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Recent Research of Carpal Tunnel Syndrome
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Recent Research of Carpal Tunnel Syndrome

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (31 May 2022) | Viewed by 53114

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editor

Dr. Jorma Ryhänen

E-Mail Website
Guest Editor
Head of Hand Surgery, Adj. Professor of Hand Surgery, Department of Musculoskeletal and Plastic Surgery, Helsinki University Hospital, Helsinki, Finland
Interests: entrapment neuropathies; nerve surgery; hand surgery

Special Issue Information

Dear Colleagues,

Carpal tunnel syndrome (CTS) is a very common compression neuropathy in the general population. In addition to unpleasant symptoms, the disease significantly causes sick leave, incapacity for work, and doctor visits. Conservative treatment helps with mild and transient symptoms, but often this syndrome requires surgical treatment. Surgical decompression of the median nerve is one of the most common surgical operations. If the symptom persists for a long time and treatment is delayed, this can result in a lack of sensation in the median area in addition to thenar atrophy and weakness of the thumb opposition. This can lead to disability, and for example, older people have difficulty coping alone at home. Research into carpal tunnel syndrome is active, and we are gaining a better understanding of the etiology and implications of this interesting disease. There are many impressive things behind CTS that we do not know yet; anatomical causes, links to other diseases and medication, occupational exposures and predisposing lifestyle risk factors. Is genetics providing any new information about the underlying factors and pathology of carpal tunnel syndrome? Diagnostics and differential diagnostics of CTS have their own challenges, and new methods such as ultrasound and handheld devices can challenge traditional electrodiagnostic methods. Conservative treatment practices of CTS are diverse and unambiguous best practice is not clear. Clinical symptoms, electromyography (EMG) finding, and possible differential diagnostic challenges should be considered when deciding on surgery. Surgical treatment varies somewhat from hospital to hospital and from country to country. In some hospitals, surgical decompression of median nerve is a short mini-invasive endoscopic wide-awake procedure, while in others, surgery is still an open procedure under general anesthesia or axillary block. When the CTS diagnosis and treatment is done too late for nerves to recover or there is perioperative complication, some late reconstructive surgeries might be needed. These nerve surgery techniques can be done by experienced hand surgeons. The quality of care, complications, and cost effectiveness of different methods require further research. This Special Issue will present the latest research on this interesting and clinically significant syndrome from the best researchers in the field. The focus is to present a broad range of high-quality articles in carpal tunnel syndrome research.

Dr. Jorma Ryhänen
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • carpal tunnel syndrome
  • entrapment neuropathy
  • carpal tunnel syndrome* / epidemiology
  • carpal tunnel syndrome* / diagnosis
  • carpal tunnel syndrome* / therapy
  • carpal tunnel syndrome* / surgery
  • carpal tunnel syndrome* / risk factors

Published Papers (15 papers)

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Editorial

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3 pages, 182 KiB  
Editorial
Recent Research Provides Significant New Information about Predisposing Factors, Diagnostic Practices, and Treatment of Carpal Tunnel Syndrome
by Jorma Ryhänen
J. Clin. Med. 2022, 11(18), 5382; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11185382 - 14 Sep 2022
Viewed by 1166
Abstract
This current Special Issue of JCM will highlight some of the latest studies on carpal tunnel syndrome (CTS) [...] Full article
(This article belongs to the Special Issue Recent Research of Carpal Tunnel Syndrome)

