Occurrence Of Carpal Tunnel Syndrome Research Articles

Carpal Tunnel Syndrome as a Potential Indicator of Cardiac Amyloidosis: A Systematic Review and Meta-Analysis.

Carpal tunnel syndrome (CTS) and cardiac amyloidosis (CA) are seemingly disparate medical conditions but may be linked. CTS can be a sign of early CA, and CA can be a hidden cause of heart failure. Therefore, in this systematic review and meta-analysis, we aim to investigate the expected correlation between the occurrence of CTS and CA. A comprehensive search was conducted across multiple databases, including PubMed, Web of Science, Scopus, and Cochrane Library, to get relevant studies previously published before June 2023. No language restrictions were applied. Randomized clinical trials and observational studies have been included to investigate the proportion of patients reporting CA among patients with an established diagnosis of CA, and also the incidence of patients who have CTS among patients with CA has been investigated with a pooled estimation of the expected time from the diagnosis of CTS till the development of CA.Studies that did not report data on CTS or CA or lacked sufficient details were excluded. Meta-analysis of data for each outcome was performed using R version R.4.3.2 software (RFoundation for Statistical Computing, Vienna, Austria) using the Meta package. Heterogeneity across studies was assessed using the I² statistic. A meta-analysis of 15 studies, including 1416 patients, evaluated the relationship between CTSand CA. Among these, 495 patients with CTS were assessed for the presence of CA, and 915 patients with CA were evaluated for the presence of CTS. The pooled meta-analysis of eight studies, which included 915 patients with CA, revealed that 38% (95% CI: 35%-41%) had a history of CTS. Conversely, the proportion of patients with CTS who developed CA was 13% (95% CI: 4%-35%). The pooled mean time from CTS to the development of CA, based on 639 patients across four studies, was 6.02 years (95% CI: 3.76-8.36).Significant heterogeneity was noted for some outcomes (e.g., proportion of CA in patients with CTS: I²=93%), likely influenced by variations in study populations, age distributions, and diagnostic criteria. Our review of the literature suggests that there may be a link between CTS and CA. However, more research is needed to confirm this link and to understand how the two conditions are related. It is important to consider the possibility of CA in patients with CTS, as screening, early detection, and timely treatment can improve outcomes by slowing disease progression and reducing complications.

Carpal tunnel syndrome related to rheumatic disease (Review).

Carpal tunnel syndrome (CTS) is the most commonly occurring type of entrapment neuropathy in the world. Several conditions may contribute to the development of CTS, such as obesity, repetitive wrist movements, pregnancy, genetic predisposition and rheumatoid arthritis (RA) inflammation. CTS is characterized by a wide range of pathophysiological factors, including increased pressure, mechanical trauma and ischemic damage to the median nerve that runs through the wrist tunnel. In the present narrative literature review, the way rheumatic diseases (RDs) contribute to CTS occurrence is investigated. The epidemiological, clinical, paraclinical and pathogenesis aspects of the relationship are examined. CTS is the most common neurological finding in RA, and incidences of RA, psoriatic arthritis and CTS are closely related. The association of CTS with systemic lupus erythematosus, Sjögren's syndrome, Behcet's disease and systemic sclerosis is weaker. In these cases, the prevalence of CTS is similar to that in the general population. As the occurrence of CTS is increasing, understanding the common mechanism and making an early diagnosis are required to limit pain and costs. When patients with RD present with symptoms such as wrist pain, tingling sensations or numbness in their fingers, CTS should be suspected. This suspicion should not be interpreted in terms of RD. To accurately evaluate patients with RD, a detailed electrophysiological examination should be included in the evaluation process. A diagnostic algorithm should include neuromuscular ultrasound or magnetic resonance imaging for patients with RD.

