Epidemiology and approach in Carpal Tunnel Syndrom: An analysis of the impact on return on labor

Background: Carpal Tunnel Syndrome (CTS) is defined as a focal, chronic and symptomatic compressive neuropathy of the median nerve at the wrist. It is the most prevalent neuropathy in the population. The objective of the study to describe the epidemiological, clinical and occupational profile of patients with CTS who underwent median nerve neurolysis in the carpus and the Occupational Therapy intervention attended by the Sistema Único de Saúde (SUS). Methods: This is a descriptive study, carried out from january 2014 to december 2017 at Centro Estadual de Reabilitação e Readaptação Dr. Henrique Santillo (CRER), in the city of Goiânia, located in the Center-West region of Brazil. The Reference population covered the medical records of patients submitted to the surgical procedure and rehabilitation. During this period, 698 patients underwent surgery and rehabilitation, and the sample of 249 charts analyzed was defined by means of a sample calculation using the finite sample proportion test. A margin of error of 5% was considered in the calculation. Out-of-time-range patients and those with other associated hand injuries were excluded. Our study was approved by the Research Ethics Committee registered under number 97279.121. The data were analyzed with the aid of the SPSS 23 statistical package. In all analyzes, thes ignificancel evel adopted was 5% (p <0.05).Results: The demographic profile was composed of 223 women, representing 89.6% of the sample, in the age group between 40 and 59 years, being 74.7% of right-handed patients. Comorbidities were present in 63.1% of the patients and the main ones are Systemic Arterial Hypertension (SAH), Diabetes Mellitus (DM) and Fibromyalgia. The vast majority of cases were classified as severe or very severe staging. The labor distribution was categorized into 12 distinct groups, with workers doing domestic work prevailing. Conclusion: A greater bilateral involvement was observed in the studied sample, classified in the severe or very severe stages, which resulted in the surgical treatment and early intervention and systematization of occupational therapy, which favored the patient to be replaced in work activities in about 84, 7% of the cases surveyed.

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Selective Motor Neuropathy of the Median Nerve Caused by a Ganglion in the Carpal Tunnel

Journal of Hand Surgery (European Volume) ◽

10.1016/s0266-7681(98)80013-2 ◽

1998 ◽

Vol 23 (5) ◽

pp. 611-612 ◽

Cited By ~ 9

Author(s):

B. CROWLEY ◽

C. R. GSCHWIND ◽

C. STOREY

Keyword(s):

Carpal Tunnel Syndrome ◽

Median Nerve ◽

Carpal Tunnel ◽

Motor Dysfunction ◽

Motor Neuropathy ◽

Compressive Neuropathy ◽

Tunnel Syndrome

Carpal tunnel syndrome is the commonest peripheral compressive neuropathy. Typically, sensory symptoms predominate at presentation with motor dysfunction seen in more chronic cases. Isolated motor compression is rare. We present a case of selective median nerve motor neuropathy caused by a carpal tunnel ganglion.

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Nesteroidic Antiinflammators with Variable Chemical Structure that Prevent Anti-inflammatory Effect in the Carpal Tunnel Syndrome - Compressive Neuropaty of the Median Nerve

Revista de Chimie ◽

10.37358/rc.18.7.6416 ◽

2018 ◽

Vol 69 (7) ◽

pp. 1779-1784

Author(s):

Alice Arina Ciocan Pendefunda ◽

Razvan Leata ◽

Vasile Nicolae ◽

Codrina Ancuta ◽

Adriana Elena Craciun ◽

...

