• Korean Journal of Radiology
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• v.22 no.7
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• pp.1132-1141
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• 2021

Objective: To investigate changes in the median nerve, retinaculum, and carpal tunnel on ultrasound after successful endoscopic carpal tunnel release (ECTR). Materials and Methods: This prospective study involved 37 wrists in 35 patients (5 male, 30 female; mean age ± standard deviation [SD], 56.9 ± 6.7 years) with primary carpal tunnel syndrome (CTS). An in-house developed scoring system (0-3) was used to gauge the clinical improvement after ECTR. Ultrasound was performed before ECTR, and at 1, 3, and 12 months post-ECTR. Changes in the median nerve, flexor retinaculum, and carpal tunnel morphology on ultrasound after ECTR were analyzed. Ultrasound parameters for different clinical improvement groups were compared. Results: All patients improved clinically after ECTR. The average clinical improvement score ± SD at 12 months post-ECTR was 2.2 ± 0.7. The median nerve cross-sectional area proximal and distal to the tunnel decreased at all time intervals post-ECTR but remained swollen compared to normal values. Serial changes in the median nerve caliber and retinacular bowing after ECTR were more pronounced at the tunnel outlet than at the tunnel inlet. The flexor retinaculum had reformed in 25 (68%) of 37 wrists after 12 months. Conclusion: Postoperative changes in median nerve and retinaculum parameters were most pronounced at the tunnel outlet. Even in patients with clinical improvement after ECTR, nearly all ultrasound parameters remain abnormal at one year post-ECTR. These ultrasound parameters should not necessarily be relied upon to diagnose persistent CTS after ECTR.

• Annals of Clinical Neurophysiology
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• v.15 no.1
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• pp.7-12
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• 2013

Background: Local steroid injection is used to treat carpal tunnel syndrome (CTS). The aim of this study was to evaluate the clinical and electrophysiological effects of local steroid injection in patients with CTS over a 3-months period. Methods: Twenty-one patients (35 hands) with clinical and electrophysiological evidence of CTS were treated by injection of triamcinolone 40 mg to the carpal tunnel. Visual analog scale (VAS), Boston Carpal Tunnel Questionnaire (BCTQ), rates of paresthesia, night awakening, and electrophysiological studies were used as outcomes. Clinical and electrophysiological assessments were performed before, 1 and 3 months after treatment. Results: Prior to treatment, 86% of patients complained of night awakening. At 1 and 3 months after injection, only 17% and 29% of the patients, respectively, had night awakening (p<0.001). All patients complained of paresthesia before the treatment. This symptom disappeared in 60% and 31% of the patients after 1 and 3 months, respectively (p<0.001). Compared to baseline, both BCTQ and VAS show significant improvement during the 3 months of the study (p<0.005). Although significant improvements in clinical parameters were shown, electrophysiological parameters were not significantly improved at 1 and 3 months. Conclusions: Local corticosteroid injection for the treatment of CTS provides significant improvement in symptoms for 3 months. On the other hand, no significant improvement was observed in electrophysiological parameters.

• Journal of Fashion Business
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• v.27 no.5
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• pp.1-12
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• 2023

The purpose of this study was to investigate impact of wearing low-level current wrist guards on pain scale, range of motion (ROM), and muscle strength in elderly women with Carpal Tunnel Syndrome (CTS). Subjects were 12 elderly women aged between 65 and 85 years who were diagnosed with CTS symptoms. Measurements included grip strength and wrist ROM. Wrist ROM was assessed through flexion and dorsiflexion. Wrist guards were worn. After two weeks, pain level was assessed using the Visual Analogue Scale (VAS). Results showed a significant reduction in VAS score in the MES group after stimulation, whereas there was no difference in the control group. However, there was no significant difference in ROM between the MES group and the control group. Grip strength increased in the MES group after two weeks (p ≤ 0.001). In conclusion, clinical trials suggest that MES wrist guards might be provided as an adjunctive treatment method for CTS patients. This study provides foundational data for the design and use of auxiliary devices such as gloves in the field of MES research for pain reduction, ROM improvement, and muscle strength enhancement resulting from CTS.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.16 no.2
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• pp.48-52
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• 2010