Research

Jump to: Editorial, Review, Other

10 pages, 2287 KiB  
Article
Trends in Open vs. Endoscopic Carpal Tunnel Release: A Comprehensive Survey in Japan
by Michiro Yamamoto, James Curley and Hitoshi Hirata
J. Clin. Med. 2022, 11(17), 4966; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11174966 - 24 Aug 2022
Cited by 5 | Viewed by 1627 | Correction
Abstract
We analyzed trends in open and endoscopic carpal tunnel release (CTR) from 2014 to 2019 using the National Database of Health Insurance Claims and Specific Health Checkups in Japan (NDB). Japan has a universal health insurance system and more than 95% of all [...] Read more.
We analyzed trends in open and endoscopic carpal tunnel release (CTR) from 2014 to 2019 using the National Database of Health Insurance Claims and Specific Health Checkups in Japan (NDB). Japan has a universal health insurance system and more than 95% of all claims are searchable in the NDB open data repository. The results revealed that nearly 40,000 CTRs were performed annually in Japan, and open CTR was performed almost 4 times more often than endoscopic CTR. The crude annual incidence of CTR in the general population among people 20 years of age or older was 32.2 per 100,000. The incidence of open CTR peaked in the 80–84 age range for both males and females. The incidence of endoscopic CTR peaked at 80–84 years in females and at 75–79 years in males. There was a mild correlation coefficient between the endoscopic CTRs and the number of hand surgery specialists by prefecture per population (r = 0.32, p = 0.04). However, the number of hand surgeons per capita by region and open CTR per capita was not correlated (r = 0.06, p = 0.67). There were about twice as many outpatient as inpatient surgeries, reflecting a trend toward ambulatory treatment. Full article
(This article belongs to the Special Issue Recent Research of Carpal Tunnel Syndrome)
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12 pages, 833 KiB  
Article
Carpal Tunnel Syndrome and Ulnar Nerve Entrapment Are Associated with Impaired Psychological Health in Adults as Appraised by Their Increased Use of Psychotropic Medication
by Lars B. Dahlin, Raquel Perez, Erika Nyman, Malin Zimmerman and Juan Merlo
J. Clin. Med. 2022, 11(13), 3871; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11133871 - 04 Jul 2022
Cited by 7 | Viewed by 1464
Abstract
We aimed to study psychological health, as approximated by the use of psychotropic drugs, in a population diagnosed and surgically treated for carpal tunnel syndrome (CTS) or ulnar nerve entrapment (UNE), or both, also considering the demographic and socioeconomic factors of the individuals. [...] Read more.
We aimed to study psychological health, as approximated by the use of psychotropic drugs, in a population diagnosed and surgically treated for carpal tunnel syndrome (CTS) or ulnar nerve entrapment (UNE), or both, also considering the demographic and socioeconomic factors of the individuals. Linking data from five large national registers, use of psychotropics (at least one dispensation during the first year after the surgery or the baseline date) was examined in around 5.8 million people 25–80 years old residing in Sweden 2010. Among these individuals, 9728 (0.17%), 890 (0.02%) and 149 (0.00%) were identified as diagnosed and surgically treated for CTS, UNE, or both, respectively. As much as 28%, 34% and 36% in each group, respectively, used psychotropic drugs, compared with 19% in the general population. Regression analyses showed a general higher risk for use of psychotropics related to these nerve compression disorders, to higher age, being a woman, and having low income or low occupational qualification level. Individuals born outside of Sweden had a lower risk. We conclude that surgically treated individuals with a nerve compression disorder have an increased risk of impaired psychological health. Caregivers should be aware of the risk and provide necessary attention. Full article
(This article belongs to the Special Issue Recent Research of Carpal Tunnel Syndrome)
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13 pages, 2075 KiB  
Article
Electrodiagnostic Testing and Nerve Ultrasound of the Carpal Tunnel in Patients with Type 2 Diabetes
