strategies for carpal tunnel, cubital tunnel, and meralgia paraesthetica are discussed in this chapter along with a brief overview of other entrapment syndromes. Current controversies between open and endoscopic carpal tunnel release are also reviewed.

scholarly journals Surgical treatment of nerve entrapment syndromes

2003 ◽  
Vol 50 (1) ◽  
pp. 73-82
Author(s):  
Lukas Rasulic ◽  
Vladimir Bascarevic ◽  
Irena Cvrkota
Keyword(s):  
Surgical Treatment ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Descriptive Analysis ◽  
Cubital Tunnel Syndrome ◽  
Nerve Entrapment ◽  
Cubital Tunnel ◽  
Clinical Center ◽  
Tunnel Syndrome ◽  
Entrapment Syndromes

Nerve entrapment syndromes are, by definition, states of disproportion between the volume of the peripheral nerve and the space through which a nerve in extremities passes. In the Institute of Neurosurgery, Clinical Center of Serbia carpal tunnel syndrome and cubital tunnel syndrome are the most frequent compressive neuropathies, and their frequency in our series is 91%. This study represents comparative analysis of parameters which can influence on surgical treatment of carpal and cubital tunnel syndrome. Analysis was performed on 169 patients operated on because of carpal tunnel syndrome, and 83 patients operated on because of cubital tunnel syndrome by microsurgical procedures such as decompression, transposition, epineurectomy or interfascicular neurolysis, during the period from 1979. up to 2000. Through the comparative and descriptive analysis it was investigated corelation between clinical and electrodiagnostical findings, as well as between results of the surgical treatment with intention of checking of indication for surgical treatment.

The association between surgery for carpal and cubital tunnel syndrome: analysis of incidence and risk factors within a geographical area

2021 ◽  
Vol 46 (3) ◽  
pp. 260-264
Author(s):  
Nick A. Johnson ◽  
Oliver Darwin ◽  
Dimitrious Chasiouras ◽  
Anna Selby ◽  
Chris Bainbridge
Keyword(s):  
Relative Risk ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Geographical Area ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Level Of Evidence ◽  
Tunnel Syndrome ◽  
The Relationship ◽  
Syndrome Analysis

The relationship between surgery for cubital tunnel and carpal tunnel syndrome was examined in this retrospective study. Between 1997 and 2018, data from consecutive patients who underwent carpal tunnel release (8352 patients), cubital tunnel release (1681 patients) or both procedures (692 patients) were analysed. The relative risk of undergoing cubital tunnel release in the population who had carpal tunnel release compared with those with no carpal tunnel release was 15.3 (male 20.3; female 12.5). The relative risk of undergoing carpal tunnel release in the population who had cubital tunnel release compared with those who did not undergo carpal tunnel release was 11.5 (male 16.5; female 9.1). Our study showed that men and women who undergo carpal tunnel release are over 20 times and 10 times more likely to have cubital tunnel release than those who did not undergo carpal tunnel release, respectively. These findings suggest that the two conditions may share a similar aetiology. Level of evidence: IV

scholarly journals Current Clinical Concepts: Clinical Management of Patellar Tendinopathy

2021 ◽  
Author(s):  
Adam B. Rosen ◽  
Elizabeth Wellsandt ◽  
Mike Nicola ◽  
Matthew A. Tao
Keyword(s):  
Effective Treatment ◽  
Clinical Management ◽  
Management Strategies ◽  
Treatment Strategies ◽  
Patellar Tendinopathy ◽  
Load Management ◽  
Evidence Based ◽  
Effective Treatment Option ◽  
Treatment Interventions

ABSTRACT Patellar tendinopathy is a common, yet misunderstood pathoetiology afflicting a variety of patient populations. This lack of unified understanding affects the capability of clinicians to provide effective treatment interventions. Patients with tendinopathy often report long-term and low to moderate levels of pain, diminished flexibility, and strength, as well as decreased physical function. Load-management strategies combined with exercise regimens focused on progressive tendon loading are the most effective treatment option for patients with patellar tendinopathy. This review will provide an evidence-based approach to patellar tendinopathy, including its pathoetiology, evaluation, and treatment strategies.

scholarly journals The management of failed cubital tunnel decompression

2021 ◽  
Vol 6 (9) ◽  
pp. 735-742
Author(s):  
Abdus S. Burahee ◽  
Andrew D. Sanders ◽  
Dominic M. Power
Keyword(s):  
Outcome Assessment ◽  
Diagnostic Criteria ◽  
Failure Rate ◽  
Carpal Tunnel ◽  
Revision Surgery ◽  
Carpal Tunnel Release ◽  
Nerve Transfer ◽  
Cubital Tunnel ◽  
Quality Research ◽  
Primary Procedure

