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Bîrsanu L, Vulpoi GA, Cuciureanu DI, Antal CD, Popescu IR, Turliuc DM. Carpal tunnel syndrome related to rheumatic disease (Review). Exp Ther Med 2024; 28:389. [PMID: 39161613 PMCID: PMC11332155 DOI: 10.3892/etm.2024.12678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 07/16/2024] [Indexed: 08/21/2024] Open
Abstract
Carpal tunnel syndrome (CTS) is the most commonly occurring type of entrapment neuropathy in the world. Several conditions may contribute to the development of CTS, such as obesity, repetitive wrist movements, pregnancy, genetic predisposition and rheumatoid arthritis (RA) inflammation. CTS is characterized by a wide range of pathophysiological factors, including increased pressure, mechanical trauma and ischemic damage to the median nerve that runs through the wrist tunnel. In the present narrative literature review, the way rheumatic diseases (RDs) contribute to CTS occurrence is investigated. The epidemiological, clinical, paraclinical and pathogenesis aspects of the relationship are examined. CTS is the most common neurological finding in RA, and incidences of RA, psoriatic arthritis and CTS are closely related. The association of CTS with systemic lupus erythematosus, Sjögren's syndrome, Behcet's disease and systemic sclerosis is weaker. In these cases, the prevalence of CTS is similar to that in the general population. As the occurrence of CTS is increasing, understanding the common mechanism and making an early diagnosis are required to limit pain and costs. When patients with RD present with symptoms such as wrist pain, tingling sensations or numbness in their fingers, CTS should be suspected. This suspicion should not be interpreted in terms of RD. To accurately evaluate patients with RD, a detailed electrophysiological examination should be included in the evaluation process. A diagnostic algorithm should include neuromuscular ultrasound or magnetic resonance imaging for patients with RD.
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Affiliation(s)
- Lenuța Bîrsanu
- Faculty of Medicine, University of Medicine and Pharmacy ‘Grigore T. Popa’, Iași 700115, Romania
- Department of Neurology, Clinical Rehabilitation Hospital, Iași 700081, Romania
| | - Georgiana-Anca Vulpoi
- Faculty of Medicine, University of Medicine and Pharmacy ‘Grigore T. Popa’, Iași 700115, Romania
- Dorna Medical Clinic, Iași 700022, Romania
| | - Dan Iulian Cuciureanu
- Faculty of Medicine, University of Medicine and Pharmacy ‘Grigore T. Popa’, Iași 700115, Romania
- Neurology Department 1, Clinical Emergency Hospital ‘Prof. Dr. Nicolae Oblu’, Iași 700309, Romania
| | - Cristian Dorin Antal
- Faculty of Medicine, University of Medicine and Pharmacy ‘Grigore T. Popa’, Iași 700115, Romania
- Department of Neurology, Clinical Rehabilitation Hospital, Iași 700081, Romania
| | - Ionut Raducu Popescu
- Faculty of Medicine, University of Medicine and Pharmacy ‘Grigore T. Popa’, Iași 700115, Romania
| | - Dana Mihaela Turliuc
- Faculty of Medicine, University of Medicine and Pharmacy ‘Grigore T. Popa’, Iași 700115, Romania
- Neurosurgery Department 2, Clinical Emergency Hospital ‘Prof. Dr. Nicolae Oblu’, Iasi 700309, Romania
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AlKhodier H, Alqahtani M, Alshenaifi A, Alnuwaiser M. Prevalence of First Carpometacarpal Joint Osteoarthritis and Carpal Tunnel Syndrome Among Dentists in Saudi Arabia. Cureus 2022; 14:e23876. [PMID: 35530881 PMCID: PMC9074908 DOI: 10.7759/cureus.23876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2022] [Indexed: 01/09/2023] Open
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Kayani B, Konan S, Huq SS, Ibrahim MS, Ayuob A, Haddad FS. The learning curve of robotic-arm assisted acetabular cup positioning during total hip arthroplasty. Hip Int 2021; 31:311-319. [PMID: 31838874 DOI: 10.1177/1120700019889334] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Robotic-arm assisted surgery aims to reduce manual errors and improve the accuracy of implant positioning and orientation during total hip arthroplasty (THA). The objective of this study was to assess the surgical team's learning curve for robotic-arm assisted acetabular cup positioning during THA. METHODS This prospective cohort study included 100 patients with symptomatic hip osteoarthritis undergoing primary total THA performed by a single surgeon. This included 50 patients receiving conventional manual THA and 50 patients