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Entrapment Syndromes

Young Hak Roh, Young Do Koh, Jong Oh Kim, Kyu Ho Lee, Hyun Sik Gong, Goo Hyun Baek
BACKGROUND: Postoperative pillar pain (deep-seated wrist pain worsened by leaning on the heel of the hand) sometimes occurs after carpal tunnel release (CTR), leading to weakness in the hand and delayed return to work. Increased pain sensitivity has been found to be associated with worse symptoms and poorer treatment response in a number of chronic musculoskeletal conditions, but few studies have investigated the association of pain sensitization with pillar pain after CTR. QUESTIONS/PURPOSES: (1) Is preoperative pain sensitization in patients with carpal tunnel syndrome (CTS) associated with increased severity of pillar pain after open CTR? (2) What other demographic, electrophysiological, or preoperative clinical characteristics are associated with pillar pain after CTR? METHODS: Over a 35-month period, one surgeon performed 162 open carpal tunnel releases...
April 2018: Clinical Orthopaedics and related Research
Tae Hoon Ro, Lance Edmonds
Piriformis syndrome is an uncommon condition that causes significant pain in the posterior lower buttocks and leg due to entrapment of the sciatic nerve at the level of the piriformis muscle. In the typical anatomical presentation, the sciatic nerve exits directly ventral and inferior to the piriformis muscle and continues down the posterior leg. Several causes that have been linked to this condition include trauma, differences in leg length, hip arthroplasty, inflammation, neoplastic mass effect, and anatomic variations...
2018: Journal of Clinical Imaging Science
Sudarshan Anandkumar, Murugavel Manivasagam
This case series describes three patients who presented with right medial elbow pain managed unsuccessfully with conservative treatment that included medication, massage, exercise therapy, ultrasound therapy, neurodynamic mobilization, and taping. Diagnosis of cubital tunnel syndrome was based on palpatory findings, a positive elbow flexion test, and a positive Tinel's sign. Conventionally, the intervention for this entrapment has been surgical decompression, with successful outcomes. This is potentially a first-time description of the successful management of cubital tunnel syndrome with dry needling (DN) using a recently published DN grading system...
March 12, 2018: Physiotherapy Theory and Practice
P Moscatiello, D Carracedo Calvo, L Yupanqui Guerra, M E Rivera Martínez, A Mendiola de la Hoza, M Sánchez Encinas
INTRODUCTION: Pudendal nerve entrapment syndrome (PNE) is characterised by the presence of neuropathic pain in the pudendal nerve (PN) territory, associated or not with urinary, defecatory and sexual disorders. Surgical PN decompression is an effective and safe alternative for cases when conservative treatment fails. The aim of this study is to describe the first robot-assisted pudendal neurolysis procedure performed in our country. MATERIAL AND METHODS: We describe step by step the technique of robot-assisted laparoscopic neurolysis of the left PN performed with intraoperative neurophysiological monitoring on a 60-year-old patient diagnosed with left PNE...
March 8, 2018: Actas Urologicas Españolas
Brigitte Tampin, Jan Vollert, Annina B Schmid
OBJECTIVE: Distal and proximal entrapment neuropathies such as carpal tunnel syndrome (CTS) and cervical radiculopathy (CR) share similar etiologies. Experimental models suggest that despite comparable etiology, pathomechanisms associated with injuries of the peripheral and central axon branches are distinct. This study therefore compared self-reported and elicited sensory profiles in patients with distal and proximal entrapment neuropathies. METHODS: Patients with electrodiagnostically confirmed CTS (n = 103) and patients with CR (n = 23) were included in this study...
March 10, 2018: Current Medical Research and Opinion
Erek W Latzka, P Troy Henning, Adam M Pourcho
Carpal Tunnel Syndrome (CTS) is the most common entrapment neuropathy, resulting in 500,000 carpal tunnel release (CTR) surgeries and a total cost of over 2 billion dollars annually in the United States.1,2 Although initially performed via a large (3-5 cm), palmar incision, CTR techniques have continually evolved to reduce recovery times and post-operative pain, and improve cosmesis and clinical outcomes.2,3 More recently, multiple authors have reported excellent results following ultrasound-guided carpal tunnel release (USCTR) using a variety techniques, and one prospective randomized trial reported faster recovery following USCTR compared to traditional mini-open CTR...
