Diagnosis and Management of Carpal Tunnel Syndrome Caused by Local Lesions

Cho,  Joong Mo; Nam,  Hyun Jae; Kim,  Kyung Chul; Woo,  Sang Hyun

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Original Article

Journal of the Korean Society for Surgery of the Hand 2012;17(1):37-42.
Published online March 1, 2012.

Diagnosis and Management of Carpal Tunnel Syndrome Caused by Local Lesions

Joong Mo Cho, Hyun Jae Nam, Kyung Chul Kim, Sang Hyun Woo

Kim & Woo's Institute for Hand Surgery and Reconstructive Microsurgery, W Hospital, Daegu, Korea. handwoo@hotmail.com

Abstract

Purpose
To discuss the diagnosis and treatment of nonidiopathic carpal tunnel syndrome (CTS) caused by variable local lesions. MATERIALS AND METHODS: Fifteen patients who underwent surgery for CTS caused by local lesions were studied. The average age was 53.3 years. There were 5 men and 10 women. Plain radiographs including carpal tunnel view and ultrasonography were routinely performed, and magnetic resonance imaging and computed tomography were taken in selected cases. Carpal tunnel release were done by a single surgeon.

Results
Lesions causing CTS included calcification in five cases, ganglion in two, malunion after distal radius fracture in one, osteophyte of carpal bone in one, tuberculosis tenosynovitis in one, synovitis by foreign body in one, acute lunate dislocation in one, lipoma in two, median artery in one. Following surgery, all cases showed alleviation of symptoms.

Conclusion
Prior to surgical decompression of CTS, it is important to assess any lesion around median nerve and carpal tunnel through physical examination, radiographs including carpal tunnel view and ultrasonography.

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