undergoing robotic-arm assisted acetabular cup positioning during THA. Independent observers recorded surrogate markers of the learning curve including operative times, confidence levels amongst the surgical team using the state-trait anxiety inventory (STAI) questionnaire, accuracy in restoring native hip biomechanics, acetabular cup positioning, leg-length discrepancy, and complications within 90 days of surgery. RESULTS Cumulative summation (CUSUM) analysis revealed robotic-arm assisted acetabular cup positioning during THA was associated with a learning curve of 12 cases for achieving operative times (p < 0.001) and surgical team confidence levels (p < 0.001) comparable to conventional manual THA. There was no learning curve of robotic-arm assisted THA for accuracy of achieving the planned horizontal (p = 0.83) and vertical (p = 0.71) centres of rotation, combined offset (p = 0.67), cup inclination (p = 0.68), cup anteversion (p = 0.72), and correction of leg-length discrepancy (p = 0.61). There was no difference in postoperative complications between the two treatment groups. CONCLUSIONS Integration of robotic-arm assisted acetabular cup positioning during THA was associated with a learning curve of 12 cases for operative times and surgical team confidence levels but there was no learning curve effect for accuracy in restoring native hip biomechanics or achieving planned acetabular cup positioning and orientation.
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Affiliation(s)
- Babar Kayani
- University College Hospital, London, UK.,Princess Grace Hospital, London, UK
| | - Sujith Konan
- University College Hospital, London, UK.,Princess Grace Hospital, London, UK
| | - Sumon S Huq
- University College Hospital, London, UK.,Princess Grace Hospital, London, UK
| | - Mazin S Ibrahim
- University College Hospital, London, UK.,Princess Grace Hospital, London, UK
| | - Atif Ayuob
- University College Hospital, London, UK.,Princess Grace Hospital, London, UK
| | - Fares S Haddad
- University College Hospital, London, UK.,Princess Grace Hospital, London, UK
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Associations between hand function and electrophysiological measurements in hand osteoarthritis patients of different ages with or without carpal tunnel syndrome. Sci Rep 2020; 10:19278. [PMID: 33159094 PMCID: PMC7648779 DOI: 10.1038/s41598-020-74795-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 09/29/2020] [Indexed: 12/31/2022] Open
Abstract
Osteoarthritis is a common degenerative disease that most frequently involves the hand. The objective was to compare clinical functional outcome measures including hand grip, pinch strength, and dexterity with various electrophysiological measures in patients of different ages with hand osteoarthritis with or without the presence of carpal tunnel syndrome (CTS). Patients with hand osteoarthritis (208 patients, 404 hands) who underwent hand-function tests and motor and sensory nerve conduction studies (NCS) between June 2015 and June 2016 were enrolled. The patients' hands were assigned to carpal tunnel syndrome (CTS) (206 hands; mean age, 56.37 ± 10.52; male:female, 46:160) or control groups (198 hands; mean age, 57.88 ± 9.68; male:female, 55:143). The strength of hand grip and lateral pinch, the time required to complete the nine-hole pegboard test (9HPT), and motor and sensory nerve conduction parameters were measured and compared across age groups and between hands with or without CTS. The CTS group showed significantly lower hand grip and lateral pinch strength, and a longer time to complete the 9HPT in comparison with the control group. Female patients showed significantly lower hand grip and lateral pinch strength than male patients. However, there was no difference in the 9HPT completion time between genders. Multivariate regression analysis identified the amplitude of the median compound muscle action potential (CMAP), age, and male gender as independent predictors of grip strength (adjusted R2 = 0.679), and amplitude of median CMAP and male gender as independent predictors of KP strength (adjusted R2 = 0.603). Velocity of median CMAP, amplitude of median sensory nerve action potential, and age were identified as independent predictors of 9HPT time (adjusted R2 = 0.329). Nerve conduction measurements were significantly related to hand-function test results, and CTS induced significant deficits in strength and performance of the affected hand.