Enhancing Awareness and Management of Carpal Tunnel Syndrome Among Medical Professionals and Athletes

Introduction and objective: The objective of this research is to enhance the awareness of carpal tunnel among medical professionals and individuals engaged in sports. The acquired knowledge will enable medical professionals to more effectively identify, treat, and prevent issues related to carpal tunnel. Additionally, individuals engaged in sports will be able to prevent the occurrence of carpal tunnel syndrome in themselves or their pupils, thereby allowing them to engage in long-term and safe physical activity. Review methods: Review and summary of research studies available in open-source format on Google Scholar, PubMed. Abbreviated description of the state of knowledge: Carpal tunnel syndrome is a disease belonging to the group of compression neuropathies. The symptoms of carpal tunnel syndrome typically manifest as an uncomfortable sensation in the thumb, index finger, and half of the ring finger. Such symptoms may include numbness and tingling. In some cases, weakness of the hand muscles may occur, and in rarer instances, atrophy of the hand muscles. The condition of carpal tunnel syndrome is primarily the result of repetitive movements of the fingers and wrist. Such activities include typing, using a mouse, riding a bicycle, or playing a musical instrument. Summary: Carpal tunnel syndrome is a prevalent condition among the general population. This condition may affect individuals who engage in regular physical activity, resulting in diminished efficiency and a notable reduction in the quality of life. The objective of this study is to examine the risk factors, symptoms, and diagnostic methods associated with carpal tunnel syndrome. In the context of sports, we will examine the mechanisms of disease development in athletes and focus on prevention. This encompasses the rehabilitation of individuals at risk of developing the disease and patient education, which will facilitate the minimisation of the appearance or recurrence of disease symptoms.

Association Between Thenar Musculature and Carpal Tunnel Syndrome.

Background: Dynamic forces acting on the transverse carpal ligament (TCL) may influence the mechanics of the carpal tunnel (CT), thus affecting the occurrence of CT syndrome (CTS). Previous studies demonstrated an association between muscle overlying the CT and the diagnosis of CTS. Understanding the location of insertion/origin of the thenar musculature will allow mechanical analysis of the forces applied to the TCL during performance of individual tasks. Our purpose was to determine the location of muscle overlying the CT on magnetic resonance imaging (MRI) in CTS and controls. Methods: Case-control study of 21 normal adult wrist MRI scans. MRI measurements were performed on an axial cut at the level of the hook-of-hamate. Median nerve cross-sectional area (CSA), median nerve shape and increased signal intensity within the CT were associated with CTS. The amount and length of muscle crossing the midline and the CT on the same cut was measured and the association with the occurrence of CTS was analysed. Results: We found an inverse relationship between the amount of muscle crossing the midline and the size of the CT, and a direct relationship with occurrence of CTS p less than 0.01, but no differences regarding length of muscle crossing the midline. Conclusions: This study supports an association between the thenar musculature location relative to the CT and the predictors of CTS on MRI. Since the location of muscle origin/insertion is variable, their effect may differ accordingly, therefore, further study is needed to describe the exact location of origin/insertion and its differential dynamic or static effect on the pathogenesis of CTS. Level of Evidence: Level IV (Diagnostic).

Association of upper extremity anthropometry and subcutaneus adipose tissue with carpal tunnel syndrome

<p>Body mass index (BMI) is positively correlated with the frequency of carpal tunnel syndrome (CTS). However, there are different types of obesity, and the localization of adipose tissue differs between the genders. In this study, we purposed to investigate whether there was an association between the amount of local adipose tissue thickness and anthropometry in upper extremity with the presence and/or electrophysiological severity of CTS on both genders.</p>. <p>Our study included 150 patients who were diagnosed with CTS clinically and electrophysiologically and 165 healthy controls. The biceps and triceps skinfold thickness, the diameters of the wrist and metacarpal joints, and the upper arm circumferences over the belly of the biceps muscle were measured by using skinfold caliper and measuring cylinder. All data were analyzed by using the Statistics Open For All package (SofaStats) programme. To detect the role of anthropometric indexes, we used multivariable multinomial logistic regression models.&nbsp;</p>. <p>We revealed that BMI, biceps and triceps adipose tissue thicknesses were higher in females and also in patients with CTS. There was a positive correlation between electrophysiological grades of CTS and BMI with logistic regression analyzes. The mean Wrist circumference/Metacarpo&shy;ph&shy;arengeal Circumference ratio and biceps circumference were higher in moderate CTS groups. Metacarpofarengeal circumference was smaller in mild and moderate CTS cases compared to healthy ones.</p>. <p>We suggest that the differen&shy;ces between the anatomical bone structure and local adiposity between the genders may play an important role in the occurrence of CTS. Moreover, the structures of proximal muscle groups and distal metacarpal joints may contribute both to the development and severity of CTS.</p>.