Keyword(s):

Carpal Tunnel Syndrome ◽

Median Nerve ◽

Carpal Tunnel ◽

Moderate Intensity ◽

Distribution Area ◽

Posterior Aspect ◽

Compressive Neuropathy ◽

Gradual Process ◽

Dental Practitioners ◽

Tunnel Syndrome

Musculoskeletal pathology reaches important proportions in dental practitioners. Besides the articular manifestations of inflammatory or degenerative rheumatism, in daily practice we often find patients suffering from abarticular pathological processes, during which tendons, synovial dysplasia, schizophrenia, fascia, aponevrozes are affected. The Carpal Tunnel Syndrome represents a compressive neuropathy of the median nerve inside the carpal tunnel of the wrist. Any condition that lowers the dimensions of the carpal tunnel can cause symptoms of carpal tunnel syndrome. The carpal channel (Carpal Tunnel) is divided by a sagittal fibrous divider into two osteofibrosis osteofibrosis: medial and lateral. This blade separates from the posterior aspect of the flexor retina and is inserted into the carpal bones (scaffold, trapezoid and capita). This syndrome has received particular attention in recent years due to the fact that it can occur in people whose work involves repetitive hand activities. Repeated use of the hand, repetition of the same movements and activities of the hand and wrist, over a long period of time, can cause inflammation of the tendons in the wrist, causing swelling, which puts pressure on the nerve. Symptoms of Carpal Tunnel Syndrome begin gradually - without specific trauma. It is a gradual process for most people, carpal tunnel syndrome is aggravated over time without appropriate treatment. The study includes a batch of 75 dentists from Galati County, selected following the application of the inclusion criteria referring to the presence of signs and symptoms characterizing carpal tunnel syndrome in 2015-2017. Sensitivity disorders and paraesthesias accompanying nerve suffering are symptoms that create discomfort and contributes to the deterioration of pretension and force so useful to the professional act of dental medicine. Perceived cramping pain, often of moderate intensity, located at the fist and distal in the distribution area of the median nerve, rarely the pains are intense and radiate upward along upper limb to shoulder.

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The History of Carpal Tunnel Syndrome

Journal of Hand Surgery (European Volume) ◽

10.1016/0266-7681_88_90046-0 ◽

1988 ◽

Vol 13 (1) ◽

pp. 28-34

Author(s):

G. B. PFEFFER ◽

R. H. GELBERMAN ◽

J. H. BOYES ◽

B. RYDEVIK

Keyword(s):

Carpal Tunnel Syndrome ◽

Median Nerve ◽

Carpal Tunnel ◽

Transverse Carpal Ligament ◽

Motor Branch ◽

Compressive Neuropathy ◽

Anatomical Localization ◽

History Of ◽

Idiopathic Carpal Tunnel Syndrome ◽

Tunnel Syndrome

Carpal tunnel syndrome is the most frequently diagnosed, best understood and most easily treated entrapment neuropathy. During the first half of the 20th century, however, most patients with carpal tunnel syndrome were diagnosed as having compression of either the brachial plexus or thenar nerve motor branch of the median nerve. As late as 1950, only twelve patients with operative release of the transverse carpal ligament for idiopathic carpal tunnel syndrome had been reported. The delay in accurate anatomical localization of this compressive neuropathy can be attributed both to the confusion caused by the diverse manifestations of median nerve compression in the carpal tunnel, and to some interesting developments that altered early investigations in this area.

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The Influence of the Type of Surgical Thread and Suture in the Open Carpal Tunnel Syndrome Surgery

Arquivos Brasileiros de Neurocirurgia Brazilian Neurosurgery ◽

10.1055/s-0037-1603106 ◽

2017 ◽

Vol 38 (04) ◽

pp. 292-296 ◽

Cited By ~ 1

Author(s):

Marcelo José Silva Magalhães ◽

Beatriz Xavier Cruz ◽

Fabrício Conceição dos Santos ◽

Isabella Mendes de Oliveira ◽

João Pedro Saraiva Sousa ◽

...

