The most common disorders of the hand associated with carpal tunnel syndrome in adults

Dushanka Grujoska-Veta,Daniela Georgieva,Liljana Angeleska,Jasna Bogdanska,Ilir Shabani,Nenad Atanasov,Antonio Georgiev

doi:10.3889/aph.2021.6014

Dushanka Grujoska-Veta, Daniela Georgieva + Show 5 more

Open Access

https://doi.org/10.3889/aph.2021.6014

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Abstract

Carpal tunnel syndrome (CTS) is one of the most common peripheral neuropathies caused by chronic compression of the median nerve in the area of the carpal tunnel and its etiology is multifactorial. Trigger fingers and de Quervain’s disease are common disorders of the hand related to CTS in adults.Theaim of this study was to present the most common disorders of the hand such as stenosing tenosynovitis in adults with surgically treated CTS and to evaluate their demographic data.Material and methods: A total of 116 surgically treated patients with established diagnosis of CTS (clinically and by electrophysiological examination) were included in this prospective study, which was conducted at the University Clinic for Orthopedic Diseases in Skopje. Demographic data, findings of history of the disease and clinical examination were recorded and analyzed.Results: Participants with CTS included in the study were with a mean age of 55.41±10.7 years (age range 29-75). 75% of them were female. 63.8% of participants suffered from one or more comorbid chronic diseases. On admission to hospital, disorders such as trigger fingers and de Quervain’s disease were concomitantly diagnosed in 15.51% on ipsilateral hand with CTS. All disorders were surgically treated following open carpal tunnel release, as “one stage procedure”, under local anesthesia.Conclusion: Our findings have determined concomitant existence of CTS and stenosing tenosynovitis (trigger fingers and de Quervain’s disease) on ipsilateral hand, which suggests common etiological factors. Female gender and age range 40-60 years are major common factors related to these three disorders.

Highlights

Carpal tunnel syndrome (CTS) is one of the most common non-traumatic disorders of the hand in adult patients and the most common reason for visiting orthopaedic surgeons
In the distribution according to the level of education, most of the patients had completed secondary education - 62.9% (73). 86.2% (100) of CTS patients were of Macedonian ethnicity, followed by patients of Albanian - 6% (7), and Serbian ethnicity - 4.3% (5)
Mutual existence of CTS and stenotic tenosynovitis with different times of occurrence refer to common etiological factors that act on a similar anatomical structure and lead to inadequacy of the space in the bone-fibrous tunnel and its contents, resulting in morphological and functional changes of both of them

Summary

Introduction

Carpal tunnel syndrome (CTS) is one of the most common non-traumatic disorders of the hand in adult patients and the most common reason for visiting orthopaedic surgeons. This syndrome is often associated with trigger fingers and de Quervain’s disease in adults. In more severe cases, when motor component of the median nerve is involved, clumsiness during everyday activities and hypotrophy of tenor muscles, are observed.[1] Nocturnal pains are typical due to the additional pressure on median nerve because of the prolonged flexion position of the wrist during sleeping. Shaking of the hand during nights is a typical act in patients with CTS in order to relieve pain

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