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Study of Carpal tunnel syndrome (수근관 증후군(Carpal tunnel syndrome)에 관한 고찰 - 동의보감(東醫寶鑑)을 중심으로 -)

  • Kim, Yong-Kul;Oh, Min-Seok
    • Journal of Haehwa Medicine
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    • v.17 no.1
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    • pp.129-136
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    • 2008
  • This study was performed to investigate the cause, symptom, treatment of carpal tunnel syndrome through Western medicine and Dong-Eui-Bo-Kham(東醫寶鑑). Results & conclusions 1. Carpal tunnel syndrome is a common peripheral nerve entrapment syndrome that is characterixed by pain, numbness, sensory disturbance along the dsitribution of the meridian nerve in hand 2. Treatment of carpal tunnel syndrome have included wrist immobilization, anti-inflammatory drug, local injection of steroid, nerve block and surgical decompression. 3. Carpal tunnel syndrome seems to be similar with numbness(痺證). The causes were usually pathogenic Wind, Cold, Dampness. 4.Acupuncture, herbal medicine, herbal acupuncture were used for treatment of carpal tunnel syndrome. We considered that more study to find various and effective methods oriental medicine for carpal tunnel syndrome should be made.

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Anomalous Muscles of the Wrist Encountered During Endoscopic Carpal Tunnel Surgery

  • Park, Se-Hyuck
    • Journal of Korean Neurosurgical Society
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    • v.62 no.1
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    • pp.90-95
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    • 2019
  • Objective : Anomalous muscles of the wrist are infrequently encountered during carpal tunnel surgery. Anatomic variants of the palmaris longus (PL), flexor digitorum superficialis, lumbricalis and abductor digiti minimi (ADM) have been reported but are usually clinically insignificant. Anomalies of the wrist muscles, encountered during endoscopic carpal tunnel surgery have rarely been described. I conducted this study to evaluate muscular anomalies of the volar aspect of the wrist, encountered during endoscopic carpal tunnel surgery. Methods : I studied a consecutive series of 1235 hands in 809 patients with carpal tunnel syndrome who underwent single-portal endoscopic carpal tunnel release (ECTR) from 2002 to 2014. Nine hundred seventy-three hands in 644 patients who had minimal 6-month postoperative follow-up were included in the study. The postoperative surgical outcome was assessed at least 6 months after surgery. Results : In eight patients, anomalous muscles were found under the antebrachial fascia at the proximal wrist crease and superficial to the ulnar bursa, passing superficial to the transverse carpal ligament. Those anomalous muscles were presumed to be variants of the PL or accessory ADM muscle, necessitating splitting and retraction to enter the carpal tunnel during the ECTR procedure. Other muscle anomalies were not seen within the carpal tunnel on the endoscopic view. The surgical outcome for all eight wrists was successful at the 6-month postoperative follow-up. Conclusion : Carpal tunnel surgeons, especially those using an endoscope should be familiar with unusual findings of anomalous muscles of the wrist because early recognition of those muscles can contribute to avoiding unnecessary surgical exploration and unsuccessful surgical outcomes.

Recurrent carpal tunnel syndrome associated with extension of flexor digitorum muscle bellies into the carpal tunnel: A case series

  • Castillo, Rochelle;Sheth, Khushboo;Babigian, Alan;Scola, Christopher
    • Archives of Plastic Surgery
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    • v.45 no.5
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    • pp.474-478
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    • 2018
  • While the success or failure of carpal tunnel release ultimately depends on the interplay of a wide array of factors, a broad understanding of the normal anatomy of the carpal tunnel accompanied by awareness of the possible variations of the individual structures that make up its contents is crucial to optimizing surgical outcomes. While anatomic variants such as extension of the flexor digitorum muscle bellies have been described as a cause of primary carpal tunnel syndrome (CTS), there have been no reports depicting its association with recurrent CTS following initially successful carpal tunnel release, a finding with potentially significant prognostic implications that can aid in operative planning. In such cases where muscle extension is identified preoperatively, careful debulking of the muscle belly may be beneficial in improving long-term surgical outcomes.

Does Aging Matter? The Efficacy of Carpal Tunnel Release in the Elderly

  • Fung, Bettina Wai Yan;Tang, Chris Yuk Kwan;Fung, Boris Kwok Keung
    • Archives of Plastic Surgery
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    • v.42 no.3
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    • pp.278-281
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    • 2015
  • Open release remains the gold standard in the treatment of carpal tunnel syndrome in cases where conservative treatment fails. However, the efficacy of carpal tunnel release in the elderly has been debated in the literature throughout the years. This review aims to review the current evidence pertaining to the efficacy of carpal tunnel release in the elderly. Based on the current evidence, the outcome of carpal tunnel release is unpredictable in the elderly. Elderly patients are also less satisfied with the operation compared to younger patients. The authors recommend that these messages be conveyed to elderly patients before surgery. Moreover, open carpal tunnel release should be offered in the early stages of treatment whenever operative management is indicated.

