The effect of metabolic syndrome on recurrence in patients who had undergone surgery for carpal tunnel syndrome

Abstract

ÖZ AmaçPatients were examined clinically and demographically for the presence of MS. Patients were also evaluated using a visual analog scale and the Boston Carpal Tunnel Syndrome Questionnaire. Diagnoses of recurrence were established using electromyography in patients with clinical CTS and Tinel and/or Phalen test positivity. The effect of MS on recurrent CTS was examined statistically by independent t-test. Results: At the end of a mean follow-up period of 36.2±19.2 months (range 12 to 60 months), recurrence was identified in 31 (36%) of the 86 hands. Of these 31 hands, MS was present in 23 (74.2%). In the 55 hands (64%) without recurrence, MS was present in 10 (18.2%). According to these differences, the effect of MS on recurrent CTS was statistically significant (p<0.001). Conclusion: Our study indicated that MS affected recurrence in patients who had undergone CTS surgery.

Does median nerve translate pre- and postoperatively in carpal tunnel syndrome?

“…It is caused by increased pressure or pressure-induced injury on the median nerve in its course through the carpal tunnel. [1] It is clear that the size and shape of the median nerve are highly affected by the increased pressure and several morphological changes have been shown in previous studies. [2] Moreover, release of the transverse carpal ligament (TCL) can improve the clinical condition of patients with CTS and reduce the pressure in the carpal tunnel.…”

“…Therefore, CTR is one of the most common procedures performed on the hand. [1,2] Magnetic resonance imaging is a sensitive method to diagnose CTS; and traditionally, signal changes were used for diagnosis of CTS. [3,4] Since the appearance of the first MRI reports of the median nerve in the carpal tunnel in the early 1990s, MRI has been recently shown to be of potential value in the diagnosis of CTS through achieved high-resolution imaging by using small surface coils and a limited field of view.…”

“…Several studies have used magnetic resonance imaging (MRI) for the assessment of CTS and have described characteristic MRI findings in CTS patients. [1][2][3] These findings include lesions with high signal intensity on T 2 -weighted images, swelling of the nerve in the proximal and distal carpal tunnel and flattening of the median nerve within the carpal tunnel. However, to the best of our knowledge, the relative position of the median nerve has not been studied in the literature, nor the effect of carpal tunnel release (CTR) on its location within the carpal tunnel.…”

Cirugía de rescate en el síndrome del túnel del carpo: nuestra experiencia utilizando el colgajo vascularizado de grasa hipotenar

“…7 En diversos estudios encontramos asociados ciertos factores de riesgo a una mayor tasa de recurrencia del STC tras la neurolisis primaria. La hipertensión arterial, la diabetes mellitus y el síndrome metabólico 1,2 ; una hemostasia pobre en el lecho quirúrgico, la inmovilización prolongada o una terapia física muy intensa tras la cirugía, se han asociado a una mayor formación de fibrosis perineural. 5 Podemos plantear la indicación de una cirugía de rescate en esos casos, cuando existan unos síntomas incapacitantes que no respondan al tratamiento médico.…”