Sindrom karpalnog tunela - suvremena dijagnostika i liječenje

Medica Jadertina (; Vol.38 No.3-4 01/2008;
Source: OAI

ABSTRACT Carpal tunnel syndrome is the most common compressive neuropathy in the human body, which is expressed by a deficit in the median nerve innervation area, with prevalence of 50 to 150 cases per 100.000 inhabitants. Symptoms depend on nerve compression duration and intensity. Sensibility disorders are the first and one of the most persistent symptoms, while motoric disorders arise in patients with prolonged nerve compression. Electroneurophysiological diagnostics is a "golden standard” in diagnosis setting, and it is necessary to be done in every patient with a clinical doubt on carpal tunnel syndrome. Additional diagnostics means in atypical cases can be performed by ultrasound and magnetic resonance of the carpal tunnel. Non-surgical treatment is reserved for mild forms of nerve compression, and in cases of syndrome in temporary conditions like pregnancy, lactation, taking oral contraceptives etc. The method of choice for persistent and progressive forms of carpal tunnel syndrome, as well for those who don't respond to the conservative treatment, is surgery. Decompression of median nerve is an efficient and secure procedure, which, in most cases, releases the patient from its symptoms. Procedure can be performed by an "open field” method or via endoscopy, although, for now, no indicators on advantages of endoscopic technique vs. classical technique of an "open field” have been found, and iatrogenous damage of the median nerve are much more frequent in surgery via endoscopy. In everyday practice, the most important is early recognition of the carpal tunnel syndrome, and its timely and adequate treatment. On the contrary, unnecessaryprolongation of the condition leads to much more severe nerve damage, which diminishes chances for a successful treatment and causes necessary economy losses.

160 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Carpal tunnel syndrome is a common disorder characterised by the classical symptoms of numbness and paraesthesiae along the distribution of the median nerve. Thenar muscle weakness is a late manifestation of advanced disease. Tinel's and Phalen's signs are helpful in suggesting the diagnosis. The symptoms and signs arise from entrapment of the median nerve. Electrophysiological tests are helpful in confirming the diagnosis and magnetic resonance imaging may be used in the diagnosis of atypical cases. Ergonomic manoeuvers and steroid injections may alleviate symptoms in mild cases. Surgery is reserved for severe cases and those who do not respond to conservative therapy. Open carpal tunnel release is the classical surgery with usually excellent results. Endoscopic carpal tunnel release surgery was introduced to decrease the morbidity of open surgery. This latter technique also has its complications and is still being refined.
    British Journal of General Practice 05/2001; 51(465):311-4. · 2.29 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Typescript. Thesis (M.Sc.)--York University, 2004. Graduate Programme in Kinesiology and Health Science. Includes bibliographical references (leaves 68-74). Microfiche. System requirements for Internet version: Adobe Acrobat reader.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Thirty-eight (49 per cent) of seventy-seven paraplegic patients whose level of injury was at or caudad to the second thoracic vertebra were found to have signs and symptoms of carpal tunnel syndrome. The prevalence of carpal tunnel syndrome was found to increase with the length of time after the injury. In the eighteen patients in whom manometric studies were done, the carpal tunnel pressures when the wrist was in the neutral position were higher than those that have been reported in non-paraplegic patients who did not have carpal tunnel syndrome but were lower than the values in non-paraplegic patients who did have the syndrome. When the wrist was in flexion, the pressures were similar to the values that have been reported for non-paraplegic patients. However, in the paraplegic patients, regardless of whether or not they had carpal tunnel syndrome, the pressures that developed when the wrist was in extension were significantly higher than those in non-paraplegic patients, regardless of whether or not they had carpal tunnel syndrome. Most of the activities of daily living of paraplegic patients, including the maneuver to relieve ischial pressure that consists of arising from the seated position using the extended arms, are performed with the wrists locked in maximum extension. The pressure that develops in the carpal canal during this forced extension of the wrist, probably combined with the repetitive trauma to the volar aspect of the extended wrist while propelling a wheelchair, contributes to the high frequency with which carpal tunnel syndrome is found in paraplegic patients.
    The Journal of Bone and Joint Surgery 05/1988; 70(4):517-9. · 5.28 Impact Factor
Show more

Preview (2 Sources)

160 Reads
Available from