Correlation between Palmaris Longus Muscle and Carpel Tunnel Syndrome in Badminton Players

Background: Carpal Tunnel Syndrome (CTS) is commonly observed in athletes, especially those engaged in sports involving repetitive wrist activities. The role of the Palmaris Longus Muscle (PLM) in the development of CTS has been a subject of interest due to its anatomical location. Objective: To examine the correlation between the presence or absence of the PLM and the incidence of CTS among badminton players. Methods: In this cross-sectional study, 258 badminton players aged 18-23 years were assessed. Players with a history of carpal tunnel release surgery were excluded. The presence of the PLM was evaluated using Schaeffer’s test, while Phalen’s test was used to diagnose CTS. Statistical analysis involved chi-square tests to determine the association between PLM and CTS. Results: Of the participants, 193 (74.8%) had a positive Schaeffer’s test (indicating the presence of PLM), and of these, 72 (37.3%) also had a positive Phalen’s test (indicative of CTS). Conversely, among the 65 (25.2%) with a negative Schaeffer’s test, only 10 (15.4%) had a positive Phalen’s test. The chi-square analysis yielded a P-value of 0.001, indicating a statistically significant association between the presence of PLM and the occurrence of CTS. Conclusion: There is a significant correlation between the presence of the Palmaris Longus Muscle and the development of Carpal Tunnel Syndrome in badminton players. These findings underscore the importance of considering anatomical variations in PLM during the assessment and management of CTS in athletes.

The Relationship Between Work Duration and Carpal Tunnel Syndrome in Cigarette Rolling Workers

Aims: This study aimed to identify the correlation between the length and the period of Work correlated with the incidence of carpal tunnel syndrome among cigarette rolling workers at the Breadfruit Factory. Methods: This is an analytic observational study with a cross-sectional method. It utilizes the sample selection method of purposive sampling. The information collection tool consists of questions covering personal information, length of service, and physical examination sheets. Statistical test implemented with Chi-square. Results: The number of cigarette rolling workers used as the sample for this study was 103 people. The statistical test results applying chi-square work duration obtained p-value = 0.005 (p ≤0.05), a p-value of 0.000 (p ≤0.05) was obtained for years of service, indicating a correlation between length of Work and working time with the possible occurrence of Carpal Tunnel Syndrome (CTS) in workers. Conclusion: There is a significant correlation between length of Work and duration of Work on the emergence of CTS symptoms. As a form of prevention, occupational health and safety nurses can provide adequate education to cigarette companies to pay attention to employee conditions and the possibility of health problems occurring for their employees.

