Carpal Tunnel Syndrome

Question 1

What are good prognostic indicators in carpal tunnel syndrome?

Answer 1

1) Night symptoms
2) Symptoms relieved by steroid injection
3) Short incisions

Question 2

What is the most radial structure in the carpal tunnel?

Answer 2

FPL

Question 3

What is the most specific test for carpal tunnel syndrome?

Answer 3

Self administered hand diagram (76%)

Most sensitive test is Durkan’s compression test

Question 4

What type of splint is recommended in carpal tunnel syndrome?

Answer 4

Neutral splints at night

Question 5

When is grip strength expected to return to 100% following carpal tunnel release?

Answer 5

12 weeks

Question 6

What advantage does endoscopic CTR have over traditional open release?

Answer 6

Faster rehabilitation; no difference in long term outcomes

Question 7

What can lead to progressive thenar atrophy following carpal tunnel release?

Answer 7

Inadvertent transection of the recurrent motor branch of the median nerve; transligamentous 20%, can avoid with more ulnar release

Question 8

How is gout related carpal tunnel syndrome treated?

Answer 8

Acute flares:
Medical management with rheum referral, NSAIDs
Chronic:
May need debridement and release

Question 9

Approximately what percentage of pre-operative grip strength would be expected 3 months after carpal tunnel release?

Answer 9

100%; 116% at 6 months