Osteopathic correction in complex treatment of carpal tunnel syndrome with complicated closed forearm fractures

Abstract

A clinical case, described in this study, demonstrates a successful combined treatment of posttraumatic neuropathy of the medial and radial nerves in a patient after the closed comminuted fracture of the distal metaepiphysis of the left radial bone with a fragment displacement. One of the most serious complications of such injuries is the development of carpal tunnel syndrome [1]. Osteopathic physicians were involved in the process of treatment and rehabilitation. According to the data of various authors [1, 2], it is necessary to use complex surgical aids such as decompression of the medial nerve by dissecting the carpal ligament with the scar, as well as nerve transposition if the conservative methods are not effective. Unfortunately, surgical treatment does not always lead to a positive result [4]. Invalidization of patients is significant — 5–7%. It is known that early complex pathogenetic treatment allows to fight against the developing carpal tunnel syndrome in patients with severe bone trauma much more successfully. In order to prevent scar changes of the carpal ligament and maintain adequate trophicity in the injured limb, it is necessary to implement measures aimed at stabilizing microcirculatory disorders in the distal parts of the injured forearm as soon as possible. In order to make the treatment of this pathology even more effective, an integrated approach to solving this complex and socially significant problem is needed, as well as the search for new advanced and relatively safe treatment tactics, these include osteopathic correction too.