Hubungan Karakteristik, Riwayat Penyakit, dan Obesitas dengan Keluhan Carpal Tunnel Syndrom (CTS) Pada Komunitas Ojek Online Wilayah Kecamatan Ciracas Jakarta Timur Tahun 2022

Activities involving intensive use of hands over an extended period are often associated with the occurrence of Carpal Tunnel Syndrome (CTS). According to the 2013 ILO report, CTS is consistently detected in almost every incident of work-related diseases in several countries. One type of occupation at risk of CTS is online motorcycle taxi drivers. The aim of this study is to determine the relationship between characteristics, medical history, and obesity with CTS complaints in the Online Motorcycle Taxi Community of the Ciracas District, East Jakarta, in the year 2022. The study design is cross-sectional. The sample consists of 107 online motorcycle taxi drivers from the Ciracas District. The research was conducted from April to September 2022. Data collection was done using questionnaires. Data analysis included univariate, bivariate (Chi-square test), and multivariate (Logistic Regression test). The research findings reveal that respondents with CTS complaints in the at-risk category are 29.9%. The majority of respondents are below 40 years old (52.3%), have a work experience of less than 4.5 years (51.4%), work for more than 8 hours per day (59.8%), have no medical history (59.8%), and are not obese (71.0%). The bivariate analysis results show that variables significantly associated with CTS complaints include work experience (p = 0.012 and OR = 3.3), work duration (p = 0.021 and OR = 3.297), medical history (p = 0.046 and OR = 2.571), and obesity (p = 0.049 and OR = 2.654). The multivariate analysis results indicate that there is no single dominant factor with the highest influence on CTS complaints within the online motorcycle taxi community (p &gt; 0.05). The recommendation is to provide Health Education to online motorcycle taxi drivers regarding preventive measures for CTS complaints. This aims to help them manage their work schedule effectively and take preventive actions against CTS issues, such as regular breaks, supportive nutrition, and so forth.&#x0D; Keywords: characteristics, medical history, obesity, Carpal Tunnel Syndrome (CTS) complaints, Online Motorcycle Taxi

Body mass index and carpal tunnel syndrome: A case-control study.

To investigate the electrophysiological characteristics of carpal tunnel syndrome (CTS) and to evaluate the relationship between electrophysiological indexes and body mass index (BMI). In the analysis of 153 hospitalized patients with CTS, the median motor conduction velocity, motor conduction amplitude, motor conduction latency, sensor conduction velocity, sensor conduction amplitude and median sensory latency were analyzed. BMI was calculated. Total 171 healthy individuals were selected as control group. According to Guidelines for Prevention and Control of Overweight and Obesity in Chinese Adults, patients were divided into groups A, B and C. Patients with BMI (kg/m2) <24 were classified into group A; those with 24 ≤ BMI < 28 were regarded as overweight and classified into group B; and those with BMI ≥ 28 were regarded as obese and classified into group C. The BMI of CTS patients was significantly higher than that of healthy individuals (P < .05). For the sensory nerve, with the increase of BMI, the incubation period was gradually prolonged and the conduction velocity gradually decreases (P < .05). In terms of motor latency, with an increase in BMI, the latency showed a trend of first decreasing and then increasing, while the conduction velocity showed a trend of first increasing and then decreasing (P < .05). Electrophysiological examination plays an important supporting role in the diagnosis of CTS. BMI is positively correlated with the degree of CTS injury to a certain extent. Weight loss can effectively prevent the occurrence of CTS and slow the progression of nerve damage in CTS patients.

Serum Transforming Growth Factor β1 and Its Genetic Variants Are Associated with Increased Macrophage Inflammatory Protein 1β and Susceptibility to Idiopathic Carpal Tunnel Syndrome.

Carpal tunnel syndrome (CTS) is a common entrapment neuropathy in which one of the body's peripheral nerves becomes pinched or crushed. Transforming growth factor beta 1 (TGF-β1) plays an important role in the pathogenesis of CTS. An association between TGF-β1 polymorphisms and the susceptibility or progression of a number of diseases has been reported. In this study, three TGF-β1 single nucleotide polymorphisms (SNPs), serum TGF-β1, and macrophage inflammatory protein 1 beta (MIP-1β) were investigated as potential diagnostic markers for the progression of CTS in Egyptian patients. One hundred CTS patients and 100 healthy controls were recruited for the study. TGF-β1 SNPs +915G/C, -509C/T and -800G/A were determined by TaqMan genotyping assay. Serum TGF-β1 and MIP-1β levels were measured by ELISA. Serum TGF-β1 and MIP-1β levels increased significantly and were strongly correlated with the occurrence of CTS. The C allele of +915G/C, the T allele of -509C/T, and the G allele of -800G/A occurred more frequently in patients from CTS than in controls. The serum levels of TGF-β1 and MIP-1β in the group of carriers of the genotypes +915G/C GC and CC, the genotype -509C/T TT and the genotype -800G/A GA and AA were significantly higher in CTS patients. TGF-β1 and its +915G/C, -509C/T, and -800G/A SNPs and MIP-1β could be useful prognostic markers for the occurrence of CTS.

