Carpal Tunnel Syndrome

Question 1

What is the carpal tunnel of the wrist?

Answer 1

Formed by the carpal bones an the flexor retinaculum

Question 2

What nerve passes through the carpal tunnel?

Answer 2

Median nerve

Question 3

What passes through the carpal tunnel?

Answer 3

Median nerve

9 flexor tendons (FDS and FDP to 4 digits and FPL) with their synovial covering

Question 4

Causes of carpal tunnel syndrome

Answer 4

Idiopathic
Secondary to RA
Pregnancy
Diabetes
Chronic renal failure
Hypothyroidism
Fractures around the wrist
Women 8 times more likely to get it than men

Question 5

Symptoms of carpal tunnel syndrome

Answer 5

Parathesiae in the median nerve innervated digits (thumb and radial 2 1/2 fingers)- worse at night, loss of sensation, weakness of the thumb or clumsiness in the areas of the hand supplied by the median nerve
Symptoms reproduced by Tinel’s test or Phalen’s test

Question 6

Diagnostic test for carpal tunnel syndrome

Answer 6

Nerve conduction studies

Question 7

Non-operative treatment of carpal tunnel syndrome

Answer 7

Wrist splints at night to prevent flexion

Corticosteroid injections

Question 8

Surgical treatment of carpal tunnel syndrome

Answer 8

Decompression - division of transverse carpal ligament under local anaesthetic

Question 9

Risk of carpal tunnel decompression surgery

Answer 9

Damage to the median nerve or one of its smaller branches