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Smith CS, Mollon B, Vannabouathong C, Fu JM, Sales B, Bhandari M, Whelan DB. An Assessment of Randomized Controlled Trial Quality in The Journal of Bone & Joint Surgery: Update from 2001 to 2013. J Bone Joint Surg Am 2020; 102:e116. [PMID: 33086352 DOI: 10.2106/jbjs.18.00653] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The quality of reporting of randomized controlled trials (RCTs) published in The Journal of Bone & Joint Surgery (JBJS) from 1988 to 2000 was previously analyzed. The purpose of this current study was to analyze the quality of reporting of RCTs published in JBJS from 2001 to 2013 to identify trends over time and potential areas of improvement for future clinical trials. METHODS A manual search of the JBJS database identified RCTs published between January 2001 and December 2013. Quality assessments, using the Detsky quality-of-reporting index (Detsky score), a modified Cochrane risk-of-bias tool, and abstraction of relevant data identifying predictors of quality, were conducted. RESULTS A total of 5,780 publications were identified in JBJS from 2001 to 2013, with 285 RCTs (4.9%), representing an increase from the prior 13-year period. The overall mean transformed Detsky score (and standard error) increased significantly (p < 0.001) from 68.1% ± 1.67% to 76.24% ± 0.72%. The percentage of multicenter RCTs decreased from 67% to 31%. The percentage of positive trials also decreased from 80% to 50.5%, as did the mean sample size (212 to 166). Regression analysis indicated that trials with an epidemiologist as the first author and nonsurgical trials were significantly associated (p = 0.001) with a higher overall trial quality score. The categories of the lowest mean methodology scores were randomization and concealment, eligibility criteria, and reasons for patient exclusion, as identified with the Detsky score, and patient and assessor blinding, as identified with the risk-of-bias assessment. CONCLUSIONS The quantity and quality of published RCTs in JBJS have increased in the 2001 to 2013 time period compared with the previous time period. Although these improvements are encouraging, trends to smaller, single-center trials were also observed. To efficiently determine the efficacy of orthopaedic treatments and limit bias, high-quality randomized trials of appropriate sample size and rigorous design are needed.
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Affiliation(s)
| | - Brent Mollon
- Soldiers' Memorial Hospital, Orillia, Ontario, Canada
| | | | - Joyce M Fu
- Department of Orthopaedics, University of Toronto, Toronto, Ontario, Canada
| | | | - Mohit Bhandari
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Daniel B Whelan
- University of Toronto Orthopaedic Sports Medicine, St. Michael's and Women's College Hospitals, Toronto, Ontario, Canada
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Chan CM, Cisneros EF, M T. Trapeziometacarpal Joint Arthroplasty of the Thumb without Osseous Tunnels and Carpal Tunnel Release via a Radial Approach; Technique, and Results. Surg J (N Y) 2019; 5:e120-e125. [PMID: 31555744 PMCID: PMC6759417 DOI: 10.1055/s-0039-1697635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 08/07/2019] [Indexed: 11/20/2022] Open
Abstract
Background
Numerous surgeries have been described for osteoarthritis of the trapeziometacarpal (TMC) joint. We describe the senior author's experience with his technique of concurrent arthroplasty of the TMC joint, and carpal tunnel release (CTR) via a radial approach.
Methods
The study is a case series of patients managed over a 3-year period. We included 86 patients over 40 years of age that had concurrent CTR. We used the paired
t
-test to compare the preoperative and postoperative grip strength and functional scoring (including the Levine-Katz questionnaire for carpal tunnel syndrome, disabilities of the arm shoulder and hand [DASH] score and QuickDASH9).
Results
Mean age at surgery was 62.8 years, and mean follow-up was 13.1 months. Functional outcomes were analyzed in 65 patients. Grip strength returned to the preoperative measurement by 3 months. Analysis of the nine patients followed up for more than 13 months postoperatively showed a significant increase in grip strength at last follow-up. The grip strength in both hands was also similar beyond 13 months. Significant decreases in the functional scores recorded indicated a reduction in disability, symptom severity, and functional impairment.
Conclusions
In conclusion, we present the favorable results of this technique of TMC arthroplasty and CTR involving no bone tunnels and short-term immobilization.
