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The Role of Epineurotomy in Carpal Tunnel Syndrome

Aim: The purpose of this study is to compare the effect of epineurotomy of median nerve with just division of the transverse carpal ligament in the treatment of carpal tunnel syndrome. Patients & Methods: We conducted a prospective, random study to evaluate the effect of epineurotomy on the outcome of operative treatment of established median-nerve compression in the carpal canal. Fifty hands (forty-four patients) were selected randomly into two groups: group I had a release of the transverse carpal ligament alone, and group II had a release and adjuvant epineurotomy of the median nerve. The groups were similar with regard to age group, gender, duration of symptoms, and preoperative physical findings. All patients had electrophysiological evidence of sensory delays and fibrillations on preoperative testing. Results: The patients were evaluated perioperatively and postoperatively after 6 months. The results show (60%) in group I and (56%) in group II who no longer had any symptoms referable to the dysfunction of the median nerve. On physical examination, the average two-point discrimination was 5.1 mm in group I, and 4.7 mm in group II. The electrophysiological tests revealed an average sensory latency 4.1 msec in both groups. The follow-up examination revealed no detectable differences between the two groups with regard to symptoms, objective findings, or electrophysiological findings. Conclusions: we conclude that the epineurotomy of the median nerve offers no benefit compared with sectioning of the transverse carpal ligament alone.

Publication Date
Fri Jan 02 2009
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Simple carpal ligament release versus release plus epineurotomy in the treatment of carpal tunnel syndromeA comparative study

Background: surgical treatment of established carpal tunnel syndrome (CTS) can be accomplished by various operative modalities, epineurotomy of the median nerve plus carpal ligament release has been advocated by many authors, This study try to evaluate the role of epineurotomy on the outcome of operative treatment of CTS postoperatively, compared to simple release only .

Patients and Methods: 48 hands of 42 patients, 34 female and 8 male. where classified in to two groups, one group had a release of the transverse carpal ligament alone, group (1). and the other group had a release plus epineurotomy of the median nerve, group (2). Selection of patients was according to the same clinical criteria regarding physical finding, periods

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Publication Date
Sun Jul 01 2012
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Carpal tunnel syndrome in Iraqi paraplegic patients

Background: The median nerve in paraplegic patients, who must rely on increased hand activities including transfer and wheel-chair propulsion, may be subjected to increased pressure, so that the incidence of carpal tunnel syndrome (CTS) may be higher than that in the normal population.
Objectives: To study the prevalence and the severity of carpal tunnel syndrome in Iraqi paraplegic patients and to identify the effect of duration of the injury as a possible factor related to its occurrence to avoid any chronic problems which interfere with the hand functions since these patients are greatly dependent on their hands for their daily activities.
Patients and Methods: Fifty paraplegic patients (100 hands), whose level of spinal cord in

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Publication Date
Wed Oct 01 2008
Journal Name
Journal Of The Faculty Of Medicine Baghdad
A study of 124 with cases carpal tunnel syndrome

Background: carpal tunnel syndrome (CTS) a relatively common disease affecting ♀ more than ♂, usually at the age between 40 -60 , diagnosed by EMG & NCS, treated when moderate
to severe by surgical decompression of the median nerve.
Objective: To study the role of surgery in the management of CTS.
Patients & method: 124 patients collected from the neuro-surgical departments of the specialized surgical hospital from August 2001 till March 2007, all patients studied thoroughly
regarding age, sex, associated diseases, clinical features, EMG studies, surgery & out come & follow up for at least one year.
Results & discussion: there was around 2:1 ♀:♂ , with age predomena between 40-60

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Publication Date
Mon Oct 01 2012
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Effectiveness of Low Level Laser in the Treatment of Carpal Tunnel Syndrome

Background: Carpal tunnel syndrome (CTS) is one of common peripheral nerve disorder which involves an entrapment neuropathy of the median nerve at the wrist which occurs either due to primary idiopathic cause or secondary to systemic causes. The diagnosis of CTS is clinical and supported by neurophysiological analysis. Surgical intervention is the main treatment modality.
Objective: The aim of the present study is to evaluate the effectiveness of low level laser therapy (LLLT) to treat mild – moderate CTS cases.
Pateients and methods: The study involves 60 symptomatic patients complaining of CTS were divided into two groups. Group A was subjected to real LLLT by Gallium – Arsenide (Ga-As) laser (904 nm), whereas group B was sub

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Publication Date
Sat Jun 25 2022
Journal Name
International Journal Of Drug Delivery Technology
Ultrasonic and Electrophysiological Evaluation of Carpal Tunnel Syndrome in Diabetic and Non-diabetic Subjects

Background: Carpal tunnel syndrome (CTS) is the most prevalent upper-limb entrapped neuropathy. A nerve conduction study (NCS) is the simplest method for identifying CTS when combined with a satisfactory clinical assessment and physical assessment. Ultrasound is a beneficial non-traumatic screening approach for CTS and there is a relationship between the NCS tests and the measures of CSA by ultrasound. Objective: to assess whether or not sonographic observations of the median nerve seems to be varied amongst DM and non-DM CTS individual. Patients and methods: The total of 50 non-DM Individuals with CTS and 50 DM individuals with CTS have been included in this study. All individuals were submitted to full medical assessment NCS testi

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Publication Date
Fri Dec 30 2011
Journal Name
Al-kindy College Medical Journal
Intraoperative Steroid Irrigation in Carpal Tunnel

Background: Carpal tunnel syndrome
(CTS) is the most common neuropathy of the
upper limb due to compression of the median
nerve at the wrist.
Objectives: to test the benefit of steroid
irrigation of the wound to alleviate the post
operative pain.
Methods: Forty patients had carpal tunnel
release were divided into two groups with and
without steroid irrigation.
Results: Forty patients 38 female and 2 male
with forty CTS had open surgical release were
studied for postoperative pain at the wrist area.
Group 1 (patients treated with surgery alone)
and group 2 (patients treated with surgery and
steroid).In group1, 11 patients (55%) had
persistent agonizing pain at the ulnar side of
the wrist

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Publication Date
Fri Jun 03 2016
Journal Name
Iraqi Medical Journal
EVALUATION OF PATIENTS WITH CARPAL TUNNEL SYNDROME TREATED BY MINIMAL PALMAR INCISION (A PRELIMINARY STUDY)

Background : Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of upper extremities and Open carpal tunnel release is the most frequent surgical procedure and the gold standard for cases that do not respond to conservative treatment. Aims :This study is used to evaluate the functional outcome of limited palmar mini-incision of carpal tunnel release. This study aims to determine the safety and symptomatic and functional efficacy of median nerve decompression with limited incision in carpal tunnel syndrome surgery. Patients and methods:Carpal tunnel release with a 1.5-2 cm limited palmar incision was performed on 20 patients. Patients were evaluated initially at one month after treatment according to symptom severity

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Publication Date
Thu Dec 03 2015
Journal Name
Al- Kindy College Medical Journal
Proximal palmar mini-incision carpal tunnel release technique

Background: Carpal tunnel syndrome is the most common entrapment neuropathy in humans today. For patients in whom conservative treatment fails, surgical decompression is indicated. Various surgical techniques are becoming increasingly popular. Due to the rapid postoperative recovery shown after endoscopic operations, proximal palmar mini-incision for carpal tunnel release is a comparative alternative. Methods: Ninety four patients [113 hands] with a carpal tunnel syndrome underwent carpal tunnel release through a 1-cm longitudinal incision made just over the distal flexor crease. The self- administered Boston Questionnaire was used to assess the severity of patients’ symptoms and their functional status, both before and after the surgical

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Publication Date
Wed Dec 30 2015
Journal Name
Al-kindy College Medical Journal
Proximal palmar mini-incision carpal tunnel release technique

Background: Carpal tunnel syndrome is the most common entrapment neuropathy in humans today. For patients in whom conservative treatment fails, surgical decompression is indicated. Various surgical techniques are becoming increasingly popular. Due to the rapid postoperative recovery shown after endoscopic operations, proximal palmar mini-incision for carpal tunnel release is a comparative alternative.Methods: Ninety four patients [113 hands] with a carpal tunnel syndrome underwent carpal tunnel release through a 1-cm longitudinal incision made just over the distal flexor crease. The self- administered Boston Questionnaire was used to assess the severity of patients’ symptoms and their functional status, both before and after the surgic

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Publication Date
Tue Jan 01 2008
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The Role of White Blood Cells in Acute Coronary Syndrome

Background:
Inflammation has been shown to play a role in atherosclerosis and acute coronary syndromes. An elevated total WBC count has been associated with increased cardiovascular
risk, but which leukocyte subtypes carry this risk. is uncertain. This study was designed to determine the effect of WBC count and other inflammatory markers on severity and
outcome of patients with UA/NSTEMI.
Patients and Methods:
Seventy (70) patients with UA / NSTEMI admitted to CCU at the Iraqi Center for Heart Diseases were subjected to thorough history and physical examination and WBC indices to
find their relation to clinical severity and outcome for both in-hospital and/month after discharge. The results were comp

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