scholarly journals Surgical profile and management of carpal tunnel syndrome among sample of Iraqi patients attending a teaching hospital

2019 ◽  
Vol 6 (5) ◽  
pp. 1477
Author(s):  
Amir Naif Kadum Al-Imari ◽  
Amine Mohammed Bakkour ◽  
Mohammed Hillu Surriah ◽  
Ayaad Makki Saaid

Background: Carpal tunnel syndrome (CTS) is a common condition that causes pain, numbness, and weakness in the hands and wrist. CTS affecting female more than male, and diagnosed by EMG and NCS. The aim of this study was to describe the profile and surgical management among sample of Iraqi patients.Methods: Sixty-two patients collected from the neuro-surgical departments of the specialized surgical hospital from June 2015 till June 2018, all patients studied thoroughly regarding age, sex, associated diseases, clinical features, EMG studies, surgery and out come and follow up for at least one year.Results: There was around 2:1 female: male, with age predominant between 40-60 years. All the patients had pain (aching) and most of them numbness, and tingling and only 1/3 had atrophy of muscle of the hand all diagnosed by EMG and NCS, treated surgically results were good compared with other studies regarding complications and final outcome.Conclusions: Surgery for CTS is safe and successful surgery under meticulus procedure and appropriate choice of patients.

Hand Surgery ◽  
2013 ◽  
Vol 18 (03) ◽  
pp. 411-412
Author(s):  
Takashi Shimoe ◽  
Yasunori Taniguchi ◽  
Munehito Yoshida

Carpal tunnel syndrome is a common condition; however, it has not been previously reported in patients with hemihypertrophy. A 67-year-old woman with left-sided hemihypertrophy presented with carpal tunnel syndrome of the left hand. Magnetic resonance imaging showed enlargement of the median nerve proximal to the transverse carpal ligament. Carpal tunnel decompression was performed, and pain was immediately relieved by decompression of the carpal tunnel. At the six-month follow-up examination, the patient experienced relief from numbness and improvement in thenar muscle atrophy was noted.


1993 ◽  
Vol 18 (4) ◽  
pp. 467-470 ◽  
Author(s):  
B. CHANG ◽  
A. L. DELLON

An approach to the surgical management of recurrent carpal tunnel syndrome was evaluated in 30 patients with 35 involved wrists. This includes internal neurolysis of the median nerve and early post-operative mobilization of the wrist and fingers. The preferred surgical approach is through a second, more ulnar incision. Clinical assessment of sensorimotor function was converted into a numerical score ranging from zero (normal) to 9 (anaesthesia) and 10 (atrophy, severe). The average pre-operative score was mean 6.5 and median 7. At a mean follow-up of 23.5 months, the average post-operative score was mean 1.8 and median 0, a statistically significant improvement (P< 0.001).


Symmetry ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1042
Author(s):  
Oscar J. Pellicer-Valero ◽  
José D. Martín-Guerrero ◽  
César Fernández-de-las-Peñas ◽  
Ana I. De-la-Llave-Rincón ◽  
Jorge Rodríguez-Jiménez ◽  
...  

Identification of subgroups of patients with chronic pain provides meaningful insights into the characteristics of a specific population, helping to identify individuals at risk of chronification and to determine appropriate therapeutic strategies. This paper proposes the use of spectral clustering (SC) to distinguish subgroups (clusters) of individuals with carpal tunnel syndrome (CTS), making use of the obtained patient profiling to argue about potential management implications. SC is a powerful algorithm that builds a similarity graph among the data points (the patients), and tries to find the subsets of points that are strongly connected among themselves, but weakly connected to others. It was chosen due to its advantages with respect to other simpler clustering techniques, such as k-means, and the fact that it has been successfully applied to similar problems. Clinical (age, duration of symptoms, pain intensity, function, and symptom severity), psycho-physical (pressure pain thresholds—PPTs—over the three main nerve trunks of the upper extremity, cervical spine, carpal tunnel, and tibialis anterior), psychological (depressive levels), and motor (pinch tip grip force) variables were collected in 208 women with clinical/electromyographic diagnosis of CTS, whose symptoms usually started unilaterally but eventually evolved into bilateral symmetry. SC was used to identify clusters of patients without any previous assumptions, yielding three clusters. Patients in cluster 1 exhibited worse clinical features, higher widespread pressure pain hyperalgesia, higher depressive levels, and lower pinch tip grip force than the other two. Patients in cluster 2 showed higher generalized thermal pain hyperalgesia than the other two. Cluster 0 showed less hypersensitivity to pressure and thermal pain, less severe clinical features, and more normal motor output (tip grip force). The presence of subgroups of individuals with different altered nociceptive processing (one group being more sensitive to pressure pain and another group more sensitive to thermal pain) could lead to different therapeutic programs.


2020 ◽  
Vol 11 (3) ◽  
Author(s):  
Mahshid Nazarieh ◽  
Azadeh Hakakzadeh ◽  
Shima Ghannadi ◽  
Faezeh Maleklou ◽  
Zahra Tavakol ◽  
...  

: One of the most common forms of entrapment neuropathy is Carpal Tunnel Syndrome (CTS). There are various treatment options for CTS. However, there are no clear and structured guidelines. This review classified the existing treatments and developed an algorithm to help physicians to choose the best option for their patients. Treatment options were summarized in three sections: non-surgical management of CTS, post-operative management of CTS, and practical open carpal tunnel release post-op protocol. The physicians can prescribe multiple treatment options to CTS patients. Corticosteroid in oral or injectable form has strong evidence in pain control and functional improvement in the short term. Shockwave therapy and nocturnal wrist splints display moderate therapeutic effects. Post carpal tunnel release rehabilitation can be started a few days after the operation.


2020 ◽  
Vol 2;23 (4;2) ◽  
pp. E175-E183
Author(s):  
Emad Zarief Kamel

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


2011 ◽  
pp. 1021-1028
Author(s):  
Jessica Collins ◽  
Jean-Sébastien Roy ◽  
Leslie L. McKnight ◽  
Achilleas Thoma

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