Cubital Tunnel Syndrome
Ulnar Nerve
Carpal Tunnel Syndrome
Decompression, Surgical
Ulnar Nerve Compression Syndromes
Tarsal Tunnel Syndrome
The wrist of the formula 1 driver. (1/23)
OBJECTIVES: During formula 1 driving, repetitive cumulative trauma may provoke nerve disorders such as nerve compression syndrome as well as osteoligament injuries. A study based on interrogatory and clinical examination of 22 drivers was carried out during the 1998 formula 1 World Championship in order to better define the type and frequency of these lesions. METHODS: The questions investigated nervous symptoms, such as paraesthesia and diminishment of sensitivity, and osteoligamentous symptoms, such as pain, specifying the localisation (ulnar side, dorsal aspect of the wrist, snuff box) and the effect of the wrist position on the intensity of the pain. Clinical examination was carried out bilaterally and symmetrically. RESULTS: Fourteen of the 22 drivers reported symptoms. One suffered cramp in his hands at the end of each race and one described a typical forearm effort compartment syndrome. Six drivers had effort "osteoligamentous" symptoms: three scapholunate pain; one medial hypercompression of the wrist; two sequellae of a distal radius fracture. Seven reported nerve disorders: two effort carpal tunnel syndromes; one typical carpal tunnel syndrome; one effort cubital tunnel syndrome; three paraesthesia in all fingers at the end of a race, without any objective signs. CONCLUSIONS: This appears to be the first report of upper extremity disorders in competition drivers. The use of a wrist pad to reduce the effects of vibration may help to prevent trauma to the wrist in formula 1 drivers. (+info)Stabilized subcutaneous transposition of the ulnar nerve. (2/23)
We treated 50 patients (average age 47.9 years) with a stabilized subcutaneous transposition of the ulnar nerve. The average follow-up period was 42.4 months. The indication was cubital tunnel syndrome in 19 patients and injuries around the elbow in 31 patients. Postoperatively, satisfactory results were obtained in all the patients, and there was no complication or aggravation of the preoperative symptoms. None of the patients experienced slipping back of the nerve to the cubital tunnel. In the 31 patients with injuries around the elbow, there was only one patient with transient aggravation of parasthaesiae in the ulnar nerve region. Stabilized subcutaneous transposition is a simple and less invasive procedure that can facilitate decompression and prevent slipping back of the nerve. This procedure also can be applied to patients with injuries around the elbow that require ulnar nerve transfer. (+info)Incidence of ulnar nerve entrapment at the elbow in repetitive work. (3/23)
OBJECTIVES: Despite the high frequency of work-related musculoskeletal disorders, the relation between work conditions and ulnar nerve entrapment at the elbow has not been the object of much research. In the present study, the predictive factors for such ulnar nerve entrapment were determined in a 3-year prospective survey of upper-limb work-related musculoskeletal disorders in repetitive work. METHODS: In 1993-1994 and 3 years later, 598 workers whose jobs involved repetitive work underwent an examination by their occupational health physicians and completed a self-administered questionnaire. Predictive factors associated with the onset of ulnar nerve entrapment at the elbow were studied with bivariate and multivariate analyses. RESULTS: The annual incidence was estimated at 0.8% per person-year, on the basis of 15 new cases during the 3-year period. Holding a tool in position was the only predictive biomechanical factor [odds ratio (OR) 4.1, 95% confidence interval (95% CI) 1.4-12.0]. Obesity increased the risk of ulnar nerve entrapment at the elbow (OR 4.3, 95% CI 1.2-16.2), as did the presence of medial epicondylitis, carpal tunnel syndrome, radial tunnel syndrome, and cervicobrachial neuralgia. The associations with "holding a tool in position" and obesity were unchanged when the presence of other diagnoses was taken into account. CONCLUSIONS: Despite the limitations of the study, the results suggest that the incidence of ulnar nerve entrapment at the elbow is associated with one biomechanical risk factor (holding a tool in position, repetitively), overweight, and other upper-limb work-related musculoskeletal disorders, especially medial epicondylitis and other nerve entrapment disorders (cervicobrachial neuralgia and carpal and radial tunnel syndromes). (+info)Pathogenesis and electrodiagnosis of cubital tunnel syndrome. (4/23)
BACKGROUND: Cubital tunnel syndrome is a well-recognized clinical condition and is the second most common peripheral compression neuropathy. This study was designed to investigate the causes of cubital tunnel syndrome by surgical means and to assess the clinical value of the neurophysiological diagnosis of cubital tunnel syndrome. METHODS: Twenty-one patients (involving a total of 22 limbs from 16 men and 5 women, aged 22 to 63, with a mean age of 49 years) with clinical symptoms and signs indicating a problem with their ulnar nerve underwent motor conduction velocity examinations at different sites along the ulnar nerve and examinations of sensory conduction velocity in the hand, before undergoing anterior transposition of the ulnar nerve. RESULTS: Electromyographic abnormalities were seen in 21 of 22 limbs [motor nerve conduction velocity (MCV) range (15.9 - 47.5) m/s, mean 32.7 m/s] who underwent motor conduction velocity