Abstract
AimTo evaluate the efficacy of botulinum toxin A on relieving the clinical symptoms caused by median nerve compression in patients with carpal tunnel syndrome.Patients and methodsAn imbalanced randomization (3 : 1) placebo-controlled parallel group study for efficacy and safety was conducted in Tanta University, Egypt. Group I Received Botox injection. Group II Received the same amount of normal saline as Botox injection and at the same injection points as group I. All patients were subjected to clinical assessment and electrophysiological assessment of the median nerve before and after 12 weeks.ResultsHighly significant improvements were noted in group I regarding clinical symptoms and electrophysiological study of the median nerve, whereas group II showed significant improvement in clinical symptoms but no improvement in the electrophysiological study, with significant difference between the two groups.ConclusionBotox injection can be used safely as a treatment option in moderate carpal tunnel syndrome.
Highlights
Carpal tunnel is an osteofibrous canal situated in the volar wrist
The flexor carpi radialis tendon, the flexor carpi ulnaris tendon, and the palmaris longus tendon travel outside the carpal tunnel but in close contact with it
Flexor carpi ulnaris tendon inserts into the pisiform, whereas the palmaris longus tendon continues with the palmar fascia or inserts into the flexor retinaculum [2]
Summary
Carpal tunnel is an osteofibrous canal situated in the volar wrist. The boundaries are the carpal bones and the flexor retinaculum. In addition to the medial nerve, the carpal tunnel contains nine tendons: the flexor pollicis longus, the four flexor digitorum superficialis, and the four flexor digitorum profundus [1]. The flexor pollicis longus has its own synovial sheath, whereas the flexor digitorum superficialis and profundus have a common synovial sheath [2]. The flexor carpi radialis tendon, the flexor carpi ulnaris tendon, and the palmaris longus tendon travel outside the carpal tunnel but in close contact with it. The flexor carpi radialis tendon inserts into the scaphoid and the base of the second metacarpal bone after passing through the canal formed by the splitting of the flexor retinaculum. Flexor carpi ulnaris tendon inserts into the pisiform, whereas the palmaris longus tendon continues with the palmar fascia or inserts into the flexor retinaculum [2]
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