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Affiliation(s)
- Chung Ming Chan
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida
| | | | - Tsai M
- Department of Orthopedics, Hospital Español de México, Mexico City, Mexico
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Kayani B, Konan S, Chandramohan R, Haddad FS. The direct superior approach in total hip arthroplasty. Br J Hosp Med (Lond) 2019; 80:320-324. [DOI: 10.12968/hmed.2019.80.6.320] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The direct superior approach is a modification of the minimally invasive posterior approach for total hip arthroplasty which preserves the iliotibial band and external rotators except for the piriformis or conjoint tendon. This review explores the existing scientific evidence on clinical, functional and radiological outcomes in total hip arthroplasty performed using the direct superior approach. The direct superior approach reduces iatrogenic periarticular soft tissue injury compared to the direct anterior approach for total hip arthroplasty. The learning curve for the direct superior approach is 40 operative cases with operative times comparable to those of conventional approaches for total hip arthroplasty after surgical proficiency has been achieved. The direct superior approach provides improvements in pain and short-term functional outcomes after total hip arthroplasty as assessed using the Harris Hip Score. The minimally invasive posterior approach provides comparable pain scores and improved University of California, Los Angeles (UCLA) activity scale functional scores to the direct superior approach at 1-year follow up. Existing studies using plain radiographs have shown that the direct superior approach enables accurate femoral and acetabular implant positioning.
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Affiliation(s)
- Babar Kayani
- Specialist Registrar in Trauma and Orthopaedics, Department of Trauma and Orthopaedics, University College London Hospital, London NW1 2BU
| | - Sujith Konan
- Consultant Orthopaedic Surgeon, Department of Trauma and Orthopaedics, University College London Hospital, London
| | - Raja Chandramohan
- Clinical Research Fellow, Department of Trauma and Orthopaedics, University College London Hospital, London
| | - Fares S Haddad
- Professor of Orthopaedics and Sports Surgery and Consultant Orthopaedic Surgeon, Department of Trauma and Orthopaedics, University College London Hospital, London
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Abstract
OBJECTIVES The primary objective of this study was to compare accuracy in restoring the native centre of hip rotation in patients undergoing conventional manual total hip arthroplasty (THA) versus robotic-arm assisted THA. Secondary objectives were to determine differences between these treatment techniques for THA in achieving the planned combined offset, component inclination, component version, and leg-length correction. MATERIALS AND METHODS This prospective cohort study included 50 patients undergoing conventional manual THA and 25 patients receiving robotic-arm assisted THA. Patients undergoing conventional manual THA and robotic-arm assisted THA were well matched for age (mean age, 69.4 years (sd 5.2) vs 67.5 years (sd 5.8) (p = 0.25); body mass index (27.4 kg/m2 (sd 2.1) vs 26.9 kg/m2 (sd 2.2); p = 0.39); and laterality of surgery (right = 28, left = 22 vs right = 12, left = 13; p = 0.78). All operative procedures were undertaken by a single surgeon using the posterior approach. Two independent blinded observers recorded all radiological outcomes of interest using plain radiographs. RESULTS The correlation coefficient was 0.92 (95% confidence interval (CI) 0.88 to 0.95) for intraobserver agreement and 0.88 (95% CI 0.82 to 0.94) for interobserver agreement in all study outcomes. Robotic THA was associated with improved accuracy in restoring the native horizontal (p < 0.001) and vertical (p < 0.001) centres of rotation, and improved preservation of the patient's native combined offset (p < 0.001) compared with conventional THA. Robotic THA improved accuracy in positioning of the acetabular component within the combined safe zones of inclination and anteversion described by Lewinnek et al (p = 0.02) and Callanan et al (p = 0.01) compared with conventional THA. There was no difference between the two treatment groups in achieving the planned leg-length correction (p = 0.10). CONCLUSION Robotic-arm assisted THA was associated with improved accuracy in restoring the native centre of rotation, better preservation of the combined offset, and more precise acetabular component positioning within the safe zones of inclination and anteversion compared with conventional manual THA.
