A Simple Guide to Carpal Tunnel Syndrome and Hand Diseases (A Simple Guide to Medical Conditions) (English Edition) [Kindle-editie] beoordelingen het boek quotes

Carpal Tunnel Syndrome is the compression of the median nerve in the carpal tunnel of the wrist. The carpal tunnel is a ligamentous sheath which provides protection for the median nerve as it travels across the carpal boneCarpal Tunnel Syndrome occurs as a result of pressure on the median nerve between the transverse carpal ligament and the flexor tendons with their inflamed and enlarged synovium.What are the causes of Carpal Tunnel Syndrome?Local causes:1. trauma including injury, fractures2. tenosynovitis (inflammation of the tendon and their synovial sheath)3. lipoma4. ganglionSystemic causes:1. polyarthritis2. myxedema (hypothyroidism)3. pregnancy (due to fluid retention)4. Amyloid diseaseWhat are the symptoms of Carpal Tunnel Syndrome?Symptoms:The onset is usually spontaneous with gradual increasing night pains which cause the patient to seek treatment:1. Painful night tingling sensation of the fingers which can extend to the forearm-relieved by hanging the arm down or shaking 2. Parethesia and numbness of the index, middle and ring finger3. Fingers feel clumsy4. Thenar muscle wasting and weakness may be present5. Impairment of light touch and pin prick sensation on the 3 middle fingers6. Women are more affected than men1. Physical examinationa. Phalen's test- flex wrists so that the dorsal surfaces of the hands are in full contact with each other, hold for 1 min: tingling and numbness in median nerve distributionb. Reverse Phalen's test (prayer Sign)-extend wrists so that the palms of hands are in full contact like in prayer, hold for 1 min: tingling and numbness in median nerve distributionc. Tinel's test - tap volar surface of the wrist tingling means positive test2. EMG - electromyography to test movement of the muscles3. Nerve conduction tests on median nerve What is the treatment of Carpal Tunnel Syndrome?1. Treat underlying conditions such as myxedema, polyarthritis, and amyloid2. Diuretic in mild cases and those present in pregnant womenNSAIDS may reduce inflammation.3. Wrist splintage in extension4. Injection of the carpal tunnel with corticosteroid (avoiding the carpal nerve)Surgery:Surgical decompression by division of the transverse carpal ligament.Results are usually good.What is the prognosis of Carpal Tunnel Syndrome?Prognosis is usually good although recurrence may occur after cortisone injection.Surgery usually gives excellent results.TABLE OF CONTENTChapter 1 Carpal Tunnel SyndromeChapter 2 Dupuytren’s ContractureChapter 3 Trigger FingerChapter 4 De Quarvain’s DiseaseChapter 5 Extensor Carpi UlnarisChapter 6 Ganglion