Carpal tunnel syndrome: state-of-the-art review

被引:32
作者
Osiak, K. [1 ]
Elnazir, P. [2 ]
Walocha, J. A. [2 ]
Pasternak, A. [1 ,2 ,3 ]
机构
[1] Prof W Orlowski Mem Hosp, Med Ctr Postgrad Educ, Dept Plast Surg, Warsaw, Poland
[2] Jagiellonian Univ, Dept Anat, Med Coll, Krakow, Poland
[3] Prof W Orlowski Mem Hosp, Med Ctr Postgrad Educ, Dept Plast Surg, Ul Czerniakowska 231, PL-00416 Warsaw, Poland
关键词
carpal tunnel syndrome; entrapment neuropathy; median nerve; open carpal tunnel release; NERVE-CONDUCTION; PRACTICE PARAMETER; RELEASE; SURGERY; COMPLICATIONS; FLAP; DECOMPRESSION; EPINEUROTOMY; METAANALYSIS; ULTRASOUND;
D O I
10.5603/FM.a2021.0121
中图分类号
R602 [外科病理学、解剖学]; R32 [人体形态学];
学科分类号
100101 ;
摘要
Carpal tunnel syndrome is the most common peripheral nerve entrapment encountered worldwide. The aetiology can be related to repetitive exposure to vibrations or forceful angular motions, genetic predisposition, injury and spe-cific conditions, such as diabetes, pregnancy and morbid obesity. This entity is observed with increased frequency in females and the elderly. The diagnosis is largely clinical and suspected when patients present with typical symptoms such as numbness, tingling, nocturnal paraesthesia and/or neuritic "pins-and-needles" pain in the radial 3.5 digits. Certain provocative manoeuvres can be employed to evoke the symptoms of the disease to guide the diagnosis. Further testing such as electrodiagnostic studies, ultrasound or magnetic resonance imaging is required in the case of diagnostic uncertainty or if there is a need for objective evaluation whether or not more invasive surgical intervention is required. If the presenting symptoms are mild and discontinuous, non-surgical measures are indicated. However, if the symptoms are moderate to severe, further testing modalities such as nerve conduction studies or needle electromyography are used to determine whether carpal tunnel syndrome is acute or chronic. If significant evidence of axonal injury is identified, surgical treatment may be indicated. Surgical release of the carpal tunnel has evolved over time to become the most common hand surgery procedure.
引用
收藏
页码:851 / 862
页数:12
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