Carpal Tunnel Syndrome Research Today is a free monthly online journal that collates and summarizes the latest research about Carpal Tunnel Syndrome, including details on symptoms, causes, trauma, diagnosis, physiotherapy.

Muscle fibres crossing the line of incision used in carpal tunnel decompression.

Hollevoet N, Barbaix E, D'herde K, Vanhove W, Verdonk R

Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, Belgium, and the Department of Basic Medical Sciences, Anatomy and Embryology Group, Ghent University, Belgium.

Muscle fibres that cross the proposed line of incision of the flexor retinaculum at carpal tunnel decompression can be a source of confusion, particularly for the less experienced surgeon. We investigated how frequently muscle fibres crossed the line of incision on the palmar surface of the flexor retinaculum at carpal tunnel decompression in 143 hands, and dissected 103 cadaver hands to study the origin and insertion of these muscle fibres. The line of incision was defined as a longitudinal line between thenar and hypothenar eminences along the third web space, with the wrist in neutral radioulnar deviation and the fingers in extension. Muscle fibres crossing the line of incision were absent in 50% of the operated hands, 2-10 mm wide in 39% and more than 10 mm wide in 11%. In the cadaver hands the proportions were similar at 50%, 35% and 15%, respectively. The fibres were extensions of the thenar and hypothenar muscles and did not appear to represent a separate anomalous muscle.

Published 1 February 2010 in J Hand Surg Eur Vol, 35(2): 115-9.
Full-text of this article is available online (may require subscription).

Articles on Carpal Tunnel Syndrome published 1 February 2010:

Central sensitization in carpal tunnel syndrome with extraterritorial spread of sensory symptoms.   Pain, 148(2): 227-36.

Extraterritorial spread of sensory symptoms is frequent in carpal tunnel syndrome (CTS). Animal models suggest that this phenomenon may depend on central sensitization. We sought to obtain psychophysical evidence of sensitization in CTS with extraterritorial symptoms spread. We recruited 100 unilateral CTS patients. After selection to rule out concomitant upper-limb causes of pain, 48 patients were included. The hand symptoms distribution was graded with a diagram into median and extramedian ... [Abstract] [Full-text]

Validity and responsiveness of the Jebsen-Taylor Hand Function Test.   J Hand Surg Am, 35(1): 30-7.

PURPOSE: The aim of this study was to demonstrate the validity and responsiveness of the Jebsen-Taylor Hand Function Test (JTT) in measuring hand function in patients undergoing hand surgery, compared with the Michigan Hand Outcomes Questionnaire (MHQ). METHODS: A prospective cohort of patients with rheumatoid arthritis (n = 37), osteoarthritis (n= 10), carpal tunnel syndrome (n = 18), and distal radius fracture (n = 46) were evaluated preoperatively and at 9 to 12 months of follow-up. We ... [Abstract] [Full-text]

Endoscopic versus open carpal tunnel release.   Arthroscopy, 26(1): 26-33.

PURPOSE: This study compared endoscopic carpal tunnel release with the conventional open technique with respect to short- and long-term improvements in functional and clinical outcomes. METHODS: We assessed 72 outpatients diagnosed with carpal tunnel syndrome. Of these patients, 37 underwent the endoscopic method according to Chow and 35 were assigned to the open method. Improvement in symptoms, severity, and functionality were evaluated at 2 days, 1 week, 2 weeks, and 1 year postoperatively. ... [Abstract] [Full-text]

Carpal tunnel syndrome.   J Hand Surg Am, 35(1): 147-52.

Carpal tunnel syndrome (CTS) is the most common compressive neuropathy in the upper extremity. The condition is responsible for substantial annual costs to society, both in terms of lost productivity and the costs of treatment. Accurate diagnostic criteria, the selection of treatment strategies based on high-level evidence, and outcomes data have been inconsistent despite the prevalence of the condition. The increased awareness of the need for evidence-based practice guidelines has, however, ... [Abstract] [Full-text]

Articles on Carpal Tunnel Syndrome published 28 January 2010:

Intraneural blood flow analysis during an intraoperative Phalen's test in carpal tunnel syndrome.   J Orthop Res.

Phalen's test has been one of the most significant of clinical signs when making a clinical diagnosis of idiopathic carpal tunnel syndrome (CTS). However, it is unknown whether intraneural blood flow changes during Phalen's test in patients with CTS. In this study, an intraoperative Phalen's test was conducted in patients with CTS to observe the changes in intraneural blood flow using a laser Doppler flow meter. During Phalen's test, intraneural blood flow showed a sharp decrease, which lasted ... [Abstract] [Full-text]

Articles on Carpal Tunnel Syndrome published 26 January 2010:

Analysis of NHSLA claims in hand and wrist surgery.   J Hand Surg Eur Vol, 35(1): 61-4.

Claims for negligence are increasing in medical practice. We analysed data provided by the UK NHS Litigation Authority (NHSLA) on all hand and wrist surgery from 1995-2001. The numbers of claims increased from 13 to 40, but the number being successfully defended also increased from 2 to 13 during this period. Claims were most commonly attributed to errors at surgery (56%) or in outpatient clinics (24%). Strikingly the claims are clustered to a few common conditions, particularly the treatment ... [Abstract] [Full-text]

Articles on Carpal Tunnel Syndrome published 22 January 2010:

A review of nerve conduction studies in cases of suspected compression neuropathies of the upper limb.   Eur Neurol, 63(1): 11-6.

INTRODUCTION: Entrapment neuropathies, particularly those affecting upper limbs, are common reasons for referral for nerve conduction studies (NCS). However, concordance between clinical findings and NCS findings, especially in patients being considered for intervention including decompressive surgery, has not been assessed. METHODS: We conducted a retrospective study using records from a tertiary referral centre's neurophysiology database. We aimed to establish the proportions of agreement ... [Abstract] [Full-text]

Carpal tunnel syndrome: associations between risk factors and laterality.   Eur Neurol, 63(1): 43-7.

AIMS: The investigation of the association between known risk factors and laterality in patients with carpal tunnel syndrome (CTS). Patients and METHODS: 130 consecutive subjects with CTS only, or mainly, in the left hand were compared with 130 consecutive subjects with CTS only, or mainly, in the right hand. The following parameters were recorded: age, sex, job, handedness, hand mainly used in daily activities, BMI, diabetes mellitus, thyroid dysfunction, wrist trauma and connective tissue ... [Abstract] [Full-text]

© 2005-2010 Carpal Tunnel Syndrome Research Today. All Rights Reserved.