Peripheral Nerve Entrapment and their Surgical Treatment

Abstract

Nerves pass from one body area to another through channels made of connective tissue and/or bone. In these narrow passages, they can get trapped due to anatomic abnormalities, ganglion cysts, muscle or connective tissue hypertrophy, tumours, trauma or iatrogenic mishaps. Nearly all nerves can be affected. The clinical presentation is pain, paraesthesia, sensory and motor power loss. The specific clinical features will depend on the affected nerve and on the chronicity, severity, speed and mechanism of compression.Its incidence is higher under some occupations and is some systemic conditions: diabetes mellitus, hypothyroidism, acromegaly, alcoholism, oedema and inflammatory diseases. The diagnosis is suspected with the clinical presentation and provocative clinical test, being confirmed with electrodiagnostic and/or ultrasonographic studies. Magnetic Resonance Studies (MRI) rule out ganglion cysts or tumours. Conservative medical treatment is often sufficient. In refractory ones, surgical decompression should be performed before nerve damage and muscle atrophy are irreversible. The 'double crash' syndrome happens when a peripheral nerve is compressed at more than one point along its trajectory. In cases with marked muscle atrophy, a 'supercharge end-to-side' nerve transfer can be added to the decompression. After decompression in those few cases with refractory pain, a nerve neurostimulator can be applied.

Ergonomic Risk Assessment for Musculoskeletal Disorders among Ultrasonologists of Peshawar: A Cross- Sectional Survey

“…Huma Zia, Muheebur Rehman, Sitara Hayat Khan, Saba Aman, Shumaila Tahreem Most of the literature discloses that, at large, radiologists are scanning more than 10 patients daily and there is a positive association between ergonomic risk and the number of patients seen per day (Vanaclocha et al, 2017), but in our study applying the crosstabulation, there is no statistically significant association between these two variables.…”