• Journal of Korean Neurosurgical Society
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• v.29 no.11
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• pp.1451-1455
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• 2000

Objective : The goal of this study is to present whether endoscopic release(ER) is superior to open release(OR) for the treatment of carpal tunnel syndrome(CTS). Method and Material : Fifty-nine wrists in 43 patients who had clnical signs and symptoms consistent with CTS, not responded to non-operative management, were entered into the study. Authors retrospectively compared 27 wrists treated with ER(February 1999-June 1999) with 32 wrists treated with OR(October 1997-March 1999). We performed conventional open surgery in 25 patients(mean age ; 46 years) and Brown's two-portal technique in 18 patients(mean age ; 53 years) under intravenous regional block or general anesthesia. Results : Sixteen patients had CTS on both hands and left hands were affected more frequently than right hand, 34 and 25 respectively. Successful and poor results of ER were similar to those of OR. For patients in OR group, mean duration of symptoms was 5 years(range 1 month-30 years), and postoperative outcome was good in 27(84.4%) of wrists and poor in 5(15.6%). For patients in ER group, mean duration of symptoms was 7 months (range 2 months-25 years), outcome was good in 23(85.2%) of wrists and poor in 4(14.8%). The average time for complete relief of pain was 1.3 weeks and 7.6 weeks, respectively for OR and ER groups. No complication was noted in either group. Conclusion : This preliminary analysis suggests that faster relief of pain was achieved when the endoscopic method was used, although there were no significant differences in their efficacies regarding the improvement of symptoms.

• Journal of Korean Neurosurgical Society
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• v.55 no.2
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• pp.78-82
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• 2014

Objective : To investigate a diagnostic value of ultrasonography in carpal tunnel syndrome (CTS) patients and to evaluate a correlation of sonographic measurements with the degree of electrodiagnostic abnormalities and clinical severity. Methods : Two-hundred-forty-six symptomatic hands in 135 patients and 30 asymptomatic hands in 19 healthy individuals as control group were included. In ultrasonographic study, we measured the cross-sectional area (CSA) and flattening ratio (FR) of the median nerve at the pisiform as well as palmar bowing (PB) of the flexor retinaculum. Sensitivity and specificity of ultrasonographic measurements were evaluated and ultrasonographic data from the symptomatic and control hands were compared to the grade of electrodiagnostic and clinical severity. Results : The mean CSA was $13.7{\pm}4.2mm^2$ in symptomatic hands and $7.9{\pm}1.3mm^2$ in asymptomatic hands. The mean FR was $4.2{\pm}1.0$ in symptomatic hands and $3.4{\pm}0.4$ in asymptomatic hands. The mean PB was $3.5{\pm}0.5$ mm in symptomatic hands and $2.6{\pm}0.3$ mm in asymptomatic hands. Statistical analysis showed differences of the mean CSA, FR and PB between groups were significant. A cut-off value of $10mm^2$ for the mean CSA was found to be the upper limit for normal value. Both the mean CSA and PB are correlated with the grade of electrophysiological abnormalities and clinical severity, respectively. Conclusion : Ultrasographic measurement of the CSA and PB is helpful to diagnose CTS as a non-invasive and an alternative modality for the evaluation of CTS. In addition, ultrasonography also provides a reliable correlation with the grade of electrodiagnostic abnormalities and clinical severity.

• Journal of Korean Neurosurgical Society
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• v.54 no.3
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• pp.232-235
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• 2013

Objective : Major complaints of carpal tunnel syndrome (CTS) are sensory components. However, motor deficit also impedes functional status of hand. Contrary to evaluation of sensory function, the objective, quantitative evaluation of median nerve motor function is not easy. The motor function of median was evaluated quantitatively using load cell and its correlation with findings of electrodiagnostic study (EDS) was evaluated. Methods : Objective motor function of median nerve was evaluated by load cell and personal computer-based measurement system. All of the measurement was done in patients diagnosed as having idiopathic CTS by clinical features and EDS findings. The strength of thumb abduction and index finger flexion was measured in each hand three times, and the average value was used to calculate thumb index ratio (TIR). The correlation of TIR with clinical, EDS, and ultrasonographic findings were evaluated. Results : The TIR was evaluated in 67 patients (119 hands). There were 14 males and 53 females, mean age were 57.6 years (range 28 to 81). The higher preoperative nerve conductive studies grade of the patients, the lower TIR was observed [p<0.001, analysis of variance (ANOVA)]. TIR of cases with thenar atrophy were significantly lower than those without (p<0.001, t-test). TIR were significantly lower in patients with severe median nerve swelling in ultrasonography (p=0.042, ANOVA). Conclusion : Measurements of median nerve motor function using load cell is a valuable evaluation tool in CTS. It might be helpful in detecting subclinical motor dysfunction before muscle atrophy develops.

