Stress carpal tunnel pressures in patients with carpal tunnel syndrome and normal patients

Szabo, Robert M.; Chidgey, Larry K.

doi:10.1016/0363-5023(89)90178-0

Cited by 188 publications

(82 citation statements)

References 9 publications

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“…[1,2] Fibrosis of SSCT is a common histopathological finding in idiopathic CTS. [4,5] Although some research has been carried out on increased fibrosis of SSCT in idiopathic CTS, the exact mechanism which induce or facilitate fibrosis has not been established yet.…”

Section: Discussionmentioning

confidence: 99%

“…[1] It has been previously suggested that a discordance between tissue volume and the size of the tunnel might cause this disease. [2] Previous studies have demonstrated neither morphometric nor biomechanical differences between transverse carpal ligaments in idiopathic CTS. [3] Fibrosis, the most common histological finding in idiopathic carpal tunnel syndrome, is observed in subsynovial connective tissue of carpal tunnel (SSCT) which is a meshwork of areolar connective tissue and a vascular network.…”

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confidence: 99%

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Are myofibroblasts activated in idiopathic carpal tunnel syndrome? An immunohistochemical study

Yeşìl¹

2014

Eklem Hastalik Cerrahisi

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Amaç: Bu çalışmada miyofibroblastların idiopatik karpal tünel sendromundaki (KTS) fibrotik süreçte rol oynayıp oynamadığı araştırıldı. Hastalar ve yöntemler: Mart 2010-Ağustos 2010 tarihleri arasında kliniğimizde ameliyat edilen 40 hasta (12 erkek, 28 kadın; ort. yaş 50.85±11.2 yıl; dağılım 30-71 yıl) çalışmaya alındı. Yirmi beş idiopatik KTS hastası çalışma grubuna, 15 travma hastası kontrol grubuna dahil edildi. Katılımcıların hem transvers karpal ligaman hem de subsinovyal bağ dokusundan (SSBD) örnekler alındı ve bunlar immünohistokimyasal yöntem ile analiz edildi. Miyofibroblast varlığını ve damar duvar kalınlığını (alfa düz kas aktin [a-DKA]), kollajen tip IV antikorları, T (CD3) ve B (CD20) lenfositleri incelemek için dört immünohistokimyasal işaretleyici kullanıldı. Bulgular: İdiopatik KTS'nin erken aşamasında olan hastaların SSBD'sinde miyofibroblast varlığı (a-DKA) antikorlarının fibroblastlar ile pozitif reaksiyonu yoluyla gösterildi. Subsinovyal bağ dokusunun vasküler yapısında a-DKA ve kollajen antikor reaksiyonunun anlamlı şekilde artmış olması, çalışma grubunda damar duvar kalınlığı ve vaskülaritenin artmış olduğunu gösterdi (p<0.01). İki grup arasında T ve B lenfosit antikor reaksiyonu açısından anlamlı fark saptanmadı (inflamasyon). Sonuç: Bu çalışmanın bulguları, miyofibroblastların hastalığın erken döneminde aktifleşip hastalığın başlangıcına katkı yapma olasılıkları olduğuna işaret etmektedir. İleride yapılacak daha büyük örneklem sayılı çalışmalar miyofibroblastların idiopatik KTS'deki rolünün anlaşılmasına büyük katkı sağlayacaktır.Anahtar sözcükler: Karpal; fibrozis; idiopatik; miyofibroblast; sendrom.Objectives: This study aims to investigate whether myofibroblasts participate in the fibrotic process of idiopathic carpal tunnel syndrome (CTS). Patients and methods: Forty patients (12 males, 28 females; median age 50.85±11.2 years; range 30 to 71 years) who were operated in our clinic between March 2010 and August 2010 were included in the study. Twenty-five idiopathic CTS patients were assigned to the study group, and 15 trauma patients were assigned to the control group. Samples were taken from both transverse carpal ligament and subsynovial connective tissue (SSCT) of participants and they were analyzed by immunohistochemical method. Four immunohistochemical markers were used to analyze myofibroblast existence and vascular wall thickness (alpha smooth muscle actin [a-SMA]), collagen type IV antibodies, and T (CD3) and B (CD20) lymphocytes. Results: The existence of myofibroblasts (a-SMA) in SSCT of patients who were in early phase of idiopathic CTS was shown through the positive reaction of their antibodies with fibroblasts. A significantly increased reaction of a-SMA and collagen antibodies in vascular structure of SSCT demonstrated increased vascular wall thickness and vascularity in the study group (p<0.01). No significant difference was detected between the two groups in terms of T and B lymphocyte antibody reaction (inflammation). Conclusion: The findings of this study indicate a po...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Are myofibroblasts activated in idiopathic carpal tunnel syndrome? An immunohistochemical study

Yeşìl¹

2014

Eklem Hastalik Cerrahisi

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“…Proliferation of connective tissue in response to repeated stress can increase nerve compression during work, 12,13 and increased pressure may persist after work in patients with CTS. 17 Inflammation in response to the injury produces swelling of the nerve itself that is visible with magnetic resonance imaging, 18,19 compounding the increased pressure within the carpal tunnel. If these mechanisms are correct, then a task requiring moderately forceful pinching with a nonneutral wrist posture may be sufficient to expose the median nerve to damaging forces.…”

Section: Introductionmentioning

confidence: 99%

Towards development of a nonhuman primate model of carpal tunnel syndrome: Performance of a voluntary, repetitive pinching task induces median mononeuropathy in Macaca fascicularis

Sommerich

Lavender

Buford

et al. 2007

Journal Orthopaedic Research

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This study investigated changes in median sensory nerve conduction velocity (SNCV) over several weeks of exposure to a voluntary, moderately forceful, repetitive pinching task performed for food rewards by a small sample of young adult female monkeys (Macaca fascicularis). SNCV, derived from peak latency, decreased significantly in the working hands of three of the four subjects. The overall decline in NCV was 25%-31% from baseline. There was no decrease in SNCV in the contralateral, nonworking hands. Several weeks after being removed from the task, SNCV returned to within 87%-100% of baseline. MRI showed enlargement of the affected nerves near the proximal end of the carpal tunnel, at the time of maximal SNCV slowing. This new animal model demonstrates a temporally unambiguous relationship between exposure to a moderately forceful, repetitive manual task and development of median mononeuropathy at the wrist, and recovery of SNCV following termination of task exposure. This study contributes to the pattern of evidence of a causal relationship between manual work, median mononeuropathy, and carpal tunnel syndrome in humans. In the future, this new animal model could be used to characterize dose-response relationships between risk factors and carpal tunnel syndrome. ß

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“…The intracanal pressure may increase in some patients with median nerve neuropathy. The pressure can go up to 90 mm Hg (12 kPa) in symptomatic patients, especially in repetitive wrist flexion and extension (15,16). We do not have sufficient evidence to attribute the neurophysiological findings of the floor cleaners to a mechanical etiology, despite the frequency of flexion-extension of the wrist in their daily work activities.…”

Section: Discussionmentioning

confidence: 87%

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Pierre-Jerome¹,

Si²,

Si³

et al. 1996

Scand J Work Environ Health

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Stress carpal tunnel pressures in patients with carpal tunnel syndrome and normal patients

Cited by 188 publications

References 9 publications

Are myofibroblasts activated in idiopathic carpal tunnel syndrome? An immunohistochemical study

Are myofibroblasts activated in idiopathic carpal tunnel syndrome? An immunohistochemical study

Towards development of a nonhuman primate model of carpal tunnel syndrome: Performance of a voluntary, repetitive pinching task induces median mononeuropathy in Macaca fascicularis

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