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Carpal tunnel syndrome

Luca Padua, Daniele Coraci, Carmen Erra, Costanza Pazzaglia, Ilaria Paolasso, Claudia Loreti, Pietro Caliandro, Lisa D Hobson-Webb
Carpal tunnel syndrome is the most common peripheral nerve entrapment syndrome worldwide. The clinical symptoms and physical examination findings in patients with this syndrome are recognised widely and various treatments exist, including non-surgical and surgical options. Despite these advantages, there is a paucity of evidence about the best approaches for assessment of carpal tunnel syndrome and to guide treatment decisions. More objective methods for assessment, including electrodiagnostic testing and nerve imaging, provide additional information about the extent of axonal involvement and structural change, but their exact benefit to patients is unknown...
November 2016: Lancet Neurology
Fariba Eslamian, Bina Eftekharsadat, Arash Babaei-Ghazani, Fateme Jahanjoo, Mojgan Zeinali
INTRODUCTION: The aim of this study was to compare the clinical and electrodiagnostic efficacy of ultrasound (US) guided vs. landmark (LM) guided steroid injections in patients with carpal tunnel syndrome (CTS). METHODS: This randomized clinical trial included 47 patients (60 affected hands) with moderate CTS (30 hands in each group). All clinically suspected CTS patients who met the inclusion criteria confirmed by electrodiagnostic tests were enrolled. The subjects received 40mg of methylprednisolone either with the US-guide or the LM -guide injection technique...
October 1, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Yi-Ming Ren, Xi-Shan Wang, Zhi-Jian Wei, Bao-You Fan, Wei Lin, Xian-Hu Zhou, Shi-Qing Feng
BACKGROUND: Carpal tunnel syndrome (CTS) is a common peripheral nerve entrapment disease. Either surgical or conservative intervention for CTS patients is needed to choose. We conducted this systematic review and meta-analysis to compare the clinical efficacy, safety, and cost of surgical versus nonsurgical intervention. METHODS: The eligible studies were acquired from PubMed, Medline, Embase, Web of Science, Google, and Cochrane Library. The data were extracted by 2 of the coauthors independently and were analyzed by RevMan5...
October 2016: Medicine (Baltimore)
Jimmy Tat, Aaron M Kociolek, Peter J Keir
The most common finding in carpal tunnel syndrome is fibrosis and thickening of the subsynovial connective tissue (SSCT). While the SSCT mediates tendon gliding in the carpal tunnel, this histopathology suggests excessive shear forces are involved in injury development. Ultrasound is often used to quantify relative motion between the finger flexor tendons and SSCT as an indirect measure of "shear-strain"; however, the underlying mechanical implications of using ultrasound are not well understood. The middle flexor digitorum superficialis (FDS) tendon of 8 cadavers was moved in a combination of 2 wrist postures (neutral, flexed), 3 velocities (5, 10, 15cm/s), and 3 forces (10, 20, 30N) to assess ultrasound-based FDS-SSCT relative displacement while simultaneously quantifying tendon frictional work in the carpal tunnel...
October 6, 2016: Journal of Biomechanics
Eman M Khedr, Gharib Fawi, Mohammed Abd-Allah Abbas, Noha Abo El-Fetoh, Ahmed F Zaki, Ayman Gamea, Ghada Al Attar
BACKGROUND: Few epidemiological studies of the prevalence of neuromuscular disorders have been undertaken. The aim of the study was to estimate the prevalence of the most common types of neuromuscular disorders in Qena governorate/Egypt. METHODS: A random sample was taken from 11 districts, involving 9303 inhabitants with 57.3% urban residents and 42.7% rural residence. Patients were diagnosed using a screening questionnaire for the diagnosis of neuromuscular disorders...
October 17, 2016: Neurological Research
O Herisson, M Dury, E Rapp, F Marin-Braun
Carpal tunnel syndrome is the most common entrapment syndrome. The incidence of a bilateral condition varies between 22% and 87%. The aim of our study was to assess the level of satisfaction and the clinical outcomes in a group of patients operated on through a bilateral neurolysis on the median nerve in the carpal tunnel, in one operating session. This is a retrospective study involving patients with an electromyographic and clinical diagnosis of bilateral carpal tunnel syndrome. Patients were treated on an outpatient basis and the bilateral neurolysis was performed by endoscopy...
