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Radial tunnel syndrome

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
Hideto Irifune, Nobuyuki Takahashi, Suguru Hirayama, Eichi Narimatsu, Toshihiko Yamashita
In this article, we report two cases in which recurrent adhesive hand neuropathy with allodynia were successfully treated with radial and ulnar artery adipofascial perforator flap coverage. Treatment of recurrent neuropathy, such as recurrent carpal tunnel syndrome and re-adhesion after neurolysis using free and pedicle flaps to cover the nerves, has been reported to show good results. However, for severe painful nerve disorders, such as complex regional pain syndrome, the efficacy of this treatment was unclear...
March 2018: Journal of Hand Surgery Asian-Pacific Volume
Takuma Wakasugi, Ritsuro Shirasaka, Toshiyuki Kawauchi, Koji Fujita, Atsushi Okawa
BACKGROUND: Intramedullary fixation for distal radius fractures is reported to be free of hardware irritation and less invasive than other fixation methods. Some specific complications associated with intramedullary fixation, such as radial nerve sensory neuritis, have been reported, but no study has focused on the complication rates of intramedullary fixation for distal radius fractures in the elderly population. Furthermore, no studies have analyzed common complications, such as carpal tunnel syndrome and flexor tenosynovitis including trigger finger, among patients with distal radius fractures treated by intramedullary fixation based on a comprehensive complication checklist...
March 2018: Journal of Hand Surgery Asian-Pacific Volume
Pichitchai Atthakomol, Worapaka Manosroi, Areerak Phanphaisarn, Sureeporn Phrompaet, Sawan Iammatavee, Siam Tongprasert
BACKGROUND: Recent studies have reported that radial extracorporeal shock wave therapy (rESWT) reduces pain and improves function in patients with mild to moderately severe carpal tunnel syndrome (CTS) compared to a placebo. However, most of those studies used multi-session rESWT combined with wrist support and evaluation of efficacy was limited to a maximum of 14 weeks. METHODS: The prospective randomized controlled trial compared efficacy in relieving pain and improving clinical function between single-dose rESWT and local corticosteroid injection (LCsI) over the mid-term (24 weeks)...
January 25, 2018: BMC Musculoskeletal Disorders
Jason R Ummel, John G Coury, Zachary C Lum, Marc A Trzeciak
BACKGROUND: Recent anatomic studies have failed to demonstrate a single utilitarian approach to intraoperative identification and surgical release of all 5 potential sites of posterior interosseous nerve (PIN) compression in the radial tunnel. This study examines if a single incision brachioradialis-splitting approach without the use of additional anatomic windows is capable of adequately exposing the entire length of the radial tunnel, including all 5 sites of PIN compression to allow for adequate release...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Rameshwar Nath Chaurasia, Sagar S Kawale, Abhishek Pathak, Vijaya Nath Mishra, Deepika Joshi
Background and Purpose: The purpose of the study is to determine whether the clinical profile of patients with carpal tunnel syndrome (CTS) has been same over the years with the help of routine and comparative electrodiagnostic tests. Methods: A prospective study of 100 patients with suspected CTS was conducted without controls. Three provocative maneuvers were performed. Routine and comparison nerve conduction tests were performed, i.e., second lumbrical interossei motor latency difference (2 LIMLD), digit 4 median-ulnar sensory latency difference (D4MUSLD), palm wrist distal sensory latency difference (PWDSLD), and digit 1 median-radial sensory latency difference (D1MRSLD)...
October 2017: Journal of Neurosciences in Rural Practice
Takuma Wakasugi, Ritsuro Shirasaka, Toshiyuki Kawauchi, Koji Fujita, Atsushi Okawa
We report a case of carpal tunnel syndrome and trigger wrist caused by localized amyloidosis. A 37-year-old man, who worked as a manufacturer, presented with a 5-month history of tingling sensation in the three radial fingers of the left hand and a painful click at the volar aspect of the wrist during digital motion. We divided the transverse carpal ligament and detected diffuse tenosynovitis that was especially severe around the flexor digitorum profundus tendons. Histological findings led to a diagnosis of amyloidosis...