Keyword(s):

Carpal Tunnel Syndrome ◽

Median Nerve ◽

Carpal Tunnel ◽

Wound Complications ◽

Decompression Surgery ◽

Single Individual ◽

Compressive Neuropathy ◽

Different Types ◽

Tunnel Syndrome ◽

Comparative Results

AbstractCarpal tunnel syndrome (CTS) is the result of compression and/or traction of the median nerve in the carpal tunnel. It is the most frequent compressive neuropathy of the upper limbs and it is usually idiopathic. Diagnosis is essentially clinical, defined by symptoms and provocative tests. Decompression of the median nerve by section of the transverse carpus ligament is the treatment of choice, but the lack of consensus on the type of suture and surgical thread to be used in the open carpal tunnel decompression surgery justifies the importance of evaluating the comparative results of existing studies, aiming to describe the influence of different types of sutures and surgical threads to guide the professionals about the most appropriate conduct. This is a systematic review of the international and national literature. Four studies comparing the influence of surgical threads and one study evaluating the influence of the type of suture were found. From the comparative studies, it was observed that there is advantage in the use of nonabsorbable suture due to the lower occurrence of inflammation and postoperative wound complications. When using Donatti sutures, wound edge inversion is less likely to occur compared with single individual sutures, but they are also related to longer postoperative pain.

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DYNAMICS OF CLINICAL AND ELECTROPHYSIOLOGICAL CHARACTERISTICS OF CARPAL TUNNEL SYNDROME IN CHILDREN WITH MUCOPOLYSACCHARIDOSES AGAINST THE BACKGROUND OF ENZYME-REPLACEMENT THERAPY

Российский педиатрический журнал ◽

10.18821/1560-9561-2018-21-3-152-156 ◽

2019 ◽

Vol 21 (3) ◽

pp. 152-156

Author(s):

Liliya L. Osipova ◽

L. M. Kuzenkova ◽

A. L. Kurenkov ◽

T. V. Podkletnova ◽

L. S. Namazova-Baranova ◽

...

Keyword(s):

Carpal Tunnel Syndrome ◽

Enzyme Replacement Therapy ◽

Replacement Therapy ◽

Median Nerve ◽

Carpal Tunnel ◽

Clinical Symptoms ◽

Clinical Manifestations ◽

Enzyme Replacement ◽

Tunnel Syndrome ◽

The Impact

Introduction. Mucopolysaccharidoses are the most common cause of the carpal tunnel syndrome in children. Enzyme-replacement therapy, which is available in clinical practice within last 10-15 years for mucopolysaccharidoses I, II and VI demonstrated the efficacy regarding somatic symptoms of the diseases, however, the impact of this new pathogenetic treatment on neuropathy of median nerve, arising from compression in the carpal tunnel, is poorly described. Objective. To study the dynamics of clinical and electrophysiological characteristics of carpal tunnel syndrome in children with mucopolysaccharidoses during enzyme-replacement therapy. Materials and methods. 18 children with mucopolysaccharidoses I, II and VI, received enzyme-replacement therapy, are included in the study. Dynamics of clinical symptoms of the carpal tunnel syndrome and EMG indices of median nerve testing are described against the background of enzyme-replacement therapy. Results. Objective and subjective clinical manifestations of the carpal tunnel syndrome persisted or appeared in children, receiving enzyme-replacement therapy for 21±12 months. However, there were no statistically significant changes in EMG-characteristics of median nerves testing during enzyme-replacement therapy in children with mucopolysaccharidoses Conclusion. Enzyme-replacement therapy in children with mucopolysaccharidoses I, II and VI may suspend and/or delay progressive damage of median nerves in the carpal canal, thus indicating prevention and slowing down in glycosaminoglycans storage in the carpal tunnel.