examinations across the elbow segment of the ulnar nerve. Reduced velocity was observed in 13 of 22 limbs [MCV (15.7 - 59.6) m/s, mean 40.4 m/s] undergoing MCV tests in the forearms. An absent or abnormal sensory nerve action potential following stimulation was detected in the little finger of 14 of 22 limbs. The factors responsible for ulnar compression based on observations made during surgery were as follows: 15 cases involved compression by arcuate ligaments, muscle tendons, or bone hyperplasia; 2 involved fibrous adhesion; 3 involved compression by the venous plexus or a concurrent thick vein; 2 involved compression by cysts. CONCLUSIONS: Factors inducing cubital tunnel syndrome include both common factors that have been reported and rare factors, involving the venous plexus, thick veins, and cysts. Tests of motor conduction velocity at different sites along the ulnar nerve should be helpful in diagnosis cubital tunnel syndrome, especially MCV tests indicating decreased velocity across the elbow segment of the ulnar nerve. (+info)Simple neurolysis for failed anterior submuscular transposition of the ulnar nerve at the elbow. (5/23)
From 1996 to 2000, we reoperated nine patients totally dissatisfied after previous surgery for cubital tunnel syndrome. All patients had simple external neurolysis in situ of the transposed ulnar nerve. Only the anterior aspect of the ulnar nerve was dissected and released. Dense scarring around the ulnar nerve was found to be the main cause of recurrence but could not explain the three initial cases of persistent symptoms. All patients were reviewed 2 years after the secondary neurolysis. The patients were asked to describe their remaining symptoms and examination included palpation of the ulnar nerve at the elbow, Tinel's sign, two-point discrimination, and palpation of the scar. Pinch and grip strength were measured. According to the Wilson and Krout classification, there were four good results with complete alleviation of symptoms, four fair results, and one poor result. Simple neurolysis proved to be effective after failed anterior submuscular transposition of the ulnar nerve at the elbow. (+info)Surgical treatment for ulnar nerve entrapment at the elbow. (6/23)
The outcomes of 81 operations were assessed for the treatment of ulnar nerve entrapment at the elbow performed on 55 males (bilateral operations in one) and 25 females during the period from January 1995 to December 2000. Before operation, neurophysiological examination was performed in all patients. Simple ulnar nerve decompression or anterior transposition of the ulnar nerve (subcutaneous or intramuscular) was performed with or without the operating microscope. Nine patients were lost to follow up. The outcome was excellent or good in 63 of 72 cases, no change in eight cases, and poor in one case. The outcomes of procedures performed with the operating microscope tended to be superior. (+info)Cubital tunnel syndrome. (7/23)
Cubital tunnel syndrome is the second most common peripheral nerve entrapment syndrome in the human body. It is the cause of considerable pain and disability for patients. When appropriately diagnosed, this condition may be treated by both conservative and operative means. In this review, the current thinking on this important and common condition is discussed The recent literature on cubital tunnel syndrome was reviewed, and key papers on upper limb and hand surgery were discussed with colleagues. (+info)Risk factors for ulnar nerve compression at the elbow: a case control study. (8/23)
BACKGROUND: Ulnar nerve compression at the elbow is frequently encountered as the second most common compression neuropathy in the arm. As dexterity may be severely affected, the disease entity can seriously interfere with daily life and work. However, epidemiological research considering the risk factors is rarely performed. This study intended to investigate whether potential risk factors based on historical belief contribute to the development of ulnar nerve compression at the elbow. METHOD: A hospital based case control study was performed of patients that underwent surgical treatment for ulnar nerve compression at the elbow at the neurosurgical department from June 2004 until June 2005. Controls were those patients treated for a cervical or lumbar herniated disc. The main outcome measure was the presence of ulnar nerve compression at the elbow proven clinically, and electrodiagnostically. RESULTS: 110 patients with ulnar nerve lesions and 192 controls were identified. Smoking, education level and related working experience were identified as risk factors. Conversely, gender, BMI, alcohol consumption, trauma to the elbow, diabetes mellitus, and hypertension are not risk factors for the development of ulnar nerve compression at the elbow. CONCLUSION: Risk factors are clearly defined. In the past many factors have been described, but mostly in surgical series. This study concludes that gender, previous fracture of the elbow and BMI are not predictive factors for ulnar entrapment neuropathy. However, education and working experience are closely correlated with this entity. (+info)Cubital Tunnel Syndrome is a medical condition that affects the ulnar nerve, which runs down the arm and through a narrow tunnel inside the elbow, also known as the cubital tunnel. When this nerve becomes compressed or irritated in this area, it can lead to various symptoms such as numbness, tingling, and pain in the ring and little fingers, as well as weakness in the hand and forearm.