HUBUNGAN INDEKS MASSA TUBUH DAN JENIS KELAMIN DENGAN DERAJAT KEPARAHAN CARPAL TUNNEL SYNDROME DI RSUD KOTA MATARAM

Carpal Tunnel Syndrome (CTS) is a common disorder with symptoms involving the median nerve. The risk factors for the occurrence of CTS are grouped into individual and physical factors related to work. Individual factors consisted of a history of diabetes mellitus, hypothyroidism, obesity, rheumatoid arthritis, age and gender. In addition, there are work-related physical factors, namely work with repetitive hand movements, gripping or clamping work with force, abnormal postures on the wrist for a long time. Purpose to determine the relationship between BMI and gender with the degree of severity of CTS in Mataram City Hospital. Observational analytic quantitative research with a cross-sectional study design. The sampling technique used a random sampling technique of 34 samples. The research was conducted at the Mataram City Hospital, from November to December 2022. The data obtained was analyzed using the spermaman rank test. Results of the 34 study samples, there were 8 people (23.5%) with BMI &lt; 24.9 kg/m2 and, 26 people (76.5%) with BMI ≥ 25 kg/m2. A total of 13 men (38.2%) and 21 women (61.8%) suffered from CTS. The value of p = 0.001 (p &lt;0.05) with a correlation value of 0.528 for the relationship between BMI and the severity of CTS, and p = 0.001 (p &lt;0.05) with a correlation value of 0.531 for the relationship between gender and the severity of CTS . There is a significant relationship between BMI and gender with the degree of severity of CTS in Mataram City Hospital.

Hubungan Repetitive Motion dan Masa Kerjadengan Kejadian Carpal Tunnel Syndrome pada Penjahit di Kelurahan Belian Kota Batam

Background :Carpal tunnel syndrome is a collection of symptoms due to compression of the median nerve in the carpal tunnel at the wrist, one of the risk factors for the occurrence of carpal tunnel syndrome, namely repetitive motion and working period. The purpose of this study was to determine the relationship between repetitive motion and tenure with the incidence of carpal tunnel syndrome in tailors. &#x0D; Method :This type of research is an analytic study with a cross sectional approach conducted on tailors in Belian Village, Batam City. The sampling technique was simple random sampling with a total sample of 44 respondents. The results of the study were analyzed by chi-square.&#x0D; Result :From the results of the calculation of the chi square test, the results obtained with a value of p = 0.001 (p 0.05), namely there is a relationship between years of service and the incidence of carpal tunnel syndrome in tailors and the results are obtained with a value of p = 0.002 (p 0.05), namely there is The relationship between repetitive motion and the incidence of carpal tunnel syndrome in tailors in Belian Village, Batam City&#x0D; Conclusion :Based on this research, there is a relationship between repetitive motion and length of service with the incidence of carpal tunnel syndrome in tailors in Belian Village, Batam City in 2021.

