scholarly journals Diagnostics and treatment of tunnel neuropathies

Pain medicine ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 44-51
Author(s):  
Oleksandr Lemeshov ◽  
Iurii Chyrka
Keyword(s):  
Nervous System ◽  
Cubital Tunnel Syndrome ◽  
Tarsal Tunnel ◽  
Pronator Teres ◽  
Superficial Branch ◽  
Patients With Diabetes ◽  
Tunnel Syndrome ◽  
Double Crush ◽  
Double Crush Syndrome ◽  
All Diseases

Relevance. Tunnel neuropathy – a damage of the peripheral nervous system that are common and range from 8 to 52 % of all diseases of the nervous system. Objective. To show the main features of the diagnosis and treatment of various tunnel neuropathy.Materials and Methods. Considerable experience of effective surgical treatment of tunnel neuropathies. 481 operations were performed during 2014–2019. The experience is described and structured.Results. The most common tunnel neuropathy of the upper extremity: carpal tunnel syndrome, pronator teres syndrome, cubital tunnel syndrome, Guyon's canal syndrome, radial neuropathy, thoracic outlet syndrome. Lower extremity: tarsal tunnel syndrome, Bernhardt – Roth syndrome, neuropathy of the peroneal nerve and its superficial branch. From 6.7 % to 78 % of patients with tunnel neuropathies, double crush syndrome occurs – nerve compression at two levels, which is more common in patients with diabetes mellitus. Such diseases are diagnosed clinically and instrumentally – electromyography, ultrasound, MRI. All the above pathologies are effectively treated surgically, which aims at decompression of the affected nerve. An important factor in complex treatment is early rehabilitation and physiotherapy procedures.Conclusions. Tunnel neuropathy is a common pathology that is effectively treated surgically. Diseases should be timely diagnosed to prevent severe and irreversible changes.

Double Crush Syndrome in the Lower Extremity

2012 ◽  
Vol 102 (4) ◽  
pp. 330-333 ◽  
Author(s):  
Anthony V. Borgia ◽  
Jerome K. Hruska ◽  
Karina Braun
Keyword(s):  
Lower Extremity ◽  
Crush Syndrome ◽  
Tarsal Tunnel ◽  
Massage Therapist ◽  
Proximal Lesion ◽  
Tunnel Syndrome ◽  
Double Crush ◽  
Double Crush Syndrome ◽  
Failure To Progress ◽  
Satisfactory Manner

Upton and McComas first described double crush syndrome in 1973. The theory behind double crush syndrome postulated that a proximal lesion in a nerve would make that same nerve more vulnerable to additional distal lesions. Many of the studies investigating the possibility of the double crush syndrome involve lesions in the upper extremity with very few articles written specifically about double crush syndrome in the lower extremity. We present the case of a 33-year-old massage therapist who uses her feet to provide therapy to clients who presented to our clinic with symptoms consistent with tarsal tunnel syndrome. Her failure to progress in a satisfactory manner after a variety of therapies made us search for additional etiologies for her foot pain. In cases where tarsal tunnel persists after surgical therapy, the treating physician should search for more proximal lesions along the course of the nerve. (J Am Podiatr Med Assoc 102(4): 330–333, 2012)

The Relationship of the Double Crush to Carpal Tunnel Syndrome (An Analysis of 1,000 Cases of Carpal Tunnel Syndrome)

1985 ◽  
Vol 10 (2) ◽  
pp. 202-204
Author(s):  
LAWRENCE C. HURST ◽  
DAVID WEISSBERG ◽  
ROBERT E. CARROLL
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Surgery ◽  
Significant Incidence ◽  
Tunnel Syndrome ◽  
Relationship Of ◽  
The Relationship ◽  
Double Crush ◽  
Double Crush Syndrome ◽  
Bilateral Carpal Tunnel Syndrome

In this series of 1,000 cases of carpal tunnel syndrome (888 patients) there is a statistically significant incidence of bilaterality in patients with cervical arthritis. There is also a statistically significant increase in the incidence of diabetes mellitus over the general population. These findings lend further support to Upton’s Double Crush hypothesis. Further, the double crush syndrome predisposes to bilateral carpal tunnel syndrome and may be an important prognostic factor. It may also be an explanation for some of the failures following carpal tunnel surgery and lead surgeons to look for other associated systemic diseases or mechanical blocks, when attempting to alleviate recalcitrant symptoms.

scholarly journals When the contemporary presence of a cervical radiculopathy and a carpal tunnel syndrome can suggest a "double-crush" syndrome

2018 ◽  
Vol 4 (1) ◽  
Author(s):  
Martiniani M ◽  
Meco L ◽  
Procaccini R ◽  
Carrabs Valleverdina A ◽  
Letizia Senesi ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Cervical Radiculopathy ◽  
Crush Syndrome ◽  
Tunnel Syndrome ◽  
Double Crush ◽  
Double Crush Syndrome

scholarly journals The Carpal Tunnel Syndrome and the Double Crush Syndrome Hypothesis: Revisited

2019 ◽  
Vol 87 (12) ◽  
pp. 4193-4198
Author(s):  
HEBA RAAFAT, M.D.; AMIRA A. LABIB, M.D. ◽  
MOHAMED R.A. SALEH, M.D.
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Crush Syndrome ◽  
Tunnel Syndrome ◽  
Double Crush ◽  
Double Crush Syndrome

Submuscular Transposition of the Ulnar Nerve for the Treatment of Cubital Tunnel Syndrome

