Carpal tunnel syndrome in pediatric mucopolysaccharidoses

1975 ◽  
Vol 43 (1) ◽  
pp. 102-103 ◽  
Author(s):  
Michael E. Miner ◽  
R. Neil Schimke
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Clinical Examination ◽  
Carpal Tunnel ◽  
Pediatric Patients ◽  
Surgical Decompression ◽  
Content Type ◽  
Careful Clinical Examination ◽  
Tunnel Syndrome ◽  
Fine Print

✓ Four pediatric patients with mucopolysaccharidoses and an associated carpal tunnel syndrome are presented. Findings in these cases were typical of the adult form of median nerve compression at the wrist, but the patients had minimal symptoms in view of these findings. The importance of careful clinical examination and early surgical decompression is emphasized.

Magnetic resonance neurography studies of the median nerve before and after carpal tunnel decompression

2002 ◽  
Vol 96 (6) ◽  
pp. 1046-1051 ◽  
Author(s):  
Simon A. Cudlip ◽  
Franklyn A. Howe ◽  
Andrew Clifton ◽  
Martin S. Schwartz ◽  
B. Anthony Bell
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Surgical Decompression ◽  
Mr Neurography ◽  
Magnetic Resonance Neurography ◽  
Content Type ◽  
Before And After ◽  
Tunnel Syndrome ◽  
Fine Print

Object. Recently developed novel MR protocols called MR neurography, which feature conspicuity for nerve, have been shown to demonstrate signal change and altered median nerve configuration in patients with median nerve compression. The postoperative course following median nerve decompression can be problematic, with persistent symptoms and abnormal results on electrophysiological studies for some months, despite successful surgical decompression. The authors undertook a prospective study in patients with carpal tunnel syndrome, correlating the clinical, electrophysiological, and MR neurography findings before and 3 months after surgery. Methods. Thirty patients and eight control volunteers were recruited to the study. The MR neurography consisted of axial and sagittal images (TR = 2000 msec, TE = 60 msec) obtained using a temporomandibular surface coil, fat saturation, and flow suppression. Maximum intensity projection images were used to follow the median nerve through the carpal tunnel in the sagittal plane. Magnetic resonance neurography in patients with carpal tunnel syndrome demonstrated proximal swelling (p < 0.001) and high signal change in the nerve, together with increased flattening ratios (p < 0.001) and loss of nerve signal in the distal carpal tunnel (p < 0.05). Sagittal images were very effective in precisely demonstrating the site and severity of nerve compression. After surgery, division of the flexor retinaculum could be demonstrated in all cases. Changes in nerve configuration, including increased cross-sectional area, and reduced flattening ratios (p < 0.001) were seen in all patients. In many cases restoration of the T2 signal intensity toward that of controls was seen in the median nerve in the distal carpal tunnel. Sagittal images were excellent in demonstrating expansion of the nerve at the site of surgical decompression. Conclusions. In this study the authors suggest that MR neurography is an effective means of both confirming compression of the median nerve and its successful surgical decompression in patients with carpal tunnel syndrome. This modality may prove useful in the assessment of unconfirmed or complex cases of carpal tunnel syndrome both before and after surgery.

Surgery of the carpal tunnel

1978 ◽  
Vol 49 (2) ◽  
pp. 316-318 ◽  
Author(s):  
Noel Eboh ◽  
Donald H. Wilson
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Modified Technique ◽  
Content Type ◽  
Electrical Studies ◽  
Entrapment Neuropathies ◽  
Palmaris Longus ◽  
Tunnel Syndrome ◽  
Fine Print

✓ The authors describe a modified technique for surgery of the carpal tunnel. The primary cause of the carpal tunnel syndrome is the same as other entrapment neuropathies: an enlarged nerve within a tight tunnel. Electrical studies have shown that the area of compression is in the middle of the tunnel. Treatment is surgical: a palmar incision, which begins at the wrist medial to the palmaris longus, to avoid damage to the sensory branch of the median nerve; and section of the retinaculum from the exit of the tunnel toward the entrance.

Atypical carpal tunnel syndrome with compression of the ulnar and median nerves

1981 ◽  
Vol 54 (5) ◽  
pp. 668-669 ◽  
Author(s):  
Vagn Eskesen ◽  
Jarl Rosenørn ◽  
Ole Osgaard
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Clinical Signs ◽  
Content Type ◽  
Nerve Involvement ◽  
Tunnel Syndrome ◽  
Fine Print

✓ Clinical signs of ulnar nerve involvement at the wrist level were found in a 51-year-old man. The electrophysiological changes were indicative of a median nerve involvement in the carpal tunnel. At operation, the compressed ulnar nerve was found in the carpal tunnel, together with the median nerve. This localization of the ulnar nerve has not been described previously.

