Carpal Tunnel Syndrome (C) Flashcards
What is the carpal Tunnel formed by?
Carpal bones
Flexor retinaculum
Contents of carpal tunnel?
-Median nerve
-9 flexor tendons with synovial
FDS to 4 digits
FDP to 4 digits
FPL
Pathogenesis of carpal tunnel syndrome?
- Any swelling within the confines of the carpal tunnel
- Median nerve compression
- Flexor tendons are not really susceptible to pressure
- Nerves are highly sensitive
Aetiology of Carpal Tunnel Syndrome?
Idiopathic
- Secondary to many conditions
- Fractures around wrist
What gender is carpal tunnel syndrome common in?
Females > males (8:2)
What conditions can carpal tunnel syndrome be secondary to?
- RA- synovitis > less space
- Fluid retention: pregnancy, diabetes, chronic, renal failure, hypothyroidism
- Fractures around the wrist (Colle’s fracture)
Symptoms of carpal tunnel syndrome?
- Parathesiae in median nerve innervated digits
- Worse at night
- Loss of sensation & sometimes weakness of thumb
- Clumsiness in areas of hand supplied by median nerve
Which digits are median nerve innervated?
- Thumb
- Radial 2.5 fingers
Signs of carpal tunnel syndrome?
- Loss of sensation and/or muscle wasting of the thenar eminence
- Tinel’s test
- Phalen’s test
What is Tinel’s test?
Percussing over median nerve: symptoms reproduced
Phalen’s test?
Hold the wrist hyper-flexed: symptoms reproduced
Investigation of carpal tunnel syndrome?
- Nerve conduction studies confirms diagnosis
- Slowing of conduction across wrist
Non-operative treatment of carpal tunnel syndrome?
- Wrist splints at night to prevent flexion
- Injection of corticosteroid
Surgical treatment of carpal tunnel syndrome?
Division of transverse carpal ligament
- Local anaesthetic
- Risk of damage to median nerve