June 2016: Hand Surgery and Rehabilitation
E V Bakhtereva, V A Shirokov, E L Leiderman, A N Varaksin, V G Panov
AIM: To develop the algorithm of early diagnosis of carpal tunnel syndrome (CTS) at the stage of functional neurological disturbances by expanding diagnostic possibilities of electroneuromyography using artificial compression test. MATERIAL AND METHODS: Parameters of conductivity of the median nerve in 54 patients with finger numbness were analyzed during 3 months before and after compression of the forearm (blood pressure was measured for 1 min). RESULTS AND CONCLUSION: An increase in the latency in motor fibers and a decrease in the amplitude of sensory response were identified in patients with CTS signs and normal electroneuromyographical parameters at baseline...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Craig Conlon, Steven Asch, Mark Hanson, Andrew Avins, Barbara Levitan, Carol Roth, Michael Robbins, Michael Dworsky, Seth Seabury, Teryl Nuckols
CONTEXT: Little is known about quality of care for occupational health disorders, although it may affect worker health and workers' compensation costs. Carpal tunnel syndrome (CTS) is a common work-associated condition that causes substantial disability. OBJECTIVE: To describe the design of a study that is assessing quality of care for work-associated CTS and associations with clinical outcomes and costs. DESIGN: Prospective observational study of 477 individuals with new workers' compensation claims for CTS without acute trauma who were treated at 30 occupational health clinics from 2011 to 2013 and followed for 18 months...
October 3, 2016: Permanente Journal
Linda S Chesterton, Krysia S Dziedzic, Danielle A van der Windt, Graham Davenport, Helen L Myers, Trishna Rathod, Milica Blagojevic-Bucknall, Sue M Jowet, Claire Burton, Edward Roddy, Elaine M Hay
BACKGROUND: Patients diagnosed with idiopathic mild to moderate carpal tunnel syndrome (CTS) are usually managed in primary care and commonly treated with night splints and/or corticosteroid injection. The comparative effectiveness of these interventions has not been reliably established nor investigated in the medium and long term. The primary objective of this trial is to investigate whether corticosteroid injection is effective in reducing symptoms and improving hand function in mild to moderate CTS over 6 weeks when compared with night splints...
October 6, 2016: BMC Musculoskeletal Disorders
Benson J Pulikkottil, Micah Schub, Tiffany R Kadow, William Wang, John R Fowler
PURPOSE: To determine whether there is a correlation between the cross-sectional area (CSA) of the median nerve, as measured using ultrasound, and the distal motor and/or sensory latencies as measured on nerve conduction studies. METHODS: Patients with clinical signs and symptoms of carpal tunnel syndrome were prospectively enrolled in this study. Subjects underwent ultrasound measurement of the CSA of the median nerve at the carpal tunnel inlet by a fellowship-trained hand surgeon, followed by nerve conduction studies (NCS) by a certified electrodiagnostic technician who was blinded to the results of the ultrasound examination...
October 2016: Journal of Hand Surgery
Tiffany J Pan, Richard J White, Caiyan Zhang, William C Hagberg, Joseph E Imbriglia, John R Fowler
Background: Previous studies using ultrasound for diagnosis of carpal tunnel syndrome have reported on relatively small series of patients, leading to large standard deviations and/or confidence intervals for the mean cross-sectional area of the median nerve. The purpose of this study is to define the CSA of the median nerve in a large cohort of patients. Methods: Patients (n = 175) without history of carpal tunnel release were recruited. All participants were evaluated using the Carpal Tunnel Syndrome-6 questionnaire, a validated clinical diagnostic tool, with a score of 12 or greater considered positive for CTS...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
Andrew J Rosenbaum, Andrew Dunkman, Daniel Goldberg, Richard L Uhl, Michael Mulligan
Background: Approximately 33% of Americans have inadequate health literacy, which is associated with infrequent use of preventative services, increased hospitalization and use of emergency care, and worse control of chronic diseases. In this study, the Literacy in Musculoskeletal Problems (LiMP) questionnaire was used to evaluate the prevalence of limited musculoskeletal literacy in patients undergoing carpal tunnel release (CTR), as these individuals may be at increased risk of inferior outcomes. Methods: This cross-sectional study included individuals older than or equal to 18 years of age who were scheduled for elective CTR...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
F Buck Willis, Brook Fowler
Background: The incidence of carpal tunnel syndrome (CTS) is 48 million patients in the United States. The purpose of this longitudinal study was to determine whether Dynasplint stretching (immediately after diagnosis) had an effect on a patient's decision to seek surgical treatment for CTS. Methods: Fifty patients (10 men, 40 women, mean age 51.2 ± 12 years) were recruited for this randomized, controlled, longitudinal trial. Patients were diagnosed with CTS by physical examination and nerve conduction studies...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
Luiz Guilherme de Saboya Lenzi, Carlos Henrique Fernandes, Lia Myiamoto Meirelles, João Baptista Gomes Dos Santos, Flávio Faloppa, Jorge Raduan Neto
Background: Carpal tunnel syndrome (CTS) is the most common compressive neuropathy found in clinical practice. Recent studies evaluated which external factors could be involved in the CTS symptoms, including prolonged exposure to vibration, especially in the upper limb. This study investigated signs and symptoms in patients with CTS after using urban transport on (1) both upper limbs, (2) how long before these symptoms appear, and (3) the hands position or body reaction during the act of pressing the safety bars...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
Stefanie Evers, Andrew J Bryan, Thomas L Sanders, Ruud W Selles, Russell Gelfman, Peter C Amadio
BACKGROUND: The aim of this study was to compare the effectiveness of ultrasound-guided injections to blind injections in the treatment of carpal tunnel syndrome (CTS) in a large community-based cohort. METHODS: This study evaluated residents of Olmsted County, MN, USA, treated with a corticosteroid injection for CTS between 2001 and 2010. The proportion of patients receiving retreatment and the duration of retreatment-free survival between blind and ultrasound-guided injections were compared...