Carpal Tunnel Syndrome by Ganglion: A Case Report (수근관에 발생한 결절종으로 인한 수근관 증후군의 치험1례)

  • Jang, Seo-Yoon;Ahn, Duck-Sun
    • Archives of Plastic Surgery
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    • v.38 no.1
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    • pp.117-120
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    • 2011
  • Purpose: Carpal tunnel syndrome is the most common peripheral compressive neuropathy. Most cases are idiopathic, but rarely carpal tunnel syndrome can be associated with a ganglionic mass. We report our recently encountered experience of surgical treatment of carpal tunnel syndrome caused by a simple ganglionic mass. Methods: A 53-year-old man presented with chief complaints of numbness and hypoesthesia of his left palm, thumb, index finger, long finger, and ring finger of one and half month duration. Physical examination revealed positive Tinnel's sign without previous trauma, infection or any other events. Electromyography showed entrapment neuropathy of the median nerve. Magnetic resonance imaging (MRI) showed an approximately 2.0 cm-sized mass below the transverse carpal ligament. Upon surgical excision, a $1{\times}1.5cm^2$ mass attached to the perineurium of the median nerve and synovial sheath of the flexor digitorum superficialis and redness and hypertrophy of the median nerve were discovered. With surgical intervention, we completely removed the ganglionic mass and performed surgical release of the transverse carpal ligament. Results: The pathology report confirmed the mass to be a ganglion. The patient exhibited post-operative improvement of his symptoms and did not show any complications. Conclusion: We present a review of our experience with this rare case of carpal tunnel syndrome caused by a ganglionic mass and give a detailed follow-up on the patient treated by surgical exploration with carpal tunnel release.

Six Cases of Carpal Tunnel Syndrome with Taping Therapy for Carpal Tunnel Expansion (수근관 공간확장테이핑치료를 실시한 수근관증후군 환자 6례 보고)

  • Heo, Su-Young
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.7 no.1
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    • pp.67-74
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    • 2012
  • Objectives : The purpose of this study is to evaluate the korean medical treatment for carpal tunnel syndrome, especially taping therapy for carpal space expansion. Methods : Six patients were treated with acupuncture, moxibustion and kinesio taping therapy. To evaluate the pain and numbness of the palm and finger, visual analogue scale(VAS) and Phalen's test were used. Results : After about 10 to 20 times treatment, the pain and numbness of almost cases were remarkably removed. Also the VAS of post-treatment was reduced by 1.33(means). And the time being required to response to Phalen's test was signally prolonged, as 5 cases took over one minute. Conclusions : Korean medical treatment including expansion taping of carpal space as kinesio correction therapy is remarkably effective for carpal tunnel syndrome. But further studies are required to concretely prove the effectiveness of correction taping on other compressive neuropathy.

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The Influence of Corticosteroid Injections on Postoperative Outcomes of Carpal Tunnel Release: A Systematic Review

  • Ali Kumas;Milly van de Warenburg;Tinatin Natroshvili;Marius Kemler;Mahyar Foumani
    • Archives of Plastic Surgery
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    • v.50 no.4
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    • pp.398-408
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    • 2023
  • Background Carpal tunnel syndrome can be treated with corticosteroid injections (CIs) and surgery. In this systematic review, the influence of previous CI on different postoperative outcomes after carpal tunnel release is evaluated. Methods A systematic literature search using several databases was performed to include studies that examined patients diagnosed with carpal tunnel syndrome who received preoperative or intraoperative CIs. Results Of 2,459 articles, 9 were eligible for inclusion. Four papers reported outcomes of preoperative and four outcomes of intraoperative CIs. One study evaluated patients who received both intraoperative and preoperative corticosteroids. Conclusion Intraoperative CIs are associated with reduced postoperative pain after carpal tunnel release and support earlier recovery of the hand function that can be objectified in a faster median nerve conduction speed recovery and lower Boston Carpal Tunnel Questionnaire (BCTQ) scores. Using preoperative CIs did not lead to enhanced recovery after carpal tunnel release, and both preoperative and intraoperative CIs might be predisposing factors for infections.