March 5, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Murid Siawash, Rudi Roumen, Walther Tjon A Ten, Ernst van Heurn, Marc Scheltinga
Some children suffering from chronic abdominal pain may have an abdominal wall entity such as anterior cutaneous nerve entrapment syndrome. This syndrome is largely suspected on a combination of findings at history and physical examination. The aim is to obtain clues in history and physical examinations in a selected population of children with anterior cutaneous nerve entrapment syndrome. We analyzed all children with abdominal pain visiting our hospital between January 2013 and January 2015. A total of 71 cases were identified (median age 15 years, range 8-17, 77% female)...
March 7, 2018: European Journal of Pediatrics
Julien Bachour, Fatmeh Ghandour, Alfred Ammoury
Stiff skin syndrome is a rare disease causing stony hard induration of skin usually in early childhood. We report a case of 12 years old boy who presented to our clinic with biopsy showing adipocyte entrapment which we believe is an unrecognized key pathological finding in diagnosis of this entity.
February 21, 2018: American Journal of Dermatopathology
Sang Hyun Nam, Jung Yeon Kim, Jaeki Ahn, Yongbum Park
Plexiform neurofibromas of the foot are rare, benign tumors of the peripheral nerves. Diagnosis can be challenging if they present with symptoms mimicking other peripheral nerve pathologies. Tarsal tunnel syndrome is an entrapment syndrome of the entire tibial nerve behind the medial malleolus and under the flexor retinaculum. The clinical presentation typically includes posteromedial pain, positive Tinel's sign, and neurogenic signs, including both the sensation of numbness and the actual hypoesthesia and clawing of the toes...
January 2018: The surgery journal
Patrick J Buchanan, Lee O Chieng, Zachary S Hubbard, Tsun Y Law, Harvey Chim
BACKGROUND: Cubital tunnel syndrome is the second most common peripheral entrapment syndrome. To date, there is no true consensus on the ideal surgical management. A minimally invasive, endoscopic approach has gained popularity but has not been adequately compared to the more traditional, open approach. METHODS: With compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review was performed to identify studies published between 1990 and 2016 that compared the efficacy of endoscopic cubital tunnel release to open cubital tunnel release...
March 2018: Plastic and Reconstructive Surgery
Sudarshan Anandkumar
This case report describes a 45-year-old male who presented with chronic right lateral elbow pain managed unsuccessfully with conservative treatment that included anti-inflammatory medication, injection, massage, exercise, bracing, taping, electro-physical agents, and manual therapy. Diagnosis of radial tunnel syndrome (RTS) was based on palpatory findings, range of motion testing, resisted isometrics, and a positive upper limb neural tension test 2b (radial nerve bias). Conventionally, the intervention for this entrapment has been surgical decompression, with successful outcomes...
February 23, 2018: Physiotherapy Theory and Practice
Hadley Burns, J Stephen Gunn, Saeed Chowdhry, Thomas Lee, Steven Schulz, Bradon J Wilhelmi
Objective: This paper discusses the various surgical techniques and outcomes associated with management of buried penis syndrome. Methods: Presented is the case of a 49-year-old man with morbid obesity, leading to massive panniculus and buried penis. We review our technique for reconstruction of the buried penis and treatment of the overlying large panniculus. Literature search was conducted to review current techniques in correcting buried penis syndrome. Results: The patient underwent a successful panniculectomy with removal of all excess skin and tissue...
2018: Eplasty
Yuka Taguchi, Toshiyuki Ishikawa, Katsumi Matsumoto, Yutaka Ogino, Hirooki Matsushita, Kohei Iguchi, Junya Hosoda
A 17-year-old woman was resuscitated from cardiac arrest due to ventricular fibrillation and was diagnosed with concealed long QT syndrome. She underwent subcutaneous implantable cardiac defibrillator (S-ICD) implantation at our hospital. The device electrogram immediately after implantation was normal. Four days after implantation, she received an inappropriate shock. The device interrogation revealed a continuous baseline shift and frequent oversensing for low amplitude signals, followed by a shock. A chest radiograph in the orthogonal view showed entrapped subcutaneous air surrounding the distal electrode...