Exercise Education in Carpal Tunnel Syndrom in Village Kasang Kumpeh

Education exercise on case carpal tunnel syndrome Her workout includes rest wrist hand which painful, avoid profession which cause painful, compress cold in area which painful During 10-15 minute and practice stretching. This method of education provides leaflet and explain leaflet and discussing exercise education with carpal tunnel syndrome sufferers. Service activities to Public held month October 2021 with target patients with carpal tunnel syndrome in Kasang Kumpeh village. The purpose of activity devotion Public this is for increase public knowledge regarding carpal tunnel syndrome. This activity is very beneficial and also has a good impact on the community to reduce stiffness and complaints pain and for those who only feel the signs and symptoms is very helpful because it gives knowledge to prevent more further occurrence of carpal tunnel syndrome.

HUBUNGAN POSISI PERGELANGAN TANGAN SAAT MENGETIK TERHADAP RISIKO TERJADINYA CARPAL TUNNEL SYNDROME: STUDI LITERATUR

Background: The use of computers has a high risk of experiencing wrist trauma disorders, namely the occurrence of carpal tunnel syndrome, which is caused by compression of the median nerve at the wrist and causes joint pain. This is influenced by years of activity in using a keyboard and mouse on a computer. Ergonomic position on the wrist when using the keyboard and mouse while typing is an important thing to prevent the occurrence of carpal tunnel syndrome. Objective: This study aims to analyze the results of previous studies regarding the relationship between wrist position when typing and the risk of carpal tunnel syndrome. Research Methods: The design used is a literature study. By searching through search engines, namely PubMed, Google Scholar, PMC, and Semantic Scholar. Results: Obtained 6 eligible literatures. Overall, the literature shows a significant relationship between wrist position while typing and the risk of developing carpal tunnel syndrome. Conclusion: Ergonomic position on the wrist when using the keyboard and mouse when typing is an important thing to prevent carpal tunnel syndrome.. &#x0D; &#x0D;

HUBUNGAN ANTARA GERAKAN REPETITIF DAN POSTUR KERJA DENGAN KEJADIAN CARPAL TUNNEL SYNDROME PADA PEKERJA PENGUPAS KULIT KELAPA MANUAL DI PASAR TRADISIONAL SE – KOTA SURAKARTA

Traditional markets are one of the informal sectors that have an important role in people's lives. One of the commodities that being sold is coconut. Manual coconut shell peeler workers when working often perform repetitive movements and poses in awkward work postures, especially extreme wrist positions for long periods of time. Its a risk for the occurrence of Carpal Tunnel Syndrome in workers. This research aim to find out the corellation between repetitive movements and work postures with the incidence of CTS in Manual Coconut Shell Peeler Workers in Traditional Markets of Surakarta City. This research was quantitative with cross sectional method. Research’s population was manual coconut shell peeler workers in traditional markets throughout the city of Surakarta. Samples was taken by incidental technique consisting of 30 respondents from 5 traditional markets in Surakarta. The independent variables are repetitive movements and work postures. The dependent variable is the incidence of CTS, while the confounding variables are history of diseases or acute trauma, pregnancy, and nutritional status. Data were collected using google form and analyzed using Chi - Square and Spearman Rank. The results showed that the p-value of the repetitive movement with the incidence of CTS was 0.003&lt;0.05 performed by Chi-Square test, while the p-value of work posture with the incidence of CTS was 0.013&lt;0.05 performed by Spearman Rank. There is a corellation between repetitive movements and work postures with the incidence of CTS in manual coconut shell peelers in traditional markets throughout Surakarta City.

Association between carpal tunnel syndrome and trigger finger: a clinical and electrophysiological study