Cubital tunnel decompression is a commonly performed operation with a much higher failure rate than carpal tunnel release. Failed cubital tunnel release generally occurs due to an inadequate decompression in the primary procedure, new symptoms due to an iatrogenic cause, or development of new areas of nerve irritation. Our preferred technique for failed release is revision circumferential neurolysis with medial epicondylectomy, as this eliminates strain, removes the risk of subluxation, and avoids the creation of secondary compression points. Adjuvant techniques including supercharging end-to-side nerve transfer and nerve wrapping show promise in improving the results of revision surgery. Limited quality research exists in this subject, compounded by the lack of consensus on diagnostic criteria, classification, and outcome assessment. Cite this article: EFORT Open Rev 2021;6:735-742. DOI: 10.1302/2058-5241.6.200135

Median Neuropathy—Carpal Tunnel Syndrome

2018 ◽  
Author(s):  
Meghan E. Lark ◽  
Nasa Fujihara ◽  
Kevin C. Chung
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Clinical Case ◽  
Carpal Tunnel Release ◽  
Treatment Strategies ◽  
Comprehensive Management ◽  
Tunnel Syndrome ◽  
Release Management ◽  
Phalen's Test ◽  
Median Neuropathy

This chapter presents general treatment strategies for carpal tunnel syndrome using a clinical case example. It discusses assessment and planning, diagnostic pearls, decision-making, surgical procedures (open and endoscopic carpal tunnel release), management pearls, aftercare, complications and their management, and evidence and outcomes. Physical exams, such as Phalen’s test or a Tinel sign over the median nerve, are introduced, whereas steps in the surgical procedure are shown with intraoperative photographs. The chapter provides information on modern practices for comprehensive management of carpal tunnel syndrome from start to finish.

ENDOSCOPIC CARPAL TUNNEL RELEASE: OUR EXPERIENCE WITH 12,702 CASES

Hand Surgery ◽  
2008 ◽  
Vol 13 (01) ◽  
pp. 21-26 ◽  
Author(s):  
Giorgio Pajardi ◽  
Loris Pegoli ◽  
Giorgio Pivato ◽  
Paolo Zerbinati
Keyword(s):  
Surgical Treatment ◽  
Carpal Tunnel Syndrome ◽  
Upper Extremity ◽  
Operative Treatment ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Nerve Entrapment ◽  
Entrapment Syndrome ◽  
Tunnel Syndrome ◽  
Nerve Entrapment Syndrome

Carpal tunnel syndrome (CTS) is still today the most common nerve entrapment syndrome at the level of the upper extremity. When surgery is indicated, the surgical treatment of choice is the opening of the retinaculum. The authors describe their experience on 12,702 carpal tunnel decompressions, by the endoscopic procedure in a period of 14 years, outlining the indications, post-operative treatment, complications and results.

Peripheral Nerve Entrapment Impairments Revisited: Part I

2015 ◽  
Vol 20 (1) ◽  
pp. 3-8
Author(s):  
J. Mark Melhorn ◽  
James B. Talmage ◽  
Charles N. Brooks
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Peripheral Nerve ◽  
Carpal Tunnel ◽  
Nerve Entrapment ◽  
Sensory Function ◽  
Muscle Membrane ◽  
Conduction Delay ◽  
Sixth Edition ◽  
Nerve Entrapments ◽  
Tunnel Syndrome

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, introduced the concept of diagnosis-based impairments (DBI), and a modified version of this method can be used in rating peripheral nerve injury in general (Section 5.4) and upper limb entrapment syndromes (Section 15.4f). The first portion of this article reviews the evaluation of upper extremity nerve impairment and summarizes inclusion criteria and causation correlation for carpal tunnel syndrome, Guyon's canal syndrome, cubital tunnel syndrome, anterior interosseous, Wartenberg's syndrome, and radial tunnel syndrome. Very mild nerve entrapments do exist and may fail to meet the AMA Guides criteria for impairment related to a diagnosis of nerve entrapment. Electrodiagnostic examination includes nerve conduction studies that assess the largest, most heavily myelinated axons, and needle electromyelography, which detects muscle membrane instability but not the sensory function of nerves. A case example from the AMA Guides, Sixth Edition, shows the process of permanent impairment rating in a case of carpal tunnel syndrome. Determination of impairment for peripheral nerve entrapments can be easily accomplished once one understands how to determine if the nerve under consideration from the electrodiagnostic evaluation demonstrates a conduction delay, a conduction block, or an axon loss. This establishes the test findings that usually are the only objective findings present.

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