by Bianka Heiling, Leonie I. E. E. Wiedfeld, Nicolle Müller, Niklas J. Kobler, Alexander Grimm, Christof Kloos and Hubertus Axer
J. Clin. Med. 2022, 11(12), 3374; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11123374 - 13 Jun 2022
Cited by 6 | Viewed by 2560
Abstract
In diabetic patients, controversies still exist about the validity of electrodiagnostic and nerve ultrasound diagnosis for carpal tunnel syndrome (CTS). We analyzed 69 patients with type 2 diabetes. Nerve conduction studies and peripheral nerve ultrasound of the median nerve over the carpal tunnel [...] Read more.
In diabetic patients, controversies still exist about the validity of electrodiagnostic and nerve ultrasound diagnosis for carpal tunnel syndrome (CTS). We analyzed 69 patients with type 2 diabetes. Nerve conduction studies and peripheral nerve ultrasound of the median nerve over the carpal tunnel were performed. CTS symptoms were assessed using the Boston Carpal Tunnel Questionnaire. Polyneuropathy was assessed using the Neuropathy Symptom Score and the Neuropathy Disability Score. Although 19 patients reported predominantly mild CTS symptoms, 37 patients met the electrophysiological diagnosis criteria for CTS, and six patients were classified as severe or extremely severe. The sonographic cross-sectional area (CSA) of the median nerve at the wrist was larger than 12 mm2 in 45 patients (65.2%), and the wrist-to-forearm-ratio was larger than 1.4 in 61 patients (88.4%). Receiver operating characteristic analysis showed that neither the distal motor latency, the median nerve CSA, nor the wrist-to-forearm-ratio could distinguish between patients with and without CTS symptoms. Diagnosis of CTS in diabetic patients should primarily be based upon typical clinical symptoms and signs. Results of electrodiagnostic testing and nerve ultrasound have to be interpreted with caution and additional factors have to be considered especially polyneuropathy, but also body mass index and hyperglycemia. Full article
(This article belongs to the Special Issue Recent Research of Carpal Tunnel Syndrome)
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11 pages, 1644 KiB  
Article
Correlation between Electrodiagnostic Study and Imaging Features in Patients with Suspected Carpal Tunnel Syndrome
by Jae Min Song, Jungyun Kim, Dong-Jin Chae, Jong Bum Park, Yung Jin Lee, Cheol Mog Hwang, Jieun Shin and Mi Jin Hong
J. Clin. Med. 2022, 11(10), 2808; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11102808 - 16 May 2022
Cited by 3 | Viewed by 1348
Abstract
Electrodiagnostic studies (EDXs) are the confirmative diagnostic tool for carpal tunnel syndrome (CTS). Previous studies have evaluated the relationship between EDXs and ultrasonography (US) but not with X-rays. Recently, many studies on the diagnostic value of X-rays in various diseases have been reported, [...] Read more.
Electrodiagnostic studies (EDXs) are the confirmative diagnostic tool for carpal tunnel syndrome (CTS). Previous studies have evaluated the relationship between EDXs and ultrasonography (US) but not with X-rays. Recently, many studies on the diagnostic value of X-rays in various diseases have been reported, but data on CTS are lacking. We evaluated the relationship between electrodiagnostic parameters and roentgenographic and ultrasonographic features in CTS and investigated the usefulness of X-rays and US for CTS. This retrospective study included 97 wrists of 62 patients. All patients with suspected CTS underwent EDXs, wrist US, and wrist X-rays. The CTS patients were classified into mild, moderate, and severe groups. The roentgenographic features included the ulnar variance (UV) and the anteroposterior diameter of the wrist (APDW), and the ultrasonographic features included the flattening ratio (FR) and the thickest anteroposterior diameter of the median nerve (TAPDM). Most EDX parameters showed significant correlations with roentgenographic and US features. The electrodiagnostic severity was also correlated with all imaging features. Therefore, both wrist X-rays and wrist US can be useful for the diagnosis of CTS as supplements to EDXs. Full article
(This article belongs to the Special Issue Recent Research of Carpal Tunnel Syndrome)