February 14, 2018: International Heart Journal
Seyed Ahmad Raeissadat, Afshin Karimzadeh, Masoud Hashemi, Leila Bagherzadeh
BACKGROUND: Carpal tunnel syndrome is the most common peripheral entrapment neuropathy, for which conservative treatments are the first measures taken. However, these measures are not usually sufficient. Recently major attention has been drawn to platelet-rich plasma for its possible effects on axon regeneration and neurological recovery. Although few studies have evaluated the effects of this treatment in carpal tunnel syndrome, further investigation is required to reach concrete conclusion...
February 13, 2018: BMC Musculoskeletal Disorders
A Vidoni, M Shrivastava, Rajesh Botchu
Carpal tunnel syndrome (CTS) represents the most common entrapment neuropathy of the upper extremity. Intermittent CTS has been reported in the surgical literature and usually, related to masses associated to flexor tendons. We describe a patient with an intrasynovial lipoma involving the deep flexor of the middle finger causing intermittent CTS and snapping on flexion-extension.
February 10, 2018: Journal of Ultrasound
Juntaro Matsumoto, Toyohiko Isu, Kyongsong Kim, Naotaka Iwamoto, Kazuyoshi Yamazaki, Daijiro Morimoto, Masanori Isobe
INTRODUCTION: Some patients suffer failed back surgery syndrome (FBSS) after lumbar spine surgery. We report the effect of additional treatments for para-lumbar- and peripheral nerve diseases addressing residual symptoms after lumbar spine surgery. MATERIALS AND METHODS: We enrolled 74 patients (59 men and 15 women, mean age 62.9 years) who had undergone lumbar posterior decompression surgery in our department. Mean follow-up after initial lumbar surgery was 26...
January 31, 2018: World Neurosurgery
Yara Bernaldo de Quirós, Meghan Hartwick, David S Rotstein, Michael M Garner, Andrea Bogomolni, William Greer, Misty E Niemeyer, Greg Early, Frederick Wenzel, Michael Moore
The challenge of identifying cause of death in discarded bycaught marine mammals stems from a combination of the non-specific nature of the lesions of drowning, the complex physiologic adaptations unique to breath-holding marine mammals, lack of case histories, and the diverse nature of fishing gear. While no pathognomonic lesions are recognized, signs of acute external entanglement, bulging or reddened eyes, recently ingested gastric contents, pulmonary changes, and decompression-associated gas bubbles have been identified in the condition of peracute underwater entrapment (PUE) syndrome in previous studies of marine mammals...
January 31, 2018: Diseases of Aquatic Organisms
Priscilla Tu
The differential diagnosis of heel pain is extensive, but a mechanical etiology is the most common. The specific anatomic location of the pain can help guide diagnosis. The most common diagnosis is plantar fasciitis, which leads to medial plantar heel pain, especially with the first weight-bearing steps after rest. Other causes of plantar heel pain include calcaneal stress fractures (progressively worsening pain after an increase in activity or change to a harder walking surface), nerve entrapment or neuroma (pain accompanied by burning, tingling, or numbness), heel pad syndrome (deep, bruise-like pain in the middle of the heel), and plantar warts...
January 15, 2018: American Family Physician
Michinori Nariai, Kyongsong Kim, Masaaki Kawauchi, Akihiro Ishii, Misa Kido, Toyohiko Isu, Rinko Kokubo, Daijiro Morimoto, Naotaka Iwamoto, Akio Morita
BACKGROUND: Tarsal tunnel syndrome(TTS)is an entrapment neuropathy of the posterior tibial nerve within the tarsal tunnel below the medial malleolus. An accurate diagnosis is difficult, and TTS is usually diagnosed from clinical symptoms due to the lack of accurate diagnostic tools. We aimed to standardize the diagnosis of TTS using MRI, and report the MRI conditions for clear visualization of the tarsal tunnel. METHODS: We investigated which sequences and MRI conditions would be appropriate for the imaging of the tarsal tunnel in a healthy volunteer...
January 2018: No Shinkei Geka. Neurological Surgery
Maira Hameed, Alexander Coupland, Alun H Davies
No abstract text is available yet for this article.
January 19, 2018: British Journal of Sports Medicine
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