BackgroundCarpal tunnel syndrome is a prevalent mononeuropathy. Trigger finger is a flexor stenosing tenosynovitis. The aim of the study was to assess the concomitant occurrence of carpal tunnel syndrome and trigger finger in the same hand among patients presented with idiopathic carpal tunnel syndrome or idiopathic trigger finger. The study included 110 hands (75 patients) presented with carpal tunnel syndrome or trigger finger and 60 asymptomatic hands (46 apparently healthy individuals). Clinical assessment and neurophysiological evaluation were done.ResultsRegarding the presenting clinical complaints, there were 76 hands (69.1%) from 48 patients (64.0%) presented with idiopathic carpal tunnel syndrome. There 34 hands (30.9%) from 27 patients (36.0%) presented with idiopathic trigger finger. Classification of the patients into three groups depending on the final diagnosis: (I) carpal tunnel syndrome group, 57 hands (51.8%) with only carpal tunnel syndrome from 36 patients (48.0%); (II) trigger finger group, 25 hands (22.7%) with only trigger finger from 22 patients (29.3%); and (III) carpal tunnel syndrome with trigger finger group, 28 hands (25.5%) with both conditions from 24 patients (32.0%); and among them, seven patients had contralateral hand carpal tunnel syndrome only. The duration of complaints among the carpal tunnel syndrome with trigger finger group was significantly shorter than that in the other two groups. There were statistically significantly higher values of patient global assessment of hand symptoms and effect of hand symptoms on function and quality of life among the carpal tunnel syndrome with trigger finger group versus the other two groups. There was no statistically significant difference between the carpal tunnel syndrome with trigger finger group versus the carpal tunnel syndrome group regarding different classes of the Padua neurophysiological classification scale. The most common digit to have trigger finger was the middle finger in 19 hands (35.8%).ConclusionsThe concurrent presentation of idiopathic carpal tunnel syndrome and idiopathic trigger finger in the same hand is common. Each of them could be associated with the other one. The symptoms of one of them usually predominate the patient’s complaints. The identification of this association is essential for proper diagnosis and comprehensive management of patients presented with these conditions.

The Myth of Median Nerve in Forearm and Its Role in Double Crush Syndrome: A Cadaveric Study.

Purpose: This study aims to histologically compare the median nerve in the arm, forearm, and wrist, to help understand how cervical radiculopathy in a double crush phenomenon causes distal nerve dysfunction at the carpal tunnel and median nerve with concurrent absence of symptoms at the forearm.Methods: The study was performed on 12 fresh cadaveric upper limbs free from any injury or operation. Male cadavers in the age range of 35–40 years were used. The dissection of the median nerve and the histological examination of the specimens from the arm, forearm, and wrist were conducted to evaluate variations in the epineurium thickness (μm), perineurium thickness (μm), number of fascicles per nerve trunk, area percent of myelin covering, and area percent of neurolemmal sheath.Results: Morphometric and statistical results of the cadaveric median nerve trunk revealed that the mean epineurium and perineurium thickness measured in H&E-stained sections in the forearm were significantly greater than those in the arm and wrist specimens. Further, the mean percent area of the myelin covering in the forearm was significantly lower than that in the arm and wrist specimens in the sections stained with osmium oxide (p < 0.001). There were, however, no significant differences in the neurolemmal sheath among the arm, forearm, and wrist specimens in the silver-stained sections.Conclusion: The histological differences explained the high concomitant occurrence of carpal tunnel syndrome (CTS) and cervical radiculopathy and the concurrent absence of symptoms at the forearm. Hence, we suggest cautious evaluation of patients with upper limb symptoms, since the management of these conditions requires a different approach.

Risk factors related to complications of the fingers and hand after arthroscopic rotator cuff repair - carpal tunnel syndrome, flexor tenosynovitis, and complex regional pain syndrome.