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10 pages, 1745 KiB  
Article
Evaluation of the Existing Electrophysiological Severity Classifications in Carpal Tunnel Syndrome
by Toru Sasaki, Takafumi Koyama, Tomoyuki Kuroiwa, Akimoto Nimura, Atsushi Okawa, Yoshiaki Wakabayashi and Koji Fujita
J. Clin. Med. 2022, 11(6), 1685; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11061685 - 18 Mar 2022
Cited by 7 | Viewed by 2453
Abstract
Electrophysiological examination is important for the diagnosis and evaluation of nerve function in carpal tunnel syndrome (CTS). Electrophysiological severity classifications of CTS using a nerve conduction study (NCS) have been reported, and there are many reports on the relationship between severity classifications and [...] Read more.
Electrophysiological examination is important for the diagnosis and evaluation of nerve function in carpal tunnel syndrome (CTS). Electrophysiological severity classifications of CTS using a nerve conduction study (NCS) have been reported, and there are many reports on the relationship between severity classifications and clinical symptoms. The existing electrophysiological severity classifications have several problems, such as cases that do not fit into a classification and unclear reasons for the boundary value. The purpose of this study was to clarify the relationship between sensory nerve conduction velocity (SCV) and distal motor latency (DML) and to evaluate whether the existing severity classification method is appropriate. We created a scatter diagram between SCV and DML for our NCSs and found a negative correlation between SCV and DML (correlation coefficient, −0.786). When we applied our NCSs to the existing classifications (Padua and Bland classifications), there were many unclassifiable cases (15.2%; Padua classification), and the number of Grade 3 cases was significantly higher than that of Grade 2 or 4 cases (Bland classification). Our large dataset revealed a strong negative correlation between SCV and DML, indicating that the existing severity classifications do not always accurately reflect the severity of the disease. Full article
(This article belongs to the Special Issue Recent Research of Carpal Tunnel Syndrome)
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9 pages, 374 KiB  
Article
Weight-Related and Personal Risk Factors of Carpal Tunnel Syndrome in the Northern Finland Birth Cohort 1966
by Kaisa Lampainen, Rahman Shiri, Juha Auvinen, Jaro Karppinen, Jorma Ryhänen and Sina Hulkkonen
J. Clin. Med. 2022, 11(6), 1510; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11061510 - 10 Mar 2022
Cited by 11 | Viewed by 1953
Abstract
Background: Excess body mass is a risk factor for carpal tunnel syndrome (CTS), but the mechanisms of this are unclear. This study aimed to evaluate the association between CTS and personal risk factors of body mass index (BMI), waist circumference and waist-to-hip ratio [...] Read more.
Background: Excess body mass is a risk factor for carpal tunnel syndrome (CTS), but the mechanisms of this are unclear. This study aimed to evaluate the association between CTS and personal risk factors of body mass index (BMI), waist circumference and waist-to-hip ratio (WHR). Methods: The study sample consisted of the Northern Finland Birth Cohort 1966 (n = 9246). At the age of 31 in 1997 and at the age of 46 in 2012, the participants underwent a clinical examination. Cohort A consisted of complete cases with a follow-up from 1997 to 2012 (n = 4701), and Cohort B was followed up from 2012 to 2018 (n = 4548). The data on diagnosed CTS were provided by the Care Register for Health Care until the end of 2018. Results: After an adjustment for confounding factors, BMI was associated with CTS among women (hazard ratio (HR) 1.47, 95% Cl 0.98–2.20 for overweight women and HR 2.22, 95% Cl 1.29–3.83 for obese women) and among both sexes combined (HR 1.35 95% Cl 0.96–1.90 for overweight and HR 1.98 95% Cl 1.22–3.22 for obese participants). Neither waist circumference nor WHR was associated with CTS. Conclusions: BMI is an independent risk factor for CTS and is more relevant for estimating the increased risk of CTS due to excess body mass than waist circumference or WHR. Full article