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COMPRESSIVE NEUROPATHIES RELATED TO GANGLIONS OF THE WRIST AND HAND

Hand Surgery ◽

10.1142/s021881041472006x ◽

2014 ◽

Vol 19 (01) ◽

pp. 113-116 ◽

Cited By ~ 5

Author(s):

Prakash Jayakumar ◽

Vijay Jayaram ◽

David S. Nairn

Keyword(s):

Surgical Treatment ◽

Median Nerve ◽

Carpal Tunnel ◽

Clinical Assessment ◽

Guyon’S Canal ◽

Unique Case ◽

Sensory Deficits ◽

Compressive Neuropathy ◽

Guyon's Canal

Ganglions of the wrist and hand causing compressive neuropathies are rare clinical entities. Compression of the ulnar and median nerves in their respective fibro-osseous tunnels lead to characteristic patterns of motor and/or sensory deficits, which are directly related to the location of the lesion. We present a unique case of a "dumbbell" shaped ganglion invading both Guyon's canal and the carpal tunnel causing a dual compressive neuropathy of the ulnar and median nerve. We discuss the patho-anatomy, clinical assessment, investigation and surgical treatment of this condition.

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Effects of perineural steroid injections on median nerve conduction during the carpal tunnel release

Vojnosanitetski pregled ◽

10.2298/vsp0811825s ◽

2008 ◽

Vol 65 (11) ◽

pp. 825-829 ◽

Cited By ~ 6

Author(s):

Nenad Stepic ◽

Marjan Novakovic ◽

Vesna Martic ◽

Dusan Peric

Keyword(s):

Median Nerve ◽

Carpal Tunnel ◽

Corticosteroid Injection ◽

Carpal Tunnel Release ◽

Surgical Decompression ◽

Time Intervals ◽

Steroid Injections ◽

Compressive Neuropathy ◽

Perineural Injection ◽

Tunnel Syndrome

Background/Aim. The treatment outcome of the median nerve compressive neuropathy in the carpal zone due to carpal tunnel syndrome (CTS) is represented by recovering the nerves sensibility, conductivity, condition and strength. Perineural application of betamethasone during the surgical decompression might result in faster recovery of compressed median nerve's conduction speed. Methods. In this study 40 patients with CTS were randomly divided in the two groups. In the first group (n = 20) we performed the surgical decompression of the median nerve by the open release of the carpal tunnel, and in the second group (n = 20) we applicated a perineural injection of 1 ml of betamethason immediately after the surgical decompression. We performed the electrodiagnostic (ED) examinations 7, 30 and 90 days after the surgery, and measured the conduction speed of the median nerve in the carpal tunnel zone and the sensitivity conduction speed of the median nerve. Results. Significant differences in examined ED respective variable values in different time intervals were obtained. At the final measurements, 90 days after the surgical procedure, both groups evidenced a full recovery of the conduction speed in the carpal tunnel with statistically significant better results in the second group of the patients (t = -2.116; p = 0.043). Conclusion. Intraoperative application of the corticosteroid injection during the surgical decompression results in faster regaining of conduction speed of the median nerve.

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Recurrent Compressive Neuropathy of the Median Nerve at the Wrist: Treatment with Autogenous Saphenous Vein Wrapping

Journal of Hand Surgery (European Volume) ◽

10.1054/jhsb.2000.0379 ◽

2000 ◽

Vol 25 (3) ◽

pp. 271-275 ◽

Cited By ~ 39

Author(s):

S. E. VARITIMIDIS ◽

F. RIANO ◽

D. G. VARDAKAS ◽

D. G. SOTEREANOS

Keyword(s):

Carpal Tunnel Syndrome ◽

Median Nerve ◽

Carpal Tunnel ◽

Saphenous Vein ◽

Saphenous Vein Graft ◽

Compressive Neuropathy ◽

Number Of Patients ◽

Sensory Disturbances ◽

Tunnel Syndrome

Recurrence of symptoms occurs in a significant number of patients after surgical decompression for carpal tunnel syndrome, and its management is both challenging and difficult. Fifteen patients with recurrent carpal tunnel syndrome were treated with a vein wrapping technique using the autologous saphenous vein. A total of 48 operations had been performed on these patients before wrapping the median nerve with a saphenous vein graft. At a mean follow-up of 43 months all patients reported significant pain relief and improvement in their sensory disturbances. Two-point discrimination and the findings of nerve conduction studies also improved.

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