2008 ◽  
Vol 63 (suppl_4) ◽  
pp. ONS321-ONS325 ◽  
Author(s):  
Rashid M. Janjua ◽  
Julius Fernandez ◽  
Gabriel Tender ◽  
David G. Kline
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Pronator Teres ◽  
Flexor Carpi Ulnaris ◽  
Tunnel Syndrome ◽  
Current Article

Abstract THE ULNAR NERVE is compressed at the cubical notch in patients with cubital tunnel syndrome. To definitively alleviate this compression, the nerve can be transposed under the pronator teres and flexor carpi ulnaris muscles. This procedure is also known as medianization of the ulnar nerve because it then courses parallel to the median nerve. In the current article the procedure is described in a step-by-step fashion.

scholarly journals Outcome of Surgical Treated Isolated Pronator Teres Syndromes—A Retrospective Cohort Study and Complete Review of the Literature

2021 ◽  
Vol 19 (1) ◽  
pp. 80
Author(s):  
Harald Binder ◽  
Armin Zadra ◽  
Domenik Popp ◽  
Micha Komjati ◽  
Thomas M. Tiefenboeck
Keyword(s):  
Clinical Signs ◽  
Retrospective Chart Review ◽  
Dash Score ◽  
Review Of The Literature ◽  
Pronator Teres ◽  
Hand Dynamometer ◽  
Tunnel Syndrome ◽  
Male Patients ◽  
Double Crush

Purpose: This study aims to elucidate the occurrence of postoperative carpal tunnel syndrome (CTS), the functional outcome of patients with primary pronator teres syndrome (PTS), and review complete literature regarding this topic. Material and Methods: A retrospective chart review was conducted in patients with PTS at a single center. In all patients, a numeric Visual Analog Scale (VAS) score, Pinch-Test, Jamar hand dynamometer test (JAMAR), and the Disabilities of the Arm Shoulder and Hand (DASH) score were analyzed preoperatively and at final follow-up to assess outcome. Additionally, a complete review of the literature was performed, including all data dealing with pronator teres syndrome. Results: Ten female and two male patients were included with a mean age of 49 years. Significant improvement in DASH and numeric VAS was detected at latest postoperative follow-up. In three patients, clinical signs of CTS pathology were detected during the follow-up period. One patient needed to be treated surgically, and in the other two patients, a conservative management was possible. In one patient (8%), a PTS recurrence was detected. All patients presented satisfied at latest follow-up. Conclusion: In one-fourth of our patients, a CTS occurred during the follow-up period. Therefore, focusing on double-crush syndrome in unclear or mixed symptoms is necessary to avoid multiple operations. Furthermore, it seems that assessment with NCV is not enough for diagnosing PTS; therefore, further research is needed to clarify this problem.

Distal Rupture of the Biceps Tendon with Median Nerve Neurological Symptoms

1993 ◽  
Vol 1 (4) ◽  
pp. 191-191
Author(s):  
Mm Al- Qattan ◽  
Cva Bowen
Keyword(s):  
Median Nerve ◽  
Tendon Rupture ◽  
Biceps Tendon ◽  
Acute Onset ◽  
Neurological Symptoms ◽  
Distal Biceps Tendon ◽  
Biceps Tendon Rupture ◽  
Tunnel Syndrome ◽  
Double Crush ◽  
Double Crush Syndrome

MM Al-Qattan, CVA Bowen. Distal rupture of the biceps tendon with median nerve neurological symptoms. Can J Plast Surg 1994;1(4):191. A rare case of acute onset of median nerve neurological symptoms associated with distal biceps tendon rupture is reported. The patient had a pre-existing asymptomatic carpal tunnel syndrome and the pathophysiology was thought to be the double crush syndrome.

Double Crush Syndrome Related to the Thoracic Outlet Syndrome

Hand Surgery ◽  
1997 ◽  
Vol 02 (02) ◽  
pp. 131-133 ◽  
Author(s):  
Jun Nishida ◽  
Katsuaki Ichinohe ◽  
Tadashi Shimamura ◽  
Masataka Abe
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Thoracic Outlet Syndrome ◽  
Cubital Tunnel Syndrome ◽  
Entrapment Neuropathy ◽  
Cubital Tunnel ◽  
Provocation Tests ◽  
Tunnel Syndrome ◽  
Double Crush ◽  
Ulnar Tunnel

Cases diagnosed as having thoracic outlet syndrome were examined by neurological examination, including provocation tests, electromyography and radiological examinations, to detect other sites of entrapment neuropathy of the upper extremity. During the last four years, 555 upper extremities of 494 patients were diagnosed as having thoracic outlet syndrome. Forty-five patients (9.3%) were diagnosed as having other entrapment neuropathy in one extremity. Ten cases were complicated by cervical radiculopathy, 15 by carpal tunnel syndrome, 11 by cubital tunnel syndrome, five by radial tunnel syndrome, two by ulnar tunnel syndrome, two by both carpal tunnel and cubital tunnel syndrome, and one by both cubital and ulnar tunnel syndrome. Surgery was performed for 15 limbs, and the distal lesion was operated on the first in two-thirds of these patients. The relationship between thoracic outlet syndrome and cubital tunnel syndrome or carpal tunnel syndrome has been reported by several authors, but the rates of incidence vary among reports. The rate of incidence seems to depend upon the diagnostic technique. After adoption of the appropriate provocation tests, patients with thoracic outlet syndrome complicated by other entrapment neuropathies were detected at a relatively high rate of incidence. Provocation tests seem to be an essential measure for the diagnosis of double crush syndromes.

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