(This article belongs to the Special Issue Recent Research of Carpal Tunnel Syndrome)
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12 pages, 303 KiB  
Article
Signs Indicative of Central Sensitization Are Present but Not Associated with the Central Sensitization Inventory in Patients with Focal Nerve Injury
by Luis Matesanz-García, Ferran Cuenca-Martínez, Ana Isabel Simón, David Cecilia, Carlos Goicoechea-García, Josué Fernández-Carnero and Annina B. Schmid
J. Clin. Med. 2022, 11(4), 1075; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11041075 - 18 Feb 2022
Cited by 8 | Viewed by 2030
Abstract
Objective: Carpal tunnel syndrome (CTS) is the most common focal nerve injury. People with CTS may show alterations in central processing of nociceptive information. It remains unclear whether the central sensitization inventory (CSI) is capable of detecting such altered central pain processing. Methods: [...] Read more.
Objective: Carpal tunnel syndrome (CTS) is the most common focal nerve injury. People with CTS may show alterations in central processing of nociceptive information. It remains unclear whether the central sensitization inventory (CSI) is capable of detecting such altered central pain processing. Methods: Thirty healthy volunteers were matched with 30 people with unilateral CTS from the orthopaedic waitlist. Changes to central pain processing were established through psychophysical sensory testing (bilateral pressure pain thresholds (PPT), conditioned pain modulation, temporal summation) and pain distribution on body charts. Patients also completed pain severity and function questionnaires, psychological questionnaires and the CSI. Results: Compared to healthy volunteers, patients with CTS have lower PPTs over the carpal tunnel bilaterally (t = −4.06, p < 0.0001 ipsilateral and t = −4.58, p < 0.0001 contralateral) and reduced conditioned pain modulation efficacy (t = −7.31, p <0.0001) but no differences in temporal summation (t = 0.52, p = 0.60). The CSI was not associated with psychophysical measures or pain distributions indicative of altered central pain processing. However, there was a correlation of the CSI with the Beck Depression Inventory (r = 0.426; p = 0.019). Conclusion: Patients with CTS show signs of altered central pain mechanisms. The CSI seems unsuitable to detect changes in central pain processing but is rather associated with psychological factors in people with focal nerve injuries. Full article
(This article belongs to the Special Issue Recent Research of Carpal Tunnel Syndrome)
11 pages, 2025 KiB  
Article
The Accuracy of a Screening System for Carpal Tunnel Syndrome Using Hand Drawing
by Takuro Watanabe, Takafumi Koyama, Eriku Yamada, Akimoto Nimura, Koji Fujita and Yuta Sugiura
J. Clin. Med. 2021, 10(19), 4437; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10194437 - 27 Sep 2021
Cited by 4 | Viewed by 2329
Abstract
When carpal tunnel syndrome (CTS), an entrapment neuropathy, becomes severe, thumb motion is reduced, which affects manual dexterity, such as causing difficulties in writing; therefore, early detection of CTS by screening is desirable. To develop a screening method for CTS, we developed a [...] Read more.
When carpal tunnel syndrome (CTS), an entrapment neuropathy, becomes severe, thumb motion is reduced, which affects manual dexterity, such as causing difficulties in writing; therefore, early detection of CTS by screening is desirable. To develop a screening method for CTS, we developed a tablet app to measure the stylus trajectory and pressure of the stylus tip when drawing a spiral on a tablet screen using a stylus and, subsequently, used these data as training data to predict the classification of participants as non-CTS or CTS patients using a support vector machine. We recruited 33 patients with CTS and 31 healthy volunteers for this study. From our results, non-CTS and CTS were classified by our screening method with 82% sensitivity and 71% specificity. Our CTS screening method can facilitate the screening for potential patients with CTS and provide a quantitative assessment of CTS. Full article
(This article belongs to the Special Issue Recent Research of Carpal Tunnel Syndrome)
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Review

