Median Nerve Transverse Mobility and Outcome after Carpal Tunnel Release
Nerve movement is decreased in patients with carpal tunnel syndrome and can be assessed with ultrasound. In addition to morphologic features, this study describes a novel approach in which nerve movement and the association with short-term patient-reported outcome are assessed. Ultrasound images at the carpal tunnel inlet were acquired during finger and wrist flexion. Linear regression models were used with the Boston Carpal Tunnel Questionnaire as main outcome. Eighty-five patients were included; 93% completed the 3-mo follow-up.
ConclusionThe ultrasound-guided percutaneous release of the carpal tunnel is demonstrated to be a procedure with a rapid learning curve.
Condition: Carpal Tunnel Syndrome Interventions: Procedure: Incisionless Threaded Carpal Tunnel; Procedure: Standard Mini-Open Carpal Tunnel Sponsor: Mayo Clinic Recruiting
DISCUSSION: The symptom questionnaire was associated with the median nerve pathology often seen in CTS. Moreover, the study results have shown the questionnaire to be the most effective screening method when compared to ultrasound. PMID: 31475688 [PubMed - in process]
Abstract BACKGROUND: Carpal tunnel syndrome is diagnosed based on history, physical examination, and nerve conduction testing; however, there are no clear criteria for the diagnosis of carpal tunnel syndrome. Recently, studies have aimed to diagnose carpal tunnel syndrome through ultrasound or MRI. The purpose of this study was to compare and analyze the cross-sectional area of the median nerve between patients with carpal tunnel syndrome and a control group. METHODS: From July 2015 to August 2017, we retrospectively analyzed fishery and white-collar workers (164 people, 37 men, 127 women). Carpal tunnel synd...
ABSTRACT Carpal tunnel syndrome (CTS) is a disorder of the wrist due to narrowing of the carpal tunnel. It can be caused by trauma or tumors in the tunnel resulting in compression of the median nerve. This disorder is often diagnosed with early symptoms such as tingling, numbness, and weakness that subsequently lead to hand muscle atrophy. While ultrasonography (USG) is one of the diagnostic methods of CTS, neurophysiological diagnosis, such as with nerve conduction study (NCS), is standard in clinics where the necessary equipment is available. This cross-sectional study aimed to compare USG diagnostic values with NCS ...
ConclusionPlatelet-rich plasma could be effective treatment of mild to moderate idiopathic CTS and superior to corticosteroid in improving pain, function, and distal sensory latency of median nerve.Trial registrationClinicalTrials.gov Identifier: NCT03863873Key Points:•PRP is effective treatment of mild to moderate CTS.•PRP is superior to corticosteroids in improving pain and function in CTS.
We systematically reviewed observational studies investigating ultrasound elastography for median nerves in the carpal tunnel syndrome (CTS) population. PubMed and Embase were studied from the earliest record to April 2019. The primary outcome was the comparison of elasticity of the median nerve between participants with and without CTS, quantified by the standardized mean difference (SMD) and its 95% confidence interval. The median nerve is considered to be stiffer in the CTS population when the SMD of tissue strain is negative, or that of strain ratio, shear modulus and shear wave velocity are positive.
High-resolution ultrasound is being widely used in carpal tunnel examination to understand morphological and biomechanical characteristics of the median nerve and surrounding anatomy structures.
We describe 2 cases of acute carpal tunnel syndrome due to thrombosed persistent median artery, including a case of thromboangiitis obliterans. These thrombosis might also be due to traumatic causes. No guidelines are currently available to help physicians for the management of carpal tunnel syndrome from thrombosed persistent median artery. Antiplatelet therapy, statin, anticoagulant might be helpful, and surgery has sometimes be reported as effective. PMID: 31040049 [PubMed - as supplied by publisher]
ConclusionsThis adapted technique can successfully be used to divide fascial planes over longer distances than is currently achieved in clinical practice. The improved outcomes associated with USGTR at the carpal tunnel may therefore also be achievable in fasciotomy procedures in larger anatomical compartments. Further study is required to investigate the effects of this modified USGTR technique on intracompartmental pressure.