Recurrent carpal tunnel syndrome: Evaluation and treatment of the possible causes

Abstract

AIMTo investigate the causes of the recurrent carpal tunnel syndrome (CTS) and implemented surgical interventions.METHODSFour hundred and eighty-seven patients, who were diagnosed with CTS and underwent surgical intervention between October 2016 and September 2007, were evaluated in this retrospective study. The age, gender, physical evaluation findings, electrophysiological examination reports and implemented surgical treatment methods were analyzed.RESULTSThirty-nine of the cases were operated due to recurrent CTS. Further examination of the patients with recurrent CTS revealed that ten cases had diabetic polyneuropathy, three cases had hypothyroidism, two cases had rheumatoid arthritis and one case had systemic amyloidosis. Postoperative electromyography confirmed the neuropathy was due to systemic diseases. The remaining 23 patients with recurrent CTS did not have any systemic disease and all of them had applied previously to another health center.CONCLUSIONWe concluded that the recurrence rates in CTS might be decreased with exploration and incision of the entire transverse ligament. Damage to the motor and sensory branches of the median nerve could be avoided with an incision on the ulnar side.

A giant hand lipoma as a rare cause of secondary carpal tunnel syndrome - A case report

“…In the majority of the patients the pathogenesis of CTS is unclear (idiopathic) [ 5 ]. In some cases, the compression is associated with systemic factors (diabetes, pregnancy, hypothyroidism) and, generally, conventional surgical decompression of the median nerve is successful.…”

“…Carpal tunnel syndrome (CTS) is one of the most common compression neuropathy [ 4 ] and in approximately 50% of the patients the pathogenesis is unclear (idiopathic) [ 5 ]. When secondary local underlying causes are present, simple section of the transverse carpal ligament may not be sufficient, and further surgical exploration might be warranted [ 6 ].…”

The quality of electrodiagnostic tests for carpal tunnel syndrome: Implications for surgery, outcomes, and expenditures

“…Patients initially thought to have CTS are often later found to have other neurologic and musculoskeletal conditions, whereas many of those with CTS wait months or longer for the diagnosis 4 . In addition to delays, incorrect diagnoses can lead to patients inappropriately undergoing surgery (release of the transverse carpal ligament), creating unnecessary health‐care expenditures and contributing to persistent symptoms after surgery 5–8 . For these reasons, electrodiagnostic tests play a critical role in establishing the diagnosis of CTS, particularly when surgery is under consideration 9 …”

Tratamiento del síndrome del túnel del carpo

“…Se ha demostrado que las inyecciones de corticosteroides tienen reducciones similares en la puntuación del cuestionario del túnel carpiano de Boston (CTCB) en comparación con las férulas (2). Las inyecciones también se asocian con puntajes subjetivos más altos de satisfacción del paciente y cantidades disminuidas de analgésicos administrados que el grupo de férulas (10). Además, al comparar una combinación de los dos tratamientos conservadores contra las inyecciones solas, los individuos asignados al azar al grupo combinado mostraron mejoras aún mayores según lo determinado por el CTCB, así como una función nerviosa mejorada y una reducción de los síntomas.…”