Effect of Trigger Finger on Pain, Grip Strength and Function of Upper Limb of Patients with Carpal Tunnel Syndrome: A Cross-sectional Study (방아쇠수지가 손목터널증후군 환자의 악력, 통증 및 상지기능에 미치는 영향: 단면적 연구)

  • Kim, Myoung-Kwon;Yun, Da-Eun
    • Journal of the Korean Society of Physical Medicine
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    • v.16 no.1
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    • pp.63-71
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    • 2021
  • PURPOSE: The purpose of this study was to investigate the effects of trigger finger on pain, muscle strength and function in carpal tunnel syndrome (CTS) patients. METHODS: A total of 60 subjects (30 carpal tunnel syndrome with trigger finger and 30 carpal tunnel syndrome without trigger finger) were assessment for pain, muscle strength (power grip, key pinch , tip to tip pinch, three jaw pinch) and function. The effect sizes of the two groups were compared, and the correlation between the trigger finger and each variable was analyzed. RESULTS: The results showed that there were significantly difference in the pain, muscle strength excluding three jaw pinch and function (p < .05). The results also showed correlation between trigger finger and pain (r = .552), muscle strength excluding three jaw pinch (power grip r = -.296, key pinch r = -.260, tip to tip pinch r = -.285), and function (r = .375). The function of carpal tunnel syndrome patients was related to pain (r = .550) and power grips (r = -.324) of muscle strength. CONCLUSION: In carpal tunnel syndrome patients with trigger finger compared to carpal tunnel syndrome, muscle weakness, pain increase, and function reduction were shown. In addition, trigger finger are correlated with muscle strength, pain and function, and muscle weakness and increased pain affect the daily living of carpal tunnel syndrome patients with triggers finger. Therefore, physical therapy interventions of carpal tunnel syndrome patients with trigger finger should be combined with treatment for muscle strength enhancement as well as pain reduction.

Korean Medicine for Carpal Tunnel Syndrome: a Systematic Review of Literature Published in Korea (수근관 증후군의 한의학적 치료에 대한 논문 고찰 -국내 학술지를 중심으로-)

  • Lee, Jong Ho
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.29 no.1
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    • pp.79-84
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    • 2015
  • The aim of this review is to investigate studies of Korean medical treatment of carpal tunnel syndrome published in Korea and the evidence of it's effects in order to suggest a better research method in the future. Four Korean web databases were searched by using key words such as 'carpal', and checked relevant Korean journals. The papers were classified into the field of study, publish date, diagnostic methods, evaluation methods and analysed the study tendency. There are 9 case studies, 4 controlled studies. The paper was published almost every year more than once. Acupucture, pharmacopuncture, acupotomy, warm needle acupuncture, taping, etc. were used as treatment tools. The two most commonly used diagnostic method for carpal tunnel syndrome are Phalen's test and Tinel's sign. The two most commonly used evaluation method are VAS(Visual Analog Scale) and subjective symptoms. Korean medical treatment of carpal tunnel syndrome was effective in all studies. Korean medical treatment of carpal tunnel syndrome was effective in all studies. So it is possible that Korean medical treatment of carpal tunnel syndrome is useful as therapeutic medicine, but there are not sufficient evidence based papers, so there should be further studies.

Follow Up Study of Carpal Tunnel Syndrome Patients Underwent Partial Release of Transverse Carpal Ligament Using Inching Test (인칭검사를 이용하여 부분 절개를 시행한 수근관 증후군 환자의 추적관찰)

  • Yoon, Eul Sik;Gu, Ja Hea;Kim, Dong Hwee;Kang, Yoon Kyu;Hwang, Mi Riang;Dong, Eun Sang
    • Archives of Plastic Surgery
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    • v.34 no.6
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    • pp.771-776
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    • 2007
  • Purpose: Complete release of the transverse carpal ligament (TCL) is accepted as the standard treatment for carpal tunnel syndrome (CTS). However, loss of grip and pinch power are reported in some patients after complete release of the TCL. This study was designed to evaluate the effectiveness of complete versus partial carpal tunnel release by using the inching technique. Methods: Nineteen patients (a total of 27 hands) who each had a confirmed diagnosis of CTS were selected from September 2002 to February 2003. The cases were divided into three groups(mild, moderate and severe) based on preoperative electrodiagnostic studies. The patients with partial carpal tunnel syndrome were classified into the mild or moderate groups, while patients with complete carpal tunnel syndrome were classified into the moderate or severe groups. Patient oriented data (functional and symptomatic) were collected and electrophysiologic studies were undertaken preoperatively and postoperatively(on the 2nd week, 1st month, 3rd month and 6th month after surgery).Results: In this study, the mild and moderate groups showed both good functional and symptomatic results and improvements in electrophysiologic studies.Conclusion: Carpal tunnel syndrome patients classified into mild or moderate groups based on nerve conduction studies, and whose precise compression sites were pinpointed using the inching technique, can be treated by partial carpal tunnel release.