The condition is often caused by repetitive motion or prolonged pressure on the elbow, such as from leaning on the arm or bending the elbow for extended periods of time. In some cases, it may also be due to bone spurs, cysts, or other abnormalities that narrow the cubital tunnel and put pressure on the ulnar nerve.
Treatment for Cubital Tunnel Syndrome typically involves avoiding activities that aggravate the condition, wearing a splint or brace to keep the elbow straight during sleep, and taking anti-inflammatory medications to reduce swelling and pain. In more severe cases, surgery may be necessary to relieve pressure on the ulnar nerve and alleviate symptoms.
The Ulnar nerve is one of the major nerves in the forearm and hand, which provides motor function to the majority of the intrinsic muscles of the hand (except for those innervated by the median nerve) and sensory innervation to the little finger and half of the ring finger. It originates from the brachial plexus, passes through the cubital tunnel at the elbow, and continues down the forearm, where it runs close to the ulna bone. The ulnar nerve then passes through the Guyon's canal in the wrist before branching out to innervate the hand muscles and provide sensation to the skin on the little finger and half of the ring finger.
Carpal Tunnel Syndrome (CTS) is a common peripheral nerve disorder that affects the median nerve, which runs from the forearm into the hand through a narrow tunnel-like structure in the wrist called the carpal tunnel. The condition is caused by compression or pinching of the median nerve as it passes through this tunnel, leading to various symptoms such as numbness, tingling, and weakness in the hand and fingers.
The median nerve provides sensation to the thumb, index finger, middle finger, and half of the ring finger. It also controls some small muscles in the hand that allow for fine motor movements. When the median nerve is compressed or damaged due to CTS, it can result in a range of symptoms including:
1. Numbness, tingling, or burning sensations in the fingers (especially the thumb, index finger, middle finger, and half of the ring finger)
2. Pain or discomfort in the hand, wrist, or forearm
3. Weakness in the hand, leading to difficulty gripping objects or making a fist
4. A sensation of swelling or inflammation in the fingers, even if there is no visible swelling present
5. Nighttime symptoms that may disrupt sleep patterns
The exact cause of Carpal Tunnel Syndrome can vary from person to person, but some common risk factors include:
1. Repetitive hand and wrist motions (such as typing, writing, or using tools)
2. Prolonged exposure to vibrations (from machinery or power tools)
3. Wrist trauma or fractures
4. Pregnancy and hormonal changes
5. Certain medical conditions like diabetes, rheumatoid arthritis, and thyroid disorders
6. Obesity
7. Smoking
Diagnosis of Carpal Tunnel Syndrome typically involves a physical examination, medical history review, and sometimes specialized tests like nerve conduction studies or electromyography to confirm the diagnosis and assess the severity of the condition. Treatment options may include splinting, medication, corticosteroid injections, and in severe cases, surgery to relieve pressure on the median nerve.
Surgical decompression is a medical procedure that involves relieving pressure on a nerve or tissue by creating additional space. This is typically accomplished through the removal of a portion of bone or other tissue that is causing the compression. The goal of surgical decompression is to alleviate symptoms such as pain, numbness, tingling, or weakness caused by the compression.
In the context of spinal disorders, surgical decompression is often used to treat conditions such as herniated discs, spinal stenosis, or bone spurs that are compressing nerves in the spine. The specific procedure used may vary depending on the location and severity of the compression, but common techniques include laminectomy, discectomy, and foraminotomy.
It's important to note that surgical decompression is a significant medical intervention that carries risks such as infection, bleeding, and injury to surrounding tissues. As with any surgery, it should be considered as a last resort after other conservative treatments have been tried and found to be ineffective. A thorough evaluation by a qualified medical professional is necessary to determine whether surgical decompression is appropriate in a given case.
Ulnar nerve compression syndromes refer to a group of conditions characterized by the entrapment or compression of the ulnar nerve, leading to various symptoms. The ulnar nerve provides motor function to the hand muscles and sensation to the little finger and half of the ring finger.
There are several sites along the course of the ulnar nerve where it can become compressed, resulting in different types of ulnar nerve compression syndromes:
1. Cubital Tunnel Syndrome: This occurs when the ulnar nerve is compressed at the elbow, within the cubital tunnel - a narrow passage located on the inner side of the elbow. Symptoms may include numbness and tingling in the little finger and half of the ring finger, weakness in gripping or pinching, and pain or discomfort in the elbow.
2. Guyon's Canal Syndrome: This type of ulnar nerve compression syndrome happens when the nerve is compressed at the wrist, within the Guyon's canal. Causes can include ganglion cysts, bone fractures, or repetitive motion injuries. Symptoms may include numbness and tingling in the little finger and half of the ring finger, weakness or paralysis in the hand muscles, and muscle wasting in severe cases.
Treatment for ulnar nerve compression syndromes depends on the