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Affiliation(s)
- B Kayani
- University College Hospital, London, UK and Princess Grace Hospital, London, UK
| | - S Konan
- University College Hospital, London, UK and Princess Grace Hospital, London, UK
| | - R R Thakrar
- University College Hospital, London, UK and Princess Grace Hospital, London, UK
| | - S S Huq
- University College Hospital, London, UK and Princess Grace Hospital, London, UK
| | - F S Haddad
- University College London Hospitals, The Princess Grace Hospital, and The NIHR Biomedical Research Centre at UCLH, London, UK
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Park YD, Park YJ, Park SS, Lee HL, Moon HH, Kim MK. Effects of taping therapy for carpal space expansion on electrophysiological change in patients with carpal tunnel syndrome. J Exerc Rehabil 2017. [PMID: 28702450 PMCID: PMC5498095 DOI: 10.12965//jer.1735002.501] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Taping therapy is one of the most conservative treatments for carpal tunnel syndrome (CTS). Preceding research studied on pain control, grip strength, and wrist function but no studies have been reported on electrophysiolgical changes after taping therapy. The aim of this study is to evaluate the effects of taping therapy for carpal space expansion on electrophysiological in 20 female patients aged from 40s to 60s with CTS. Experimental group applied taping therapy for carpal space expansion twice a week for 4 weeks and control group did not. There were significant differences between distal motor latency (DML) and sensory nerve conduction velocity (SNCV), but no difference between compound muscle action potential and sensory nerve action potential (SNAP) after 4 weeks taping treatment. Also, there was a significant difference in DML, SNCV, and SNAP in between groups. In conclusion, taping therapy for carpal space expansion can help to reduce the pressure of the carpal tunnel in CTS patients with mild symptoms.
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Affiliation(s)
- Yeong-Dong Park
- School of Global Sport Studies, Korea University, Sejong, Korea
| | - Yun-Jin Park
- School of Global Sport Studies, Korea University, Sejong, Korea
| | - Sang-Seo Park
- School of Global Sport Studies, Korea University, Sejong, Korea
| | - Hae-Lim Lee
- School of Global Sport Studies, Korea University, Sejong, Korea
| | - Hyeong-Hun Moon
- Department of Sports Medicine, CHA University, Pocheon, Korea
| | - Myung-Ki Kim
- School of Global Sport Studies, Korea University, Sejong, Korea
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Meermans G, Doorn JV, Kats JJ. Restoration of the centre of rotation in primary total hip arthroplasty: the influence of acetabular floor depth and reaming technique. Bone Joint J 2017; 98-B:1597-1603. [PMID: 27909120 DOI: 10.1302/0301-620x.98b12.bjj-2016-0345.r1] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 08/16/2016] [Indexed: 01/14/2023]
Abstract
AIMS One goal of total hip arthroplasty is to restore normal hip anatomy. The aim of this study was to compare displacement of the centre of rotation (COR) using a standard reaming technique with a technique in which the acetabulum was reamed immediately peripherally and referenced off the rim. PATIENTS AND METHODS In the first cohort the acetabulum was reamed to the floor followed by sequentially larger reamers. In the second cohort the acetabulum was only reamed peripherally, starting with a reamer the same size as the native femoral head. Anteroposterior pelvic radiographs were analysed for acetabular floor depth and vertical and horizontal position of the COR. RESULTS Horizontally, the mean medial displacement of the COR was 0.8 mm (standard deviation (sd) 1.4) in the peripheral remaing group and 5.0 mm (sd 3.30) in the standard reaming group (p < 0.001). Vertically, the mean superior displacement of the COR was 0.7 mm (sd 1.3) in the peripheral reaming group and 3.7 mm (sd 2.6) in the standard reaming group (p < 0.001). In the standard reaming group, there was a strong correlation between the pre-operative acetabular floor depth and displacement of the COR (p < 0.001). CONCLUSION Reaming the acetabulum to the floor can lead to significant displacement of the COR medially and superiorly. This displacement is related to the pre-operative acetabular floor depth and cannot always be compensated by using a high offset stem. Cite this article: Bone Joint J 2016;98-B:1597-603.
