scholarly journals The Association Between Concomitant Ulnar Nerve Compression at the Elbow and Carpal Tunnel Syndrome

Hand ◽  
2018 ◽  
Vol 15 (3) ◽  
pp. 335-340 ◽  
Author(s):  
Brandon Shulman ◽  
Jonathan Bekisz ◽  
Christopher Lopez ◽  
Samantha Maliha ◽  
Siddharth Mahure ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Nerve Compression ◽  
Concomitant Treatment ◽  
Ulnar Nerve Compression ◽  
Median Nerve Compression ◽  
Number Of Patients ◽  
Tunnel Syndrome

Background: Many patients treated for ulnar nerve compression at the elbow (UNE) are concomitantly treated for carpal tunnel syndrome (CTS). We sought to investigate the association between the conditions. Methods: The Statewide Planning and Research Cooperative System (SPARCS) database was used to determine the number of patients with UNE concomitantly treated for CTS in New York State from 2003 to 2014. We then retrospectively reviewed each patient who received surgical treatment for UNE (n = 222 patients) or CTS (n = 1063 patients) at our tertiary care institution in 2014 and 2015 to assess concomitant treatment. Results: In the SPARCS database, the percentage of patients surgically treated for concomitant UNE and CTS steadily increased from 23% in 2003 to 45% in 2014. At our institution, 50 of 222 patients (23%) surgically treated for UNE underwent concomitant carpal tunnel releases. For concomitantly treated patients, 94% had examinations consistent with UNE and CTS, 87% of patients had median nerve compression on electrodiagnostic tests, and 72% of patients had UNE on electrodiagnostic tests. Conclusions: Most patients concomitantly treated for UNE and CTS have objective findings of both conditions. At least one-fourth of patients indicated for operative ulnar nerve release also require a carpal tunnel release—far beyond the prevalence of CTS in the general population. A diagnosis of UNE merits a comprehensive workup by the treating surgeon and a high suspicion for concomitant median nerve compression.

Carpal Tunnel Syndrome Caused by a Simple Ganglion

HAND ◽  
1981 ◽  
Vol os-13 (2) ◽  
pp. 164-166 ◽  
Author(s):  
F. J. Harvey ◽  
J. S. Bosanquet
Keyword(s):  
Case Report ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Peripheral Nerves ◽  
Nerve Compression ◽  
Median Nerve Compression ◽  
Deep Branch ◽  
Tunnel Syndrome

The compression of peripheral nerves by simple ganglia is a well recognized and documented clinical entity. It has been reported where ganglia have been associated with the ankle, knee and elbow joints (D. M. Brooks, 1952). It is probably best known in compression of the deep branch of the ulnar nerve in the wrist, first described by Seddon (Seddon H. J. 1952). Median nerve compression at the wrist, however, that causes a carpal tunnel syndrome would appear to be well recognized but poorly documented. Brooks (1952) described a case and until now, no others have been recorded in the literature. This case report describes such median nerve involvement with some interesting features.

What symptoms are truly caused by median nerve compression in carpal tunnel syndrome?

2005 ◽  
Vol 116 (2) ◽  
pp. 275-283 ◽  
Author(s):  
Daniel Bocchese Nora ◽  
Jefferson Becker ◽  
João Arthur Ehlers ◽  
Irenio Gomes
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Compression ◽  
Median Nerve Compression ◽  
Tunnel Syndrome

Use of the Palmaris Brevis Flap for Preventing Recurrent Median Nerve Compression in Mucolipidosis

1999 ◽  
Vol 24 (3) ◽  
pp. 300-302 ◽  
Author(s):  
M. B. H. KELLY ◽  
L. BOSMANS ◽  
D. GAULT
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Compression ◽  
Median Nerve Compression ◽  
Internal Neurolysis ◽  
Tunnel Syndrome ◽  
Bilateral Carpal Tunnel Syndrome

In a patient with severe, recurrent bilateral carpal tunnel syndrome secondary to mucolipidosis, the ‘turnover’ palmaris brevis flap was used in conjunction with internal neurolysis. The procedure was effective in alleviating symptoms of recurrent carpal tunnel compression in both hands.

Bifid Median Nerve Compression due to a Musculotendinous Anomaly of FDS to the Middle Finger

1994 ◽  
Vol 19 (5) ◽  
pp. 616-617 ◽  
Author(s):  
S. FERNANDEZ-GARCIA ◽  
J. PI-FOLGUERA ◽  
F. ESTALLO-MATINO
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Muscle Contraction ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Middle Finger ◽  
The Other ◽  
Nerve Compression ◽  
Musculotendinous Junction ◽  
Median Nerve Compression ◽  
Tunnel Syndrome

A case is presented of a bifid median nerve whose longest portion had a normal course while the other portion passed through a hole in the FDS tendon of the middle finger, at its musculotendinous junction. This caused nerve compression during muscle contraction, producing pain and dysaesthesia in the middle finger suggesting carpal tunnel syndrome.

