scholarly journals Median nerve transection following carpal tunnel release with an unusual surgical approach: A case study

2021 ◽  
Vol 12 (1) ◽  
Keyword(s):  
Median Nerve ◽  
Carpal Tunnel ◽  
Surgical Approach ◽  
Carpal Tunnel Release ◽  
Nerve Transection

scholarly journals Minimally invasive carpal tunnel surgery in leprosy

2014 ◽  
Vol 33 (01) ◽  
pp. 42-44
Author(s):  
José Marcos Pondé ◽  
Clarissa Ramos ◽  
Lazaro Santos ◽  
João Pedro Magalhaes ◽  
Ana Flavia Cavalcanti
Keyword(s):  
Developing Countries ◽  
Cost Effectiveness ◽  
Minimally Invasive ◽  
Median Nerve ◽  
Local Anesthesia ◽  
Carpal Tunnel ◽  
Surgical Approach ◽  
Carpal Tunnel Release ◽  
Nerve Involvement ◽  
Carpal Tunnel Surgery

Abstract Objective: Evaluate carpal tunnel release in leprosy. Methods: The authors operated upon 60 patients with median nerve involvement by leprosy between February 2008 and February 2012. The outpatients were under local anesthesia submitted to carpal tunnel release. Results: All the patients showed post-operative improvement in pain and sensation. Conclusion: The surgical approach is a cost effectiveness procedure adequate to developing countries.

Systematic review and meta-analysis of surgical options for recurrent or persistent carpal tunnel syndrome: simple decompression versus coverage of the median nerve

2021 ◽  
pp. 175319342110017
Author(s):  
Saskia F. de Roo ◽  
Philippe N. Sprangers ◽  
Erik T. Walbeehm ◽  
Brigitte van der Heijden
Keyword(s):  
Systematic Review ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Meta Analysis ◽  
Surgical Techniques ◽  
Open Release ◽  
Flap Coverage ◽  
Tunnel Syndrome

We performed a systematic review on the success of different surgical techniques for the management of recurrent and persistent carpal tunnel syndrome. Twenty studies met the inclusion criteria and were grouped by the type of revision carpal tunnel release, which were simple open release, open release with flap coverage or open release with implant coverage. Meta-analysis showed no difference, and pooled success proportions were 0.89, 0.89 and 0.85 for simple open carpal tunnel release, additional flap coverage and implant groups, respectively. No added value for coverage of the nerve was seen. Our review indicates that simple carpal tunnel release without additional coverage of the median nerve seems preferable as it is less invasive and without additional donor site morbidity. We found that the included studies were of low quality with moderate risk of bias and did not differentiate between persistent and recurrent carpal tunnel syndrome.

scholarly journals Supraretinacular endoscopic carpal tunnel release: A safe alternative method for treatment of carpal tunnel syndrome

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199340
Author(s):  
Kotaro Sato ◽  
Kenya Murakami ◽  
Yoshikuni Mimata ◽  
Gaku Takahashi ◽  
Minoru Doita
Keyword(s):  
Learning Curve ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Open Surgery ◽  
Carpal Tunnel Release ◽  
Safe Alternative ◽  
Endoscopic Carpal Tunnel Release ◽  
Flexor Retinaculum ◽  
Carpal Tunnel Surgery ◽  
Conversion Rates

Purpose: Supraretinacular endoscopic carpal tunnel release (SRECTR) is a technique in which an endoscope is inserted superficial to the flexor retinaculum through a subcutaneous tunnel. The benefits of this method include a clear view for the surgeon and absence of median nerve compression. Surgeons can operate with a familiar view of the flexor retinaculum and median nerve downward, similar to open surgery. This study aimed to investigate the learning curve for SRECTR, an alternate method for carpal tunnel release, and evaluate its complications and the functional outcomes using a disposable commercial kit. Methods: We examined the open conversion rates and complications associated with SRECTR in 200 consecutive patients performed by two surgeons. We compared the operative time operated by a single surgeon. We evaluated outcomes in 191 patients according to Kelly’s grading system. Patients’ mean follow-up period was 12.7 months. Results: Nine patients required conversion to open surgery. There were no injuries to the nerves and tendons and no hematoma or incomplete dissection of the flexor retinaculum. The operative times varied between 11 and 34 minutes. We obtained the following results based on Kelly’s grading of outcomes: excellent in 116, good in 59, fair in 13, and poor in 3 patients. Conclusions: We found no patients with neurapraxia, major nerve injury, flexor tendon injury, superficial palmar arch injury, and hematoma. Although there was a learning curve associated with SRECTR, we performed 200 consecutive cases without neurovascular complications. This method may be a safe alternative to minimally invasive carpal tunnel surgery.