Jump to: Editorial, Research, Other

16 pages, 3137 KiB  
Review
Proximal Median Nerve Compression in the Differential Diagnosis of Carpal Tunnel Syndrome
by Pekka Löppönen, Sina Hulkkonen and Jorma Ryhänen
J. Clin. Med. 2022, 11(14), 3988; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11143988 - 09 Jul 2022
Cited by 7 | Viewed by 9489
Abstract
Carpal tunnel syndrome (CTS) is the most common median nerve compression neuropathy. Its symptoms and clinical presentation are well known. However, symptoms at median nerve distribution can also be caused by a proximal problem. Pronator syndrome (PS) and anterior interosseous nerve syndrome (AINS) [...] Read more.
Carpal tunnel syndrome (CTS) is the most common median nerve compression neuropathy. Its symptoms and clinical presentation are well known. However, symptoms at median nerve distribution can also be caused by a proximal problem. Pronator syndrome (PS) and anterior interosseous nerve syndrome (AINS) with their typical characteristics have been thought to explain proximal median nerve problems. Still, the literature on proximal median nerve compressions (PMNCs) is conflicting, making this classic split too simple. This review clarifies that PMNCs should be understood as a spectrum of mild to severe nerve lesions along a branching median nerve, thus causing variable symptoms. Clear objective findings are not always present, and therefore, diagnosis should be based on a more thorough understanding of anatomy and clinical testing. Treatment should be planned according to each patient’s individual situation. To emphasize the complexity of causes and symptoms, PMNC should be named proximal median nerve syndrome. Full article
(This article belongs to the Special Issue Recent Research of Carpal Tunnel Syndrome)
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10 pages, 995 KiB  
Review
Optimization of Carpal Tunnel Syndrome Using WALANT Method
by Kathryn R. Segal, Alexandria Debasitis and Steven M. Koehler
J. Clin. Med. 2022, 11(13), 3854; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11133854 - 03 Jul 2022
Cited by 6 | Viewed by 2481
Abstract
As surgical management of carpal tunnel release (CTR) becomes ever more common, extensive research has emerged to optimize the contextualization of this procedure. In particular, CTR under the wide-awake, local-anesthesia, no-tourniquet (WALANT) technique has emerged as a cost-effective, safe, and straightforward option for [...] Read more.
As surgical management of carpal tunnel release (CTR) becomes ever more common, extensive research has emerged to optimize the contextualization of this procedure. In particular, CTR under the wide-awake, local-anesthesia, no-tourniquet (WALANT) technique has emerged as a cost-effective, safe, and straightforward option for the millions who undergo this procedure worldwide. CTR under WALANT is associated with considerable cost savings and workflow efficiencies; it can be safely and effectively executed in an outpatient clinic under field sterility with less use of resources and production of waste, and it has consistently demonstrated standard or better post-operative pain control and satisfaction among patients. In this review of the literature, we describe the current findings on CTR using the WALANT technique. Full article
(This article belongs to the Special Issue Recent Research of Carpal Tunnel Syndrome)
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16 pages, 1577 KiB  
Review
Carpal Tunnel Syndrome and Diabetes—A Comprehensive Review
by Malin Zimmerman, Anders Gottsäter and Lars B. Dahlin
J. Clin. Med. 2022, 11(6), 1674; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11061674 - 17 Mar 2022
Cited by 17 | Viewed by 3940
Abstract
Carpal tunnel syndrome (CTS) is the most common compression neuropathy in the general population and is frequently encountered among individuals with type 1 and 2 diabetes. The reason(s) why a peripheral nerve trunk in individuals with diabetes is more susceptible to nerve compression [...] Read more.
