Carpal Tunnel Syndrome

Definition:

It's a compresion of median nerve in the carpal tunnel is called carpal tunnel

syndrome

anatomy

The median nerve travels from the

forearm into your hand through a

“tunnel” in your wrist .

Epidemiology : Most often 30 -60 years old Five times more common in women

Older, overweight, and physically inactive people

Etiology 1-primery or Idiopathic

2 -secondary A: Local etiology I: Anatomical malformation

II: Tumors III: Infections

IV: Bone prominence

B: Systemic etiology obesity, diabetes mellitus, thyroi

dysfunction, R.A

C:Computer users !!

Clinical Features

•Pain•Numbness•Tingling•Symptoms are usually worse at night and can

awaken patients from sleep.•To relieve the symptoms, patients often “flick”

their wrist as if shaking down a thermometer (flick sign).

Clinical Features

•Pain and paresthesias may radiate to the forearm, elbow, and shoulder.

•Decreased grip strength may result in loss of dexterity, and thenar muscle atrophy may

develop if the syndrome is severe.

Atrophy

Physical examination

•Phalen’s maneuver•Tinel’s sign•weak thumb abduction.•two-point discrimination

Phalen’s maneuver

Tinel’s sign

Diagnostic

•History•Physical examination•Nerve Conduction Study

Treatment

•CONSERVATIVE TREATMENTS–GENERAL MEASURES–WRIST SPLINTS–ORAL MEDICATIONS–LOCAL INJECTION–Predicting the Outcome of Conservative

Treatment•SURGERY

WRIST SPLINTS

WRIST SPLINTS

LOCAL INJECTION

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