• Archives of Plastic Surgery
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• v.33 no.4
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• pp.427-432
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• 2006

Purpose: Noninflammatory synovial fibrosis has been noted for main causal factor of carpal tunnel syndrome (CTS). Recently, there are some reports that heparin have not only anti-coagulative effect but also anti-inflammatory and anti-fibrotic potential and have an effect on interstitial pulmonary fiborosis. Authors examined whether heparin affects pathogenesis of CTS. Methods: First, heparin was administered to fibroblast that was cultured from patient's transverse carpal ligament. Secondly, we evaluated the expression from genes of type I, III collagen, TGF ${\beta}$ isoforms and MMP. Fibroblasts were isolated and cultured from transverse carpal ligaments of 5 patients with CTS. Heparin (0, 1, 10,$100{\mu}g/ml$) was administered to cultured fibroblast and reverse transcription PCR for mRNA expression of type I, III collagen, TGF-${\beta}$ isoforms and MMP was done. Results: Heparin suppressed gene expression of type I, III collagen and TGF-${\beta}1$, ${\beta}3$ but promoted gene expression of TGF-${\beta}2$ and MMP-2. Conclusion: Heparin directly suppress gene expression of type I, III collagen. But, It is undetermined that heparin can present it's effect mediated by TGF ${\beta}$ isoforms or MMP.

• Physical Therapy Rehabilitation Science
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• v.13 no.2
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• pp.231-239
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• 2024

Objective: This study was conducted to investigate the effect of high-intensity laser therapy(HILT), transcutaneous electrical nerve stimulation(TENS), and ultrasound(US) treatment on pain, grip strength, and hand function in patients who had undergone carpal tunnel syndrome surgery. Design: A randomized controlled trial. Methods: Thirty patients who had undergone carpal tunnel syndrome surgery were randomly assigned to receive either TENS combined with HILT, US combined with HILT, or only HILT as the control group. Treatments were applied around the surgical site, and pre- and post-treatment changes were evaluated. Pain was assessed using NPRS, hand symptoms using CTS-6 and BCTQ-SSS, grip strength with an electronic dynamometer, and hand function using BCTQ-FSS. Treatments were administered seven times over two weeks. Results: The pain and symptoms were significantly reduced(p<0.05) and grip strength and hand function were significantly increased(p<0.05) after treatment compared to before treatment for all subjects. Pain was significantly reduced(p<0.05) and grip strength was significantly increased(p<0.05) in the TESN+HILT group and US+HILT group compared to the Control group. Hand symptoms were significantly reduced(p<0.05) and hand function significantly increased(p<0.05) in the TENS+HILT group compared to the Control group. Conclusions: TENS combined with HILT was found to be more effective than US combined with HILT in reducing pain and symptoms and improving grip strength and hand function in patients following carpal tunnel syndrome surgery. These findings suggest that these treatment modalities can be beneficially applied in clinical practice.

• Safety and Health at Work
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• v.11 no.1
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• pp.33-40
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• 2020

Background: Exploratory study to investigate whether co-exposure to physical wrist stressors and chemicals is associated with carpal tunnel syndrome (CTS) in French male farmers and agricultural workers. Methods: Cross-sectional study of 711 men aged 30-65 years and working as either farmers or agricultural workers in 2009-2010 within a cohort covered by the French Agricultural Workers' and Farmers' Mutual Benefit Fund. CTS and exposure to physical wrist stressors and chemicals were assessed using a self-administered questionnaire. Associations between CTS and personal/medical factors, exposure to physical wrist stressors, exposure to chemicals, and co-exposure to physical wrist stressors and chemicals were studied using multivariate logistic regression models. Results: Forty-four men {5.6% [95% confidence interval (CI) 4.0-7.7]} reported that they had suffered from unilateral/bilateral CTS during the last 12 months. CTS was associated with age, current smoking [odds ratio (OR) = 2.1 (1.0-4.5)], and exposure to physical wrist stressors [OR = 2.6 (1.1-5.9)]. An association was found between CTS and co-exposure to physical wrist stressors and chemicals [OR = 3.3 (0.8-14.3), p = 0.044] in comparison with the no-exposure group. Conclusions: This exploratory study shows an association of CTS with exposure to biomechanical wrist stressors in male farmers and agricultural workers and suggests an association of CTS with co-exposure to physical wrist stressors and chemicals. Owing to the limitations of the study, this result must be confirmed by a prospective study with objective assessments of the outcome and exposure before drawing conclusions on the possible synergistic effects of mechanical stressors and chemicals on the impairment of the median nerve.

• International Journal of Clinical Preventive Dentistry
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• v.14 no.4
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• pp.235-240
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• 2018

Objective: The purpose of this study is to examine about dental hygienists' myofascial pain syndrome, lower back pain, carpal tunnel syndrome (CTS), medial and lateral epicondylitis, hand-arm vibration syndrom and work-related musculoskeletal syndrome (WMSD) experience and hygienists' posture, motion. Methods: The self-administered questionnaire was surveyed from June 1 to September 30 of 2018 targeting 280 dental hygienists in Gyeongnam province and 266 dental hygienists' answers were analyzed. Results: The average daily working hours of a dental hygienist was more than eight hours 59.0%, with an average of 33 patients per day. The average number of patients who receive treatment for more than 30 minutes is 15. The angle of motion of the subjective evaluation was above 60%. Medical position and form of movement were more than 50% above the standard level. Symptoms of posture and motion that cause WMSD were hand-arm vibration syndrome 68.1%, myofascial pain syndrome 58.6%, lower back pain 51.1%, CTS 50.4% in order. Experience WMSD related symptoms which dental hygienists experience were myofascial pain syndrome 92.9%, CTS 57.9%, lower back pain 56.4%, medial and lateral epicondylitis 37.2%, hand-arm vibration syndrome 24.4%. Conclusion: The above results showed the posture and motion of dental hygienists and were found that the experience rate which dental hygienists experience WMSD of myofascial pain syndrome, Lower back pain, and CTS was significantly more than 56%.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.11
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• pp.5305-5310
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• 2012

This study is Carpal tunnel syndrome(CTS) disorder of median nerve at wrist. It is usually diagnosed through clinical manifestation and Nerve Conduction Study(NCS). NCS of the median nerve before and after operation were compared in twenty four patient's with CTS, in order to seventeen patient's evaluate the prognostic value of that findings. Analysis result symptom profile of CTS in total number of patient's 17 (Female:17, Male:0), 21 hands (Rt:9, Lt:4, Both:4), Ages(31~60), Mean duration of symptom months($46.6{\pm}36.1$), Mean interval between 1st and 2nd NCS months($20.5{\pm}7.1$), Sensory symptoms(Tingling:21, Numbness:19, Noctunal paresthesia:17), Motor symptoms(Thenar atrophy:20, Trigger finger:2, Morning stiffness:3), Post-operative symptoms(Free:38.1%, >50% improve:52.4%, <50% improve:9.5%). NCS was normal range after operation than before in Sensory nerve conduction study 4 patients's and Motor nerve conduction study 5 patients. Surgery before and after Sensory nerve action potential (SNAP) responses showed improvement over the previous results. Forward by the patient's occupation and occupation patterns of CTS, other treatment methods and surgical treatment of CTS by comparing the degree of improvement to identify and correct nerve conduction study to judge whether the patient's operation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.10
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• pp.290-298
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• 2017

This study compared the median nerve, ulnar never, and F waves of patients diagnosed with early Carpal Tunnel Syndrome to a control group to determine whether F waves could be a useful indicator in the diagnosis of early CTS. The terminal motor latency (TML), terminal motor amplitude and sensory nerve conduction velocity (SNCV) of the section from the palms to the wrists, which are the key indicators to use in a nerve conduction study, and F waves were compared with the control group using the t-test. A correlation analysis was performed to analyze the correlation between the main indicators. The comparison between the median nerve's TML of the early CTS patients and that of the control group shows that there are 2 sections which have high significance (p<0.001). In the comparison of the SNCV of the median nerve between the control group and early CTS patients, high significance was observed (p<0.001). In the analysis of the F waves, there was high significance (p<0.001) between the control group and early CTS patients for the median nerve, but not for the ulnar nerve. The correlation analysis revealed that both the SNCV-TML and F wave-TML had significance. These results suggested that, along with TML and SNCV, F waves can be a useful indicator to diagnose CTS.

• Journal of the Ergonomics Society of Korea
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• v.15 no.2
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• pp.139-147
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• 1996

It is known fact that the CTS patients have lower pinch strength than the normal people. And we can assume that the sensory nerve action potential(SNAP) and the nerve conduction velocity(NCV) of the CTS group are lower or slower than the normal subjects. This paper analysed the grip strength and performed EMG experiment for the group Norm, G1 and G2. The results are as follows: 1) CTS patients have lower pinch strength than normal people. 2) There was no significant difference on SNAP between the CTS group and the normal group. 3) There was significant difference on NCV among Norm, G1, and G2 group. Especially, significant level was higher in the evening after the continuous use of wrist.