SYNDROME carpal tunnel

DEFINITION: The carpal tunnel syndrome is a neuropathy due to irritation or compression of the median nerve as it passes through the carpal tunnel.

ETIOLOGY: It occurs most often in people over forty women and is most frequently due to chronic inflammation of the tendon of the flexor bag that compresses the median nerve. It can occur during pregnancy, in patients with hypothyroidism and in those with rheumatoid arthritis. They are more common in people who use their hands for precision work and typically repetitive.

SYMPTOMS: The carpal tunnel syndrome is manifested by sensitivity disorders that affect the first 3 fingers (thumb, Index, medium) and half of the fourth finger of the hand. Such disorders, that occur predominantly during the night, may develop in severe cases a progressive and irreversible loss of sensation in the early 3 fingers and the hand from flying followed by hypo-atrophy of the muscles of the hand. Efforts such as bowling, muovere mouse, use the jackhammer can lead to the syndrome. The patient will have difficulty in carrying out work with your fingers like uncorking a bottle or knitting. In the early stages the patient complains of numbness in shock.

DIAGNOSIS: The diagnosis is clinical (Visit Specialist) , supported by EMG (Electromyography) method which consists in applying electrodes and measure the characteristics of nerve conduction by passing current of low intensity through the nerve.

TREATMENT: The treatment of choice is surgery under local anesthesia which consists of a release of the nerve at the wrist through a small incision in the carpal fly. For operation performed pain resolves quickly, while paresthesia may persist for several weeks as the nerve, when highly compressed, recovers very slowly.

COMPLICATIONS: If compression is lasting too long with atrophy of the nerve axons does not recover despite the intervention.

INTERVENTION carpal tunnel

Indications for surgery

The indication for surgery is always positive when you will have the typical clinical maneuvers and electromyography confirm a suffering of the median nerve.

Results

The goal of the project is the disappearance of pain. This normally occurs at a distance of 3/6 gg. intervention.

The intervention

It is performed under local anesthesia and takes about 20 my. You run a micro-incision at the level handheld with the next section of the transverse carpal ligament and consequent nerve decompression.

Conclusions relating to the intervention

• Duration intervention: 20 my
• Type of anesthesia: Local
• Dressings: 1
• Length of stay: 1 now
• Resumption of normal activities: 8 gg.