A NEW DIAGNOSTIC PROVOCATION TEST FOR CARPAL TUNNEL SYNDROME: OKUTSU TEST

Hand Surgery ◽  
2010 ◽  
Vol 15 (02) ◽  
pp. 65-69 ◽  
Author(s):  
A. Yoshida ◽  
I. Okutsu ◽  
I. Hamanaka
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Success Rate ◽  
Carpal Tunnel ◽  
Wrist Joint ◽  
Provocation Test ◽  
Joint Movement ◽  
Wrist Extension ◽  
Provocation Tests ◽  
Positive Rate ◽  
Tunnel Syndrome

Many authors have reported various clinical provocation tests for diagnosis of carpal tunnel syndrome, however, some tests cannot be administered correctly on patients who suffer from restricted wrist joint movement. We compiled positive rates from a new diagnostic provocation test (Okutsu test) carried out on 3474 hands, and compared them and their success rates with results from other provocation tests performed on these same hands. The Okutsu test positive rate was 72.4%. There were statistical differences between Phalen test (69.8%) and wrist-extension test (60.2%) results. The Okutsu test success rate was 99.9% and there were statistical differences between Phalen test (52.8%) and wrist-extension test (56.8%) results. There were no statistical differences between percussion test at the wrist results in positive rate (71.1%) and in success rate (99.7%). The Okutsu test positive rate is high and it serves as a reliable screening test for clinical diagnosis of carpal tunnel syndrome.

Longitudinal Sliding of the Median Nerve in Patients with Carpal Tunnel Syndrome

2003 ◽  
Vol 28 (5) ◽  
pp. 439-443 ◽  
Author(s):  
E. EREL ◽  
A. DILLEY ◽  
J. GREENING ◽  
V. MORRIS ◽  
B. COHEN ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Metacarpophalangeal Joint ◽  
Nerve Compression ◽  
Joint Movement ◽  
Nerve Compression Syndromes ◽  
Affected Side ◽  
Tunnel Syndrome ◽  
Compression Syndromes

In nerve compression syndromes restricted nerve sliding may lead to increased strain, possibly contributing to symptoms. Ultrasound was used to examine longitudinal median nerve sliding in 17 carpal tunnel syndrome patients and 19 controls during metacarpophalangeal joint movement. Longitudinal movement in the forearm averaged 2.62 mm in controls and was not significantly reduced in carpal tunnel syndrome (CTS) patients (mean=2.20 mm). In contrast, CTS patients had a 40% reduction in transverse nerve movement at the wrist on the most, compared to least, affected side and nerve areas were enlarged by 34%. Normal longitudinal sliding in the patients indicates that nerve strain is not increased and will not contribute to symptoms.

scholarly journals Carpal Tunnel Syndrome and its relation to dentist

2015 ◽  
Vol 27 (3) ◽  
Author(s):  
Nyoman Ayu Anggayanti ◽  
I Putu Gde Adiatmika
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Musculoskeletal Disorders ◽  
Carpal Tunnel ◽  
Wrist Joint ◽  
Compressive Force ◽  
Incidence Rates ◽  
Wrist Flexion ◽  
Entrapment Neuropathies ◽  
Compressive Neuropathy ◽  
Tunnel Syndrome

Introduction: Carpal Tunnel Syndrome (CTS) is a compressive neuropathy, caused by mechanical distortion produced by a compressive force of the median nerve at the level of the wrist. Primary sign is pain in the wrist, tingling sensation, pain or numbness in thumb, index finger, middle finger, and radial side of the ring finger, also there is a reduction of the grip strength and function of the affected hand. This sign tend to be worse at night and clumsiness during the activities that requiring wrist flexion. This syndrome is well-known and frequent accounts for 90% of all entrapment neuropathies. Incidence rates up to 276:100.000 per year. More common in females than in males, its occurrence is commonly bilaterally with a peak age range of 40 to 60 years. This is the productive age, which is often reported that the Carpal Tunnel Syndrome are work-related musculoskeletal disorders caused by strain and repeated movements. Disscussion: Dentist are high risks to go through musculoskeletal disorders covering wrist joint. The condition may happen because of the dentist position while handling patients is not in ergonomic position. These include repetitive prolonged hand activities, forceful static posture of wrist, vibration, and localized mechanical stress. To reduce the symptoms of musculoskeletal disorders since the beginning, has developed an integrated concept of teamwork in a modern dental practice. This concept is known as the four-handed dentistry which consists of dentists and assistants with their respective skills. Conclusion: The four-handed treatment techniques has been developed that is now largely acceptable. The concept of four-handed dentistry is expected to prevent the movement that makes the muscles tense, especially in the area around the wrist. And may ultimately reduce the incidence of Carpal Tunnel Syndrome

scholarly journals Iatrogenic carpal tunnel syndrome induced by wrist extension for placement of an indwelling radial artery catheter: a case report

2017 ◽  
Vol 3 (1) ◽  
Author(s):  
Kunitaro Watanabe ◽  
Shingo Mitsuda ◽  
Akira Motoyasu ◽  
Joho Tokumine ◽  
Kumi Moriyama ◽  
...  
Keyword(s):  
Case Report ◽  
Carpal Tunnel Syndrome ◽  
Radial Artery ◽  
Carpal Tunnel ◽  
Wrist Extension ◽  
Tunnel Syndrome ◽  
Radial Artery Catheter

The Accuracy of a Screening System for Carpal Tunnel Syndrome Using Hand Drawing: Case-Control Study (Preprint)