Hypothesis/BackgroundComplications involving the fingers and hand after arthroscopic rotator cuff repair (ARCR) include complex regional pain syndrome, carpal tunnel syndrome (CTS), and flexor tenosynovitis (TS). The aims of this study were to diagnose the complications after ARCR and investigate the risk factors that could predispose individuals to these finger and hand complications.MethodsFifty patients (50 shoulders) who underwent ARCR participated in this study. The patients’ ages ranged from 36 to 84 years (mean, 63 years). Before ARCR, we determined the disease history of the fingers and hand (CTS or TS) and subjectively assessed their symptoms using a questionnaire that included a scale ranging from 1 (no symptoms or no disability) to 5 (the worst symptoms or severest disability). ARCR was performed in all patients using suture anchors. The mean observation period after surgery was 15.5 months (range, 12-48 months). We diagnosed complications involving the fingers and hand after ARCR and investigated the preoperative, intraoperative, and postoperative risk factors that could predispose patients to these complications using univariable and multivariable analyses.ResultsAfter ARCR, 20 patients (20 hands) (40%) had complications of the fingers and hand. Among them, the diagnosis was CTS in 2 hands, TS in 15 hands, and both CTS and TS in 3 hands. None of the hands exhibited complex regional pain syndrome. These complications occurred at an average of 1.8 months (range, 0.1-4 months) after ARCR. In the 47 patients who did not have symptoms just before the operation, both univariable and multivariable analyses between the complication group (n = 17) and the no-complications group (n = 30) showed a significant difference in the presence of a past history of CTS or TS (complication frequency: past history: 88%, no past history: 25%) (P < .05) and the preoperative subjective assessment for edema of the fingers and hand (complication frequency: edema ≥ 2 points: 89%, edema < 2 points: 24%) (P < .05). There were no relationships between the other candidate intraoperative and postoperative factors and complications.ConclusionIn all 20 hands with complications of the fingers and hand after ARCR, the diagnosis was CTS or TS. Complications of the fingers and hand after ARCR easily occurred in patients with a past history of CTS or TS and in patients with edema as per a subjective assessment. We speculate that the ARCR triggered the occurrence of CTS and TS postoperatively in patients who had subclinical CTS or TS before surgery.

The Role of Multifactorial Contribution in Carpal Tunnel Syndrome Occurrence

As one of the common peripheral neuropathies, carpal tunnel syndrome (CTS) is accountable for the majority of typical hand pain and functional disturbance in median nerve innervation. The median nerve compression may cause some uncomfortable sensations including pain, numbness, tingling, and strength loss which also depends on the severity of the condition. Many factors could contribute to CTS occurrence. Several risk factors are thought to be in charge in CTS progressions, such as body mass index (BMI), gender, pregnancy, and biomechanical exposures combination is significantly explained as the major component in suffering CTS. Clinicians need to know the contributing risk factor to benefit the information within the implication for the treatment and reducing symptoms severity. Keywords: carpal tunnel syndrome, risk factor, multifactor.

Clinical and Electrophysiological Profile of Carpal Tunnel Syndrome: A Study in a Tertiary Care Hospital

Introduction: Carpal tunnel syndrome (CTS) is a clinical syndrome that results from compression of median nerve within the carpal tunnel at the wrist. The aim of this study was to review the clinical and demographic characteristics and electrophysiological patterns of CTS patients who presented to a tertiary care hospital in Bangladesh.&#x0D; Methodology; A descriptive cross-sectional study was conducted on 150 CTS patients at the neurology department, Dhaka Medical College Hospital between January, 2019 to March , 2020 . All the subjects had clinical evaluation and standardized nerve conduction studies of upper limbs (300 limbs) using the same protocol.&#x0D; Results: 228 hands were found to have clinical and electrophysiological features consistent with CTS. There was female predominance (90%) and the highest occurrence of CTS was in the 45-55 years age group. Bilateral CTS was found in the majority of cases ie 78 (52%) and the rest had unilateral CTS. Among those with unilateral CTS, right hand was affected more (41, 57%) than left hand (31, 43%). Most of the cases were idiopathic. Neurophysiological studies showed most patients had mild CTS (121 hands, 53%). Most of the cases were idiopathic (102, 68%). Where a risk factor was found diabetes was commonest one (32) followed by hypothyroidism (12) and pregnancy (4).&#x0D; Conclusion: There was marked female predominance and the 45-55 years age group was predominantly affected. Majority of cases had mild CTS. Bilateral involvement was more common. Right hand was more affected than the left hand.&#x0D; J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 96-99