October 1, 2016: Arthritis Care & Research
Richard Ellis, Rebecca Blyth, Nick Arnold, Warren Miner-Williams PhD
STUDY DESIGN: Systematic review. INTRODUCTION: It is accepted that the etiology of carpal tunnel syndrome (CTS) is multifactorial. One of the most commonly accepted etiologic factors for CTS is compromise of the kinematic behavior and excursion of the median nerve. PURPOSE OF THE STUDY: The objective of this systematic review was to establish if there is a relationship between impaired median nerve excursion and CTS. METHODS: A systematic review, following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, was conducted...
September 28, 2016: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
S T Kokkalis, A F Mavrogenis, C Vottis, L Papatheodorou, P J Papagelopoulos, P N Soucacos, D G Sotereanos
Nerve wrap protectors are bioabsorbable synthetic materials made of collagen or extracellular matrix that provide a non-constricting encasement for injured peripheral nerves. They are designed to be used as an interface between the nerve and the surrounding tissue. After hydrated, they transform into a soft, pliable, nonfriable, easy to handle porous conduit. The wall of the nerve wrap has a longitudinal slit that allows to be placed around the injured nerve. Τhis article presents the surgical technique for median nerve neurolysis and nerve coverage using a collagen or an extracellular matrix nerve wrap protector in 10 patients with recurrent or persistent carpal -tunnel syndrome...
August 2016: Acta Orthopaedica Belgica
Kavin Khatri, Vijay Sharma, Kamran Farooque, Vivek Tiwari
BACKGROUND: Unstable distal end radius fractures are difficult to manage and so various treatment modalities have been described. The use of variable-angle locking plates is promoted for the management of these fractures. OBJECTIVES: This study aimed to evaluate the functional and radiological outcomes in unstable distal end radius fractures treated with variable-angle locking plates. PATIENTS AND METHODS: We reviewed 23 unstable distal end radius fractures that were treated at our institution with volar variable-angle locking plates...
June 2016: Archives of Trauma Research
Sana Salah, Mariem Rekik, Iheb Bel Haj Youssef, Soumaya Boudokhane, Houda Migaou, Anis Jellad, Zohra Ben Salah Frih
OBJECTIVE: The objective of this study was to assess the musculoskeletal disorders (MSD) of diabetes mellitus (DM) patients in a Physical Medicine and Rehabilitation (PMR) department. MATERIAL/PATIENTS AND METHODS: We carried out a retrospective study (January-December 2013) in which we enrolled 193 patients with DM. General (epidemic and clinical) characteristics were measured. Statistical analysis was performed using the statistical software SPSS 16. RESULTS: The participants' median age was 58 years (20-86), 98 men (50...
September 2016: Annals of Physical and Rehabilitation Medicine
Haifa Aroui, Irtyah Merchaoui, Mohamed Adnène Henchi, Ines Rassas, Noura Belhadj, Neila Chaari, Charfeddine Amri
OBJECTIVE: Describe the medical and professional consequences in victims of carpal tunnel syndrome. MATERIAL/PATIENTS AND METHODS: Exhaustive and descriptive study on 233 cases of carpal tunnel syndrome identified in two occupational medicine departments of the center of Tunisia from 2005 to 2010. The Boston questionnaire was used to assess the functional disability. RESULTS: To study the medical and professional becoming, we contacted 128 employees (54...
September 2016: Annals of Physical and Rehabilitation Medicine
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