Carpal tunnel syndrome (CTS) is the most common compression neuropathy in the general population and is frequently encountered among individuals with type 1 and 2 diabetes. The reason(s) why a peripheral nerve trunk in individuals with diabetes is more susceptible to nerve compression is still not completely clarified, but both biochemical and structural changes in the peripheral nerve are probably implicated. In particular, individuals with neuropathy, irrespective of aetiology, have a higher risk of peripheral nerve compression disorders, as reflected among individuals with diabetic neuropathy. Diagnosis of CTS in individuals with diabetes should be carefully evaluated; detailed case history, thorough clinical examination, and electrophysiological examination is recommended. Individuals with diabetes and CTS benefit from surgery to the same extent as otherwise healthy individuals with CTS. In the present review, we describe pathophysiological aspects of the nerve compression disorder CTS in relation to diabetes, current data contributing to the explanation of the increased risk for CTS in individuals with diabetes, as well as diagnostic methods, treatment options, and prognosis of CTS in diabetes. Full article
(This article belongs to the Special Issue Recent Research of Carpal Tunnel Syndrome)
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16 pages, 6268 KiB  
Review
Revision of Carpal Tunnel Surgery
by Stahs Pripotnev and Susan E. Mackinnon
J. Clin. Med. 2022, 11(5), 1386; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11051386 - 03 Mar 2022
Cited by 13 | Viewed by 11259
Abstract
Carpal tunnel release is one of the most commonly performed upper extremity procedures. The majority of patients experience significant improvement or resolution of their symptoms. However, a small but important subset of patients will experience the failure of their initial surgery. These patients [...] Read more.
Carpal tunnel release is one of the most commonly performed upper extremity procedures. The majority of patients experience significant improvement or resolution of their symptoms. However, a small but important subset of patients will experience the failure of their initial surgery. These patients can be grouped into persistent, recurrent, and new symptom categories. The approach to these patients starts with a thorough clinical examination and is supplemented with electrodiagnostic studies. The step-wise surgical management of revision carpal tunnel surgery consists of the proximal exploration of the median nerve, Guyon’s release with neurolysis, the rerelease of the transverse retinaculum, evaluation of the nerve injury, treatment of secondary sites of compression, and potential ancillary procedures. The approach and management of failed carpal tunnel release are reviewed in this article. Full article
(This article belongs to the Special Issue Recent Research of Carpal Tunnel Syndrome)
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11 pages, 284 KiB  
Review
Update on Efficacy of Conservative Treatments for Carpal Tunnel Syndrome
by Teemu Karjalanen, Saara Raatikainen, Kati Jaatinen and Vieda Lusa
J. Clin. Med. 2022, 11(4), 950; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11040950 - 11 Feb 2022
Cited by 23 | Viewed by 5133
Abstract
Carpal tunnel syndrome (CTS) is the most common upper extremity compression neuropathy. Non-operative interventions are usually the first-line treatments, and surgery is reserved for those that do not achieve a satisfactory symptom state by non-operative means. This narrative review summarizes the current evidence [...] Read more.
Carpal tunnel syndrome (CTS) is the most common upper extremity compression neuropathy. Non-operative interventions are usually the first-line treatments, and surgery is reserved for those that do not achieve a satisfactory symptom state by non-operative means. This narrative review summarizes the current evidence regarding the efficacy of orthoses, corticosteroid injections, platelet-rich plasma injections, Kinesio taping, neurodynamic techniques, gabapentin, therapeutic ultrasound, and extracorporeal shockwave therapy in people with CTS. While many trials suggest small short-term benefits, rigorous evidence of long-term patient-important benefits is limited. To improve the utility of healthcare resources, research in this area should focus on establishing efficacy of each treatment instead of comparing various treatments with uncertain benefits. Full article
(This article belongs to the Special Issue Recent Research of Carpal Tunnel Syndrome)

Other

2 pages, 623 KiB  
Correction
Correction: Yamamoto et al. Trends in Open vs. Endoscopic Carpal Tunnel Release: A Comprehensive Survey in Japan. J. Clin. Med. 2022, 11, 4966
by Michiro Yamamoto, James Curley and Hitoshi Hirata
J. Clin. Med. 2023, 12(6), 2223; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12062223 - 13 Mar 2023
Viewed by 605
Abstract
In the original publication [...] Full article
(This article belongs to the Special Issue Recent Research of Carpal Tunnel Syndrome)
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