TWO CASES OF ENDOSCOPIC MANAGEMENT OF CARPAL TUNNEL SYNDROME IN MACRODACTYLY PATIENTS

Hand Surgery ◽  
2007 ◽  
Vol 12 (01) ◽  
pp. 41-46 ◽  
Author(s):  
A. Yoshida ◽  
I. Okutsu ◽  
I. Hamanaka ◽  
S. Morimoto
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Muscle Power ◽  
Nerve Compression ◽  
Endoscopic Management ◽  
Decompression Surgery ◽  
Median Nerve Compression ◽  
Flexor Retinaculum ◽  
Tunnel Syndrome

Some cases of carpal tunnel syndrome in macrodactyly patients have been reported. We performed endoscopic carpal canal release on two unilateral macrodactyly patients suffering from bilateral carpal tunnel syndrome. We measured carpal canal pressure before performing endoscopic surgery using the Universal Subcutaneous Endoscope system to confirm median nerve compression. We diagnosed median nerve compression in each patient due to the high preoperative carpal canal pressure. Carpal canal pressure immediately decreased to within normal range following release of both the flexor retinaculum and the distal holdfast fibres of the flexor retinaculum. One patient recovered to within normal in terms of sensory disturbances and abductor pollicis brevis muscle strength. The other patient showed improvement in terms of sensory disturbance, however, muscle power did not recover because this patient had suffered from carpal tunnel syndrome for ten years. Endoscopic carpal canal release and decompression surgery was effective for carpal tunnel syndrome in both macrodactyly patients.

Nerves

2011 ◽  
Author(s):  
David Warwick ◽  
Roderick Dunn ◽  
Erman Melikyan ◽  
Jane Vadher
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Upper Limb ◽  
Carpal Tunnel ◽  
Clinical Assessment ◽  
Ulnar Nerve Compression ◽  
Anterior Interosseous Nerve ◽  
Tunnel Syndrome ◽  
Anterior Interosseous Nerve Syndrome

Neuroanatomy 298Examination of the nerves of the upper limb 300Clinical assessment 304Neurophysiology tests 306Nerve injury 310Compression neuropathy 314Carpal tunnel syndrome 315Proximal compression of the median nerve 318Anterior interosseous nerve syndrome 319Ulnar nerve compression at the elbow ...

Complication Avoidance in Peripheral Nerve Surgery:Injuries,Entrapments, and Tumors of the Extremities—part 2

2006 ◽  
Vol 59 (suppl_4) ◽  
pp. ONS-449-ONS-457
Author(s):  
Stephen M. Russell ◽  
David G. Kline
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Peripheral Nerve ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Nerve Compression ◽  
Surgery Complications ◽  
Ulnar Nerve Compression ◽  
Peripheral Nerve Surgery ◽  
Tunnel Syndrome ◽  
Nerve Surgery

Abstract The goal of this two-part review is to discuss peripheral nerve surgery complications, along with the techniques and principles used to prevent them. In this second article, we concentrate on injuries, tumors, and entrapment of nerves in the extremities, including carpal tunnel syndrome and ulnar nerve compression at the elbow.

scholarly journals Change to movement and morphology of the median nerve resulting from steroid injection in patients with mild carpal tunnel syndrome

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hyunseok Moon ◽  
Byung Joo Lee ◽  
Donghwi Park
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Aspect Ratio ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Steroid Injection ◽  
Nerve Compression ◽  
Median Nerve Compression ◽  
Significant Difference ◽  
Before And After ◽  
Tunnel Syndrome

Abstract There are conflicting hypotheses regarding the initial pathogenesis of carpal tunnel syndrome (CTS). One hypothesis characterizes it as inflammation of the median nerve caused by compression, while another hypothesis characterizes CTS as non-inflammatory fibrosis of the subsynovial connective tissue (SSCT). This study aimed to investigate the differences in the ultrasonography parameters before and after a steroid injection, which is effective for CTS, to elucidate the initial pathogenesis of CTS and the mechanisms of action of the injected steroid. Fourteen hands from 14 healthy participants and 24 hands from 24 participants with mild CTS were examined. Dynamic movement and morphology of the median nerve before and after steroid injection were measured. There was no significant difference in the normalized maximal distance of the median nerve, which reflects the degree of fibrosis in the SSCT indirectly, during finger and wrist movements before and after the injection among patients with CTS (p > 0.05). Among the parameters that indirectly reflects the degree of median nerve compression, such as normalized maximal change in the aspect ratio of the minimum-enclosing rectangle (MER), maximal change in the median nerve perimeter, and maximal value of the median nerve cross-sectional area (CSA), statistically significant differences were not observed between values of the normalized maximal change in the aspect ratio of the MER and maximal change in the median nerve perimeter, during finger and wrist movements recorded before and after the injection in patients with CTS (p > 0.05). However, multivariate logistic regression analysis revealed that the change in the normalized maximal value of the median nerve CSA, according to finger and wrist movement was correlated with the administration of the steroid injection (p < 0.05). In conclusion, compared to that noted before steroid injection, the median nerve CSA noted during finger and wrist movements changed significantly after injection in patients with mild CTS. Given the improvement in median nerve swelling after steroid injection, but no improvement in the movement of the median nerve during finger and wrist movements, median nerve swelling due to compression (rather than fibrosis of the SSCT may be the initial pathogenesis of early-stage (mild) CTS, and the fibrous changes around the median nerves (SSCT) may be indicative of secondary pathology after median nerve compression. Further studies are required to validate the findings of our study and confirm the pathogenesis of CTS.

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