Anomalous course of the recurrent motor branch of the median nerve in a patient with carpal tunnel syndrome

1977 ◽  
Vol 47 (1) ◽  
pp. 113-114 ◽  
Author(s):  
J. Douglas Werschkul
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Motor Branch ◽  
Content Type ◽  
Tunnel Syndrome ◽  
Fine Print

✓ A case is discussed in which carpal tunnel syndrome with an unusual course of the motor recurrent branch was discovered at operation. The importance of a careful dissection of the median nerve in this condition is emphasized.

scholarly journals Incidental finding of a persistent median artery (palmar type) during a routine carpal tunnel decompression: a case report

2017 ◽  
Vol 99 (7) ◽  
pp. e204-e205
Author(s):  
J Butt ◽  
AK Ahluwalia ◽  
A Dutta
Keyword(s):  
Case Report ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Incidental Finding ◽  
Surgical Decompression ◽  
Iatrogenic Injury ◽  
Palmar Fascia ◽  
Tunnel Syndrome ◽  
Median Artery

Carpal tunnel syndrome is characterised by compression of the median nerve. The mainstay of treatment is surgical decompression. This case report highlights the occurrence of a persistent median artery, which could complicate surgery. A 55-year-old woman underwent carpal tunnel decompression. An incidental finding of a large-calibre persistent median artery, which was superficial to the flexor sheath, could have been damaged. This was carefully retracted and the procedure was completed, without any complications. Several studies have shown the prevalence of persistent median artery to range from 1.1–27.1%. It is usually found deep to the flexor retinaculum but in this case it was found to be just beneath the palmar fascia. There is increased chance of iatrogenic injury with this particular variant. Surgeons performing the procedure should be mindful of this variation, because accidental damage could result in devastating consequences to the hand.

EXTRASKELETAL CHONDROMA AS A CAUSE OF CARPAL TUNNEL SYNDROME: A CASE REPORT

Hand Surgery ◽  
2005 ◽  
Vol 10 (02n03) ◽  
pp. 327-330 ◽  
Author(s):  
D. Cumming ◽  
A. Massraf ◽  
J. W. M. Jones
Keyword(s):  
Case Report ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Clinical Examination ◽  
Carpal Tunnel ◽  
Common Causes ◽  
Tunnel Syndrome ◽  
Uncommon Condition ◽  
The Common ◽  
Space Occupying Lesion

We report a case of carpal tunnel syndrome as a result of an extraosseous chondroma in a 47-year-old gentleman. This case demonstrates the importance of clinical examination and occasional radiographs in this not uncommon condition. We also highlight that this well known entrapment syndrome is not only caused by the common causes that we all know, but also any space-occupying lesion in the carpal tunnel compressing the median nerve.

Carpal tunnel syndrome caused by thrombosis of the median artery: importance of high-resolution ultrasonography for diagnosis

2002 ◽  
Vol 97 (2) ◽  
pp. 471-473 ◽  
Author(s):  
Henrich Kele ◽  
Raphaela Verheggen ◽  
Carl Detlev Reimers
Keyword(s):  
High Resolution ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Rare Case ◽  
Content Type ◽  
The Third ◽  
Tunnel Syndrome ◽  
Median Artery ◽  
High Resolution Ultrasonography ◽  
Fine Print

✓ The rare case of a patient with carpal tunnel syndrome caused by thrombosis of a persistent median artery is presented. Progressive pain in the wrist and dysesthesias in the third and fourth fingers were the atypical complaints. High-resolution ultrasonography revealed a bifid median nerve that was compressed by an occluded median artery. The intraoperative findings are described, and emphasis is placed on the importance of using high-resolution ultrasonography for presurgical diagnosis.

Endoscopic treatment of carpal tunnel syndrome: a critical review

1998 ◽  
Vol 88 (5) ◽  
pp. 817-826 ◽  
Author(s):  
David F. Jimenez ◽  
Scott R. Gibbs ◽  
Adam T. Clapper
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Critical Review ◽  
Carpal Tunnel Release ◽  
Content Type ◽  
Endoscopic Techniques ◽  
Endoscopic Carpal Tunnel Release ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Release Surgery ◽  
Fine Print

Object. The goal of this paper is to present a critical review of the endoscopic procedures currently in use for the treatment of carpal tunnel syndrome. Endoscopic techniques and outcomes are discussed. Methods. An extensive review of published articles on the subject of endoscopic carpal tunnel release surgery is presented, encompassing six endoscopic techniques used to treat carpal tunnel syndrome. Since the first report in 1987, 7091 patients have undergone 8068 operations. The overall success rate has been 96.52%, with a complication rate of 2.67% and a failure rate of 2.61%. The mean time to return to work in patients not receiving Workers' Compensation was 17.8 days, ranging between 10.8 and 22.3 days. The most common complications were transient paresthesias of the ulnar and median nerves. Other complications included superficial palmar arch injuries, reflex sympathetic dystrophy, flexor tendon lacerations, and incomplete transverse carpal ligament division. In many studies in which open and endoscopic techniques were compared, it was reported that patients in the the latter group experienced significantly less pain and returned to work and activities of daily living earlier. Conclusions. Success and complication rates of endoscopic carpal tunnel release surgery are similar to those for standard open procedures.

Carpal tunnel syndrome

1983 ◽  
Vol 59 (6) ◽  
pp. 1031-1036 ◽  
Author(s):  
Kenneth W. E. Paine ◽  
Konstantinos S. Polyzoidis
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Clinical Findings ◽  
Transverse Carpal Ligament ◽  
Content Type ◽  
Detailed Procedure ◽  
Flexor Retinaculum ◽  
Tunnel Syndrome ◽  
Fine Print

✓ The presenting symptomatology and clinical findings of 464 patients with the carpal tunnel syndrome are reviewed. The results of decompression by section of the transverse carpal ligament are presented, with particular reference to the use of the Paine retinaculotome. Approximately 90% of patients achieved very satisfactory results and complications were minimal. The commonest reason for failure is incomplete division of the flexor retinaculum. The detailed procedure is presented.

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