2021 ◽  
Author(s):  
Takuro Watanabe ◽  
Takafumi Koyama ◽  
Eriku Yamada ◽  
Akimoto Nimura ◽  
Koji Fujita ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Wrist Joint ◽  
Screening Method ◽  
Ring Finger ◽  
Manual Dexterity ◽  
Training Data ◽  
Support Vector ◽  
Initial Symptoms ◽  
Tunnel Syndrome

BACKGROUND Carpal tunnel syndrome (CTS) is an entrapment neuropathy that occurs due to compression of the median nerve as it passes through the carpal tunnel at the wrist joint. The initial symptoms are numbness and sensory disturbance from the thumb to the ring finger. As CTS becomes severe, thumb motion is reduced, which affects manual dexterity. Patients begin to experience symptoms such as difficulties in writing. OBJECTIVE We developed a screening method for CTS using a tablet and stylus, focusing on writing motion, and verified its accuracy. METHODS We recruited 33 patients with CTS and 31 healthy volunteers for this study. The patients in the CTS group were diagnosed with CTS by hand surgeons in the orthopedic outpatient clinic based on physical examination and nerve conduction studies. We developed a tablet app to measure the stylus trajectory and pressure of the stylus tip when drawing a spiral on a tablet screen using a stylus and subsequently used these data as training data to predict the participants as non-CTS or CTS using a support vector machine. RESULTS Non-CTS and CTS were classified with 82% sensitivity and 71% specificity. The area under the curve was 0.81. CONCLUSIONS We proposed a CTS screening method that focuses on manual dexterity. This method can facilitate the screening for potential patients with CTS and provide a quantitative assessment of CTS.

Effect of Wrist Position on Power Grip and Key Pinch Strength Following Carpal Tunnel Decompression

2004 ◽  
Vol 29 (4) ◽  
pp. 390-392 ◽  
Author(s):  
K. MATHUR ◽  
P. B. PYNSENT ◽  
S. B. VOHRA ◽  
B. THOMAS ◽  
S. C. DESHMUKH
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Grip Strength ◽  
Carpal Tunnel ◽  
Pinch Strength ◽  
Wrist Flexion ◽  
Wrist Extension ◽  
Local Infiltration ◽  
Power Grip ◽  
Tunnel Syndrome ◽  
Flexion And Extension

Power grip and thumb key pinch strength were measured pre- and immediately postoperatively in 30 patients with carpal tunnel syndrome while the wrist was in flexion and extension. The carpal tunnel decompression was performed under local infiltration with 1% lignocaine. Grip strength decreased more in wrist flexion than in wrist extension. No difference was found in thumb pinch strength. The authors conclude that some of the immediate postoperative loss of grip strength in wrist flexion can be attributed to prolapse of flexor tendons out of the carpal tunnel in this position.

Provocation tests in doppler ultrasonography for carpal tunnel syndrome

2012 ◽  
Vol 47 (1) ◽  
pp. 116-117 ◽  
Author(s):  
Esther S. NG ◽  
Kay W. NG ◽  
Einar P. Wilder-Smith
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Doppler Ultrasonography ◽  
Provocation Tests ◽  
Tunnel Syndrome

A case report of carpal tunnel syndrome caused by tripartite ganglion of the wrist joint.

1984 ◽  
Vol 33 (1) ◽  
pp. 122-125
Author(s):  
Masafumi Nakamura ◽  
Fujio Higuchi ◽  
Naoto Shiba ◽  
Masanori Nakashima ◽  
Osamu Tokunaga ◽  
...  
Keyword(s):  
Case Report ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Wrist Joint ◽  
Tunnel Syndrome

The Impact of Wrist Extension Provocation on Current Perception Thresholds in Patients with Carpal Tunnel Syndrome: A Pilot Study

2006 ◽  
Vol 19 (3) ◽  
pp. 299-306 ◽  
Author(s):  
Jeff Aird ◽  
Ryan Cady ◽  
Haseeb Nagi ◽  
Shaveen Kullar ◽  
Joy C. MacDermid
Keyword(s):  
Pilot Study ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Wrist Extension ◽  
Tunnel Syndrome ◽  
The Impact

scholarly journals Periarticular Calcification Causing Acute Carpal Tunnel Syndrome: A Case Report

2009 ◽  
Vol 17 (2) ◽  
pp. 234-237 ◽  
Author(s):  
Vasu Pai ◽  
Vishal Pai ◽  
Ross Muir
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Wrist Joint ◽  
Full Blood Count ◽  
Normal Ranges ◽  
Tunnel Syndrome ◽  
Hydroxyapatite Deposition Disease ◽  
One Year ◽  
The One ◽  
Acute Carpal Tunnel Syndrome

We report a case of acute carpal tunnel syndrome caused by periarticular calcification (hydroxyapatite deposition disease) around the wrist joint in a 64-year-old woman. She had acute severe pain, exacerbated by wrist movements and extension of the fingers. Her full blood count, urea, electrolytes, uric acid, calcium, phosphate, alkaline phosphatase, and thyroid function levels were all within normal ranges, and her serum was negative for rheumatoid factor. Computed tomography revealed lobulated calcification close to the volar capsule. She underwent an emergency surgical decompression of the carpal tunnel under general anaesthesia within 3 hours of presentation. The flexor tendon sheaths were excised, and ‘toothpaste-like’ chalky material (hydroxyapatite crystals) in the capsule was removed. The pain was relieved dramatically and her median nerve function recovered. She was symptom-free at the one-year follow-up.

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