Carpal Tunnel Syndrome in Madelung’s Deformity

1988 ◽  
Vol 13 (1) ◽  
pp. 19-22
Author(s):  
R. LUCHETTI ◽  
A. MINGIONE ◽  
M. MONTELEONE ◽  
G. CRISTIANI
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Surgical Approach ◽  
Nerve Entrapment ◽  
Clinical Implications ◽  
Tunnel Syndrome ◽  
Madelung’S Deformity

The authors describe a case of carpal tunnel syndrome due to Madelung’s deformity. They discuss the pathophysiological causes of median nerve entrapment to explain the compression which occurs in this disease and its clinical implications. They take also into consideration the surgical approach to the carpal tunnel in this particular condition.

scholarly journals Combined Cubital and Carpal Tunnel Release Results in Symptom Resolution Outside of the Median or Ulnar Nerve Distributions

2016 ◽  
Vol 10 (1) ◽  
pp. 111-119 ◽  
Author(s):  
Peter C. Chimenti ◽  
Allison W. McIntyre ◽  
Sean M. Childs ◽  
Warren C. Hammert ◽  
John C. Elfar
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Symptomatic Improvement ◽  
Patient Counseling ◽  
Symptom Resolution ◽  
Persistent Symptoms ◽  
Validated Questionnaires

Background: Resolution of symptoms including pain, numbness, and tingling outside of the median nerve distribution has been shown to occur following carpal tunnel release. We hypothesized that a similar effect would be found after combined release of the ulnar nerve at the elbow with simultaneous release of the median nerve at the carpal tunnel. Methods: 20 patients with combined cubital and carpal tunnel syndrome were prospectively enrolled. The upper extremity was divided into six zones and the location of pain, numbness, tingling, or strange sensations was recorded pre-operatively. Two-point discrimination, Semmes-Weinstein monofilament testing, and validated questionnaires were collected pre-operatively and at six-week follow-up. Results: Probability of resolution was greater in the median nerve distribution than the ulnar nerve for numbness (71% vs. 43%), tingling (86% vs. 75%). Seventy percent of the cohort reported at least one extra-anatomic symptom pre-operatively, and greater than 80% of these resolved at early follow-up. There was a decrease in pain as measured by validated questionnaires. Conclusion: This study documents resolution of symptoms in both extra-ulnar and extra-median distributions after combined cubital and carpal tunnel release. Pre-operative patient counseling may therefore include the likelihood of symptomatic improvement in a non-expected nerve distribution after this procedure, assuming no other concomitant pathology which may cause persistent symptoms. Future studies could be directed at correlating pre-operative disease severity with probability of symptom resolution using a larger population.

scholarly journals Carpal Tunnel Syndrome Versus Vascular Access Induced Hand Ischaemia

2020 ◽  
Vol 25 (4) ◽  
pp. 28-30
Author(s):  
Alina Helgiu
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Arteriovenous Fistula ◽  
Median Nerve ◽  
Vascular Access ◽  
Carpal Tunnel ◽  
Hemodialysis Patient ◽  
Common Complaint ◽  
Tunnel Syndrome ◽  
Distal Flow

Abstract Hand pain is a common complaint in the hemodialysis patient on arteriovenous fistula. The problem is related to its etiology: nervous or vascular, which requires different therapeutic solutions. Ischaemic etiology involves a deviation of the distal flow in the anastomosed vein, with the decrease of the distal flow and the installation of distal ischaemia. Nerve etiology involves compression of the median nerve in the carpal tunnel. The purpose of the paper is to present a case study of diagnosis and treatment of median nerve compression in hemodialysis patient.

scholarly journals Ultrasonography Findings in Severe Carpal Tunnel Syndrome

Hand ◽  
2018 ◽  
Vol 15 (1) ◽  
pp. 64-68
Author(s):  
Gideon Nkrumah ◽  
Alan R. Blackburn ◽  
Robert J. Goitz ◽  
John R. Fowler
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Nerve Conduction Studies ◽  
Cross Sectional ◽  
Younger Patients ◽  
Tunnel Syndrome ◽  
Sensory Latency ◽  
Pisiform Bone

Background: Increasing severity of carpal tunnel syndrome (CTS), as graded by nerve conduction studies (NCS), has been demonstrated to predict the speed and completeness of recovery after carpal tunnel release (CTR). The purpose of this study is to compare the cross-sectional area (CSA) of the median nerve in patients with severe and nonsevere CTS as defined by NCS. Methods: Ultrasound CSA measurements were taken at the carpal tunnel inlet at the level of the pisiform bone by a hand fellowship–trained orthopedic surgeon. Severe CTS on NCS was defined as no response for the distal motor latency (DML) and/or distal sensory latency (DSL). Results: A total of 274 wrists were enrolled in the study. The median age was 51 years (range: 18-90 years), and 72.6% of wrists were from female patients. CSA of median nerve and age were comparatively the best predictors of severity using a linear regression model and receiver operator curves. Using cutoff of 12 mm2 for severe CTS, the sensitivity and specificity are 37.5% and 81.9%, respectively. Conclusions: Ultrasound can be used to grade severity in younger patients (<65 years) with a CTS-6 score of >12.

Influence of Carpal Tunnel Syndrome Induced by Vibratory Actions upon Fingers Mobility

2015 ◽  
Vol 801 ◽  
pp. 284-289 ◽  
Author(s):  
Diana Cotoros ◽  
Mihaela Baritz ◽  
Anca Elena Stanciu
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Range Of Motion ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Female Subject ◽  
Arm Swelling ◽  
Tunnel Syndrome ◽  
The Subject

Carpal Tunnel Syndrome (CTS) is a kind of neuropathy developed due to irritated tendons that may affect the passageway made of ligaments and bones, located at the wrist (base of palm). People affected by CTS develop symptoms such as pain in the carpal area, sometimes reflected along the entire arm, swelling, difficulties in finger motions, reduced range of motion due to pressure upon the median nerve. The present paper performs a case study upon a female subject affected by CTS. The subject is investigated and then guided to perform some exercises using the software attached to the used equipment (sensory gloves), over a controlled period of time with rehabilitation purposes.

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