Carpal Tunnel Syndrome Flashcards
What is carpal tunnel syndrome ( CTS )
Condition involving the compression of the median nerve due to raised pressure in this compartment
What are the risk factors of CTS
Female gender
Increasing age
Pregnancy
Obesity
Previous injury to the wrist
Occupations where there are repeating hand/ wrist movements
what are the clinical features of CTS
Pain, numbness, paraesthesia over the median nerve sensory distribution
Palm is spared as the branches to the palm are given off before the flexor retinaculum
Sx worse at night and relieved by hanging hand out of the bed
Later stages => weakness in thumb abduction/ wasting in thenar eminence muscles
What tests can be carried out for carpal tunnel syndrome
Tinel’s test - percussion over the median nerve
Phalens test - holding the wrist in full flexion for one min
What are the differential diagnosis
Cervical radiculopathy - C6 nerve root compression => causes similar symptoms
Pronator teres Syndrome - median nerve compressed by pronator teres
Flexor carpi radialis tenosynovitis
What are the investigations you would carry out
Clinical diagnosis largely
In uncertain cases you could do nerve conduction studies
How would you manage CTS conservatively
Wrist splint
Corticosteroid injections
How would you manage CTS surgically
Carpal tunnel release surgery - cutting through the flexor retinaculum
What are the complications of surgery
Persistent symptoms
Infection
Scar
Nerve damage
Trigger thumb
What are the long term untreated complications of CTS
neurological impairment