December 2017: Journal of Hand Surgery Asian-Pacific Volume
Aysun Ertikin, Güldeniz Argun, Mesut Mısırlıoğlu, Murat Aydın, Murat Arıkan, Nihal Kadıoğulları
Objective: In this study, we aimed to compare axillary brachial plexus block using the two-injection and four-injection techniques assisted with ultrasonography (USG) and nerve stimulator in patients operated for carpal tunnel syndrome with articaine. To evaluate which technique is more effective, we compared the onset time, effectiveness, and duration of block procedures, patient satisfaction, adverse effect of the drug, and complication rates of the motor and sensory blocks. Methods: Sixty patients were randomly divided into two groups...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
Bionka M Huisstede, Peter Hoogvliet, Thierry P Franke, Manon S Randsdorp, Bart W Koes
OBJECTIVE: To review scientific literature studying the effectiveness of physical therapy and electrophysical modalities for carpal tunnel syndrome (CTS). DATA SOURCES: The Cochrane Library, PubMed, Embase, CINAHL, and Physiotherapy Evidence Database. STUDY SELECTION: Two reviewers independently applied the inclusion criteria to select potential eligible studies. DATA EXTRACTION: Two reviewers independently extracted the data and assessed the methodologic quality using the Cochrane Risk of Bias Tool...
September 20, 2017: Archives of Physical Medicine and Rehabilitation
Parag P Moon, Dilip Maheshwari, Vijay Sardana, Bharat Bhushan, Sankalp Mohan
BACKGROUND: Numerous nerve conduction tests are used for the electrodiagnosis of carpal tunnel syndrome (CTS), with a wide range of sensitivity and specificity reported for each test in clinical studies. AIMS: The purpose of this study was to compare the diagnostic accuracy of various nerve conduction tests and determine the properties of the most accurate test. SETTINGS AND DESIGN: A prospective observational case control study. PATIENTS AND METHODS: Eighty patients with clinically confirmed CTS and 80 asymptomatic healthy controls were included in the study...
September 2017: Neurology India
J-F Hernekamp, U Kneser, T Kremer, B Bickert
OBJECTIVE: Preservation of residual mobility and pain reduction in the wrist in advanced carpal collapse (scapholunate advanced collapse, SLAC or scaphoid nonunion advanced collapse, SNAC). INDICATIONS: Advanced osteoarthritis of the radiocarpal and intercarpal articulations, SLAC/SNAC stages 2-3. CONTRAINDICATIONS: Arthrotic alterations to the proximal joint surface of the lunate bone or the corresponding joint surface of the radius (lunate fossa)...
August 8, 2017: Operative Orthopädie und Traumatologie
Charles A Gober, Tarik Mujadzic, John E Hershman, Mirsad M Mujadzic
BACKGROUND: Compression of the median nerve at the wrist, or carpal tunnel syndrome, is the most commonly recognized nerve entrapment syndrome. Carpal tunnel syndrome is usually caused by compression of the median nerve due to synovial swelling, tumor, or anomalous anatomical structure within the carpal tunnel. METHODS: During a routine carpal tunnel decompression, a large vessel was identified within the carpal tunnel. RESULTS: The large vessel was the radial artery...
September 2017: Hand: Official Journal of the American Association for Hand Surgery
Li Chen, Jie Chen, Bing Hu, Li-Xin Jiang
OBJECTIVE: The aim of this study was to investigate the prevalence of anatomic variations of the bifid median nerve, persistent median artery and persistent median vein in Chinese individuals and their relationship with carpal tunnel syndrome. METHODS: One hundred and sixty median nerves were examined using ultrasonography and colour Doppler ultrasonography. The location, shape, and size of the bifid median nerve, persistent median artery and persistent median vein were recorded...
June 2017: Clinics
N D Clement, A D Duckworth, N R Wickramasinghe, C M Court-Brown, M M McQueen
PURPOSE: The aim of this study in adult patients with a distal radial fracture was to determine whether socioeconomic status influenced the epidemiology, mechanism of injury, fracture severity, or the outcome according to function, radiographic assessment, and rate of associated complications. METHODS: We identified 3983 distal radial fractures over a 7-year period. Socioeconomic status was assigned using the Carstairs score, and the population was divided into quintiles depending on deprivation...
December 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Adam B Strohl, David S Zelouf
In addition to the more common carpal tunnel and cubital tunnel syndromes, orthopaedic surgeons must recognize and manage other potential sites of peripheral nerve compression. The distal ulnar nerve may become compressed as it travels through the wrist, which is known as ulnar tunnel or Guyon canal syndrome. The posterior interosseous nerve may become entrapped in the proximal forearm as it travels through the radial tunnel, which results in a pain syndrome without motor weakness. The median nerve may become entrapped in the proximal forearm, which can result in a variety of symptoms...
February 15, 2017: Instructional Course Lectures
Karan Dua, A Lee Osterman, Joshua M Abzug
Carpal tunnel syndrome (CTS) is a focal compressive neuropathy of the median nerve at the level of the wrist. CTS is the most common type of compressive neuropathy that occurs in the upper extremity. Typically, patients with CTS have paresthesia, pain, and numbness in the radial three and one-half digits. Nighttime symptoms are more common earlier in the disease process, with daytime symptoms becoming more frequent as CTS progresses. Electrodiagnostic studies may be performed to confirm a diagnosis of CTS or to obtain a baseline before surgical treatment; however, electrodiagnostic studies may be normal in a subset of patients who have CTS...
February 15, 2017: Instructional Course Lectures
Kejia Hu, Hao Ma, Yundong Shen, Ziv Williams, Wendong Xu
We reported a rare peripheral nerve case, a patient developed carpal tunnel syndrome with a history of floating thumb in right hand. The median nerve was found expanded and spindle-shaped and a plexiform neurofibroma was diagnosed. Our case sheds light on anatomy and possible etiological association which may help clinical management.
May 29, 2017: British Journal of Neurosurgery
Mabel Qi He Leow, Rebecca Qian Ru Lim, Shian Chao Tay
Clinical assessment of the hand is important for diagnosing underlying hand disorders. Using a case study approach, the clinical assessment for three disorders of the hands is presented: trigger finger (stenosing tenosynovitis), carpal tunnel syndrome, and ulnar-sided wrist injury (styloid impingement). We assess the annular one pulley and finger range of motion for patients with trigger finger. To diagnose for carpal tunnel syndrome, assessment for Tinel's sign, Phalen's sign, abductor pollicis brevis muscle bulk, two-point discrimination, and obtaining a nerve conduction study are performed...
May 2017: Orthopaedic Nursing
Bing Zhang, Hengrui Chang, Kunlun Yu, Jiangbo Bai, Dehu Tian, Guisheng Zhang, Xinzhong Shao, Yingze Zhang
AIMS: This study aims to compare the outcomes of intramedullary nail (IMN) and volar locking plate (VLP) fixation for treatment of extra-articular or simple intra-articular distal radius fractures. METHODS: PubMed, Embase, Medline and Cochrane Collaboration Central databases were searched for studies that compared the results of IMN and VLP fixation for the treatment of distal radius fractures up to March 2016. Stata 11.0 was used to perform the meta-analysis. RESULTS: Six randomized controlled trials (RCT) and two retrospective studies were included in this review, including 463 patients...
October 2017: International Orthopaedics
Lisa D Hobson-Webb, Vern C Juel
PURPOSE OF REVIEW: This article addresses relevant peripheral neuroanatomy, clinical presentations, and diagnostic findings in common entrapment neuropathies involving the median, ulnar, radial, and fibular (peroneal) nerves. RECENT FINDINGS: Entrapment neuropathies are a common issue in general neurology practice. Early diagnosis and effective management of entrapment mononeuropathies are essential in preserving limb function and maintaining patient quality of life...
April 2017: Continuum: Lifelong Learning in Neurology
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