Object: The aim of this study is to descrive the effect of neurodynamic technique and self management exercise for carpal tunnel syndrome patients(CTS) Method: 13 patients with CTS participated in this study. They were from 18 to 70 years old and mean age was 25.3. In the evalutaion, gripping with grip dynamometer, strength of gripping with precision pinchmeter, pain level with visual analogue scale. All measurement of each subject were measure at pre- treatment and post treatment(after 1week) and post treattment(after 2 weeks) stage. The physical therapy program consisted of neurodynamic technique and self management exercise. SPSS 12.0 program was used to compile result. Result: The grip, pinch, VAS-P were significantly difference between pre-treatment and post treatment(after 2weeks)(p<.05) Conclusion: This study suggest that 3weeks neurodynamic technique and self management exercise improved grip and pinch strength and decrease pain score.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.1
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• pp.63-71
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• 2021

PURPOSE: The purpose of this study was to investigate the effects of trigger finger on pain, muscle strength and function in carpal tunnel syndrome (CTS) patients. METHODS: A total of 60 subjects (30 carpal tunnel syndrome with trigger finger and 30 carpal tunnel syndrome without trigger finger) were assessment for pain, muscle strength (power grip, key pinch , tip to tip pinch, three jaw pinch) and function. The effect sizes of the two groups were compared, and the correlation between the trigger finger and each variable was analyzed. RESULTS: The results showed that there were significantly difference in the pain, muscle strength excluding three jaw pinch and function (p < .05). The results also showed correlation between trigger finger and pain (r = .552), muscle strength excluding three jaw pinch (power grip r = -.296, key pinch r = -.260, tip to tip pinch r = -.285), and function (r = .375). The function of carpal tunnel syndrome patients was related to pain (r = .550) and power grips (r = -.324) of muscle strength. CONCLUSION: In carpal tunnel syndrome patients with trigger finger compared to carpal tunnel syndrome, muscle weakness, pain increase, and function reduction were shown. In addition, trigger finger are correlated with muscle strength, pain and function, and muscle weakness and increased pain affect the daily living of carpal tunnel syndrome patients with triggers finger. Therefore, physical therapy interventions of carpal tunnel syndrome patients with trigger finger should be combined with treatment for muscle strength enhancement as well as pain reduction.

• Journal of Electrodiagnosis and Neuromuscular Diseases
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• v.20 no.2
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• pp.91-97
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• 2018

Objective: The aim of this study was to compare the electrodiagnostic outcomes of carpal tunnel release in patients with and without diabetes with carpal tunnel syndrome (CTS), and to evaluate the effect of diabetes mellitus (DM) on electrodiagnostic outcomes. Method: We conducted a retrospective analysis of 67 patients with electro-diagnostic evidence of CTS. Patients were classified into two groups according to the presence of DM. Both groups were evaluated using nerve conduction studies preoperatively and 3 weeks and 3 months postoperatively. Results: There were no statistical differences in any of the electrodiagnostic parameters between groups 3 weeks postoperatively. However, there were statistical differences in the amplitude and the latency of compound muscle action potential, and sensory nerve conduction velocity 3 months postoperatively. Conclusion: Patients with DM did not show a significantly different outcome 3 weeks after surgery but showed a worse electrodiagnostic outcome 3 months after surgery than those without DM.

• Archives of Plastic Surgery
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• v.46 no.4
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• pp.350-358
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• 2019

Background Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy with a high morbidity and healthcare-related costs. Currently there is no consensus about the best treatment option. The purpose of this prospective cohort study conducted at a single institution was to evaluate the clinical outcomes and patient satisfaction following a mini-open carpal tunnel release for idiopathic CTS. Methods A total of 72 patients (53 female and 19 male patients; mean age, $57.8{\pm}15.3$ years; range, 24-94 years) had a mini-open carpal tunnel release performed by a single senior surgeon between June 2015 and June 2016. The patients were evaluated preoperatively, and at 3 and 12 months post-intervention. At every follow-up, the Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) and visual analogue scale (VAS) scores for pain and satisfaction were completed. Digital sensibility (using Semmes-Weinstein monofilaments) was assessed and pinch and grip strengths were measured. Results Statistically significant and clinically relevant improvement was found in terms of digital sensibility, grip and pinch strength (except for 2-point pinch), BCTSQ scores and pain scores. The complication rate was minimal, and no major complications occurred. Two patients experienced recurrence. The availability of follow-up records (including patient-reported outcomes, BCTSQ and VAS scores, and the complication rate) at 1-year post-intervention varied between 69% and 74% (50-53 patients) depending on which parameter was assessed. Patient satisfaction was high (mean, $80.9{\pm}26.0$; range, 0-100). Conclusions This study demonstrates that mini-incision carpal tunnel release is clinically effective in the short and long term.

• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.372-376
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• 2019

Carpal tunnel syndrome (CTS) caused by pseudogout is an uncommon disease. The authors report a 65-year-old female who complained of sudden pain and neurological symptoms on her left hand. Surgical decompression was performed. In the histologic study, a calcium pyrophosphate dihydrate crystal deposit was confirmed. Her pain and neurological symptoms were relieved. Because CTS caused by pseudogout is rare, it is difficult to differentiate it from other diseases. This paper reports an uncommon case of CTS caused by pseudogout.

• Annals of Clinical Neurophysiology
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• v.6 no.2
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• pp.98-102
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• 2004

Background: Carpal tunnel syndrome (CTS) is a common condition characterized by entrapment neuropathy of the median nerves. Clinical manifestations are the most important findings for diagnosis and assessment of therapeutic effects. But, objective indicators, such as electrophysiological findings, are also valuable supplementary tools. This study investigated the relationship between clinical grading and sensory nerve conduction velocity (SNCV) of median proper palmar digital nerve (MPPDN) in CTS patients. Method: This study was done on 90 upper limbs of 53 patients with CTS (men: 6, women: 47, age: 26~69 years, mean age; 52 years). Each SNCV of MPPDN was recorded with bar electrode using antidromic method. Each SNCV was compared with clinical grading of CTS. The clinical grades of CTS were designated as follows; group 1 is mild symptoms, 2 is moderate symptoms, and 3 is severe and longstanding symptoms. Result: In thumb, the SNCV of MPPDN was not different significantly between 3 groups (p=0.817). In the index finger, the SNCV was the fastest in the group 1, but faster in group 3 than in group 2 (p=0.001). In the middle and ring fingers, SNCV was decreased in higher clinical grading groups (middle finger: p=0.015, ring finger: p=0.044). Conclusion: SNCV of MPPDN of middle and ring finger correlated with the clinical grading of CTS. SNCV of index finger was the fastest in group 1. But SNCV of thumb did not correlate with the clinical grading of CTS.

• Molecular & Cellular Toxicology
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• v.2 no.4
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• pp.266-272
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• 2006

Carpal tunnel syndrome (CTS) is one of the most common disorders by under pressure of the median nerve at the wrist in these days. However, pathological mechanism of CTS is unknown. We carried out this study to identify the changes of gene expression and to evaluate possible mechanism in CTS. 120 CTS patients and 30 control patients were included in this study. Patients with a history of diabetes, hypertension, thyroid diseases, and arthritis were excluded. CTS patients were divided to three experimental groups-Mild, Moderate, and Severe group-according to elecrodiagnosis. Radioactive cDNA microarrays (Nylon membrane including 1,152 genes) were used to examine the difference of gene expression profile in CTS. We identified up-regulated genes by more than 2.0 value of z-ratio, and down-regulated genes by less than-2.0 value of z-ratio. 20 genes such as the ITGAL, ITGAM, PECAM1, VIL2, TGFBR2, RAB7, RNF5 and NFKB1 were up-regulated, and 28 genes such as PRG5, CASP8, CDH1, IGFBP5, CBX3, HREV107, PIN, and WINT2 were down-regulated. These genes were related with TGF beta signaling pathway, NF-Kb signaling pathway, antiapoptotic pathway and T cell receptor signaling pathway. However, there were no differences in gene expression profiles according to severities of symptoms. We suggest that CTS could be related with proinflammatory mechanism and antiapoptotic mechanism.