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Affiliation(s)
- G Meermans
- Bravis Hospital, Boerhaaveplein 1, 4624VT Bergen op Zoom, The Netherlands
| | - J Van Doorn
- Bravis Hospital, Boerhaaveplein 1, 4624VT Bergen op Zoom, The Netherlands
| | - J-J Kats
- Bravis Hospital, Boerhaaveplein 1, 4624VT Bergen op Zoom, The Netherlands
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Affiliation(s)
- Seok-Woo Hong
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Hyun-Sik Gong
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Padua L, Coraci D, Erra C, Pazzaglia C, Paolasso I, Loreti C, Caliandro P, Hobson-Webb LD. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol 2016; 15:1273-1284. [PMID: 27751557 DOI: 10.1016/s1474-4422(16)30231-9] [Citation(s) in RCA: 391] [Impact Index Per Article: 48.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 08/05/2016] [Accepted: 08/12/2016] [Indexed: 12/16/2022]
Abstract
Carpal tunnel syndrome is the most common peripheral nerve entrapment syndrome worldwide. The clinical symptoms and physical examination findings in patients with this syndrome are recognised widely and various treatments exist, including non-surgical and surgical options. Despite these advantages, there is a paucity of evidence about the best approaches for assessment of carpal tunnel syndrome and to guide treatment decisions. More objective methods for assessment, including electrodiagnostic testing and nerve imaging, provide additional information about the extent of axonal involvement and structural change, but their exact benefit to patients is unknown. Although the best means of integrating clinical, functional, and anatomical information for selecting treatment choices has not yet been identified, patients can be diagnosed quickly and respond well to treatment. The high prevalence of carpal tunnel syndrome, its effects on quality of life, and the cost that disease burden generates to health systems make it important to identify the research priorities that will be resolved in clinical trials.
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Affiliation(s)
- Luca Padua
- Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, Rome, Italy; Don Carlo Gnocchi Onlus Foundation, Milan, Italy.
| | - Daniele Coraci
- Don Carlo Gnocchi Onlus Foundation, Milan, Italy; Board of Physical Medicine and Rehabilitation, Department of Orthopaedic Science, "Sapienza" University, Rome, Italy
| | - Carmen Erra
- Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | | | | | - Pietro Caliandro
- Institute of Neurology, Policlinico A Gemelli Foundation University Hospital, Rome, Italy
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Kim JH, Gong HS, Kim YH, Rhee SH, Kim J, Baek GH. Evaluation of Radiographic Instability of the Trapeziometacarpal Joint in Women With Carpal Tunnel Syndrome. J Hand Surg Am 2015; 40:1298-302. [PMID: 26050203 DOI: 10.1016/j.jhsa.2015.04.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 04/15/2015] [Accepted: 04/15/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine whether median nerve dysfunction measured by electrophysiologic studies in carpal tunnel syndrome (CTS) is associated with thumb trapeziometacarpal (TMC) joint instability. METHODS We evaluated 71 women with CTS and 31 asymptomatic control women. Patients with generalized laxity or TMC joint osteoarthritis were excluded. We classified the electrophysiologic severity of CTS based on nerve conduction time and amplitude and assessed radiographic instability of the TMC joint based on TMC joint stress radiographs. We compared subluxation ratio between patients with CTS and controls and performed correlation analysis of the relationship between the electrophysiologic grade and subluxation ratio. RESULTS Thirty-one patients were categorized into the mild CTS subgroup and 41 into the severe CTS subgroup. There was no significant difference in subluxation ratio between the control group and CTS patients or between the control group and CTS subgroup patients. Furthermore, there was no significant correlation between electrophysiologic grade and subluxation ratio. CONCLUSIONS This study demonstrated that patients with CTS did not have greater radiographic TMC joint instability compared with controls, and suggests that TMC joint stability is not affected by impaired median nerve function. Further studies could investigate how to better evaluate proprioceptive function of TMC joint and whether other nerves have effects on TMC joint motor/proprioceptive function, to elucidate the relationship between neuromuscular control of the TMC joint, its stability, and its progression to osteoarthritis. TYPE OF STUDY/LEVEL OF EVIDENCE Diagnostic II.
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Affiliation(s)
- Jeong Hwan Kim
- Department of Orthopedic Surgery, Seoul Medical Center, Seoul, Korea
| | - Hyun Sik Gong
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
| | - Youn Ho Kim
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Seung Hwan Rhee
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Jihyoung Kim
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Goo Hyun Baek
- Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea
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Douis H, Singh L, Saifuddin A. MRI differentiation of low-grade from high-grade appendicular chondrosarcoma. Eur Radiol 2013; 24:232-40. [DOI: 10.1007/s00330-013-3003-y] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 08/11/2013] [Indexed: 11/28/2022]
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