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Syndrome of a carpal tunnel


The most widespread and known tunnel syndrome is the syndrome of a carpal tunnel (English carpal tunnel syndrome, CTS), i.e. a prelum of a median nerve (Latin of nervus medianus) under a cross ligament of a wrist. The neurothlipsia occurs between three bone walls and a dense sheaf which hold sinews of the muscles bending fingers and a brush.

The syndrome of a carpal tunnel is more often observed at women, than at men (at 3-10 times according to different sources). The peak of incidence is the share of age of 40-60 years (though this disease can arise at any age, only 10% having this disease are younger than 31 years). The risk to ache with a syndrome of a carpal tunnel makes about 10% for all life, a year adults have 0,1-0,3%. The general prevalence of a syndrome makes up to 1,5-3%, and prevalence among certain risk groups - to 5%. The syndrome meets at representatives of Caucasian race more often, in some African countries practically does not meet.

Symptoms of the Syndrome of a carpal tunnel:

The most frequent complaint at a syndrome of a carpal tunnel is numbness of any of five fingers of a brush, except for a little finger. At the same time patients complain that they cannot hold a thing in a sore hand because of numbness. Disturbance of sensitivity is followed by pain which giving to a forearm. These symptoms often appear or amplify at night because at this time outflow of liquid from extremity vessels is slowed down that can lead to its accumulation in synovial vaginas. Besides, during sleep there can be an involuntary bending of a brush that can also strengthen a prelum of a median nerve. In hard cases the atrophy and weakness in muscles of area of an eminence of a thumb is noted. at 25% of patients constraint in fingers that, most likely, is caused, is noted by existence of the accompanying tendovaginitis (a sinew cover inflammation).

In most cases the diagnosis of a syndrome of a carpal tunnel is established at careful inquiry and survey by the doctor. Often symptoms appear or amplify in 60 seconds after strong compression of a brush in a fist or at percussion by a hammer on a wrist in the place of passing of a median nerve. In diagnostically difficult situations more painful is used (and expensive) a research of carrying out an electric impulse on a nerve (a stimulation electromyography).

Reasons of the Syndrome of a carpal tunnel:

The syndrome of a carpal tunnel arises at a prelum in a carpal tunnel of branches of a median nerve.

Treatment of the Syndrome of a carpal tunnel:

At patients with an easy current of a syndrome of a carpal tunnel at whom symptoms appeared recently or are expressed changeably, with success conservative therapy which consists in reception of anti-inflammatory drugs and fixing for night of a brush a langetny bandage for prevention of its bending is applied. However in many cases symptoms of a disease repeat again. In this case operational treatment is shown. Operation is a choice method at a classical syndrome of a carpal tunnel. Usually, 80-90% of patients completely get rid of disease symptoms after a section of a cross ligament of wrist which takes part in formation of a carpal tunnel. In certain cases during operation the neurolysis - excision of the cicatricial and changed fabrics around a nerve, and also partial excision of tendinous vaginas is carried out.

As a result of these manipulations squeezing of a median nerve stops, symptoms of a disease disappear. This operation is performed on an outpatient basis under local anesthesia. After operation on a complete recovery of function of a nerve some time, as a rule, disease symptoms is necessary, pass within three months. Sometimes at the long and expressed compression of a nerve there is its irreversible damage. In this case symptoms of a disease remain and even amplify after operation. In certain cases the annoying pain can be caused by existence of a tendovaginitis or arthritis (inflammation of joints). Operation can be executed as a traditional open way, and with use of the endoscopic equipment for visualization of a nerve and a cross ligament of a wrist. Advantages of endoscopic operation are: cosmetic small cuts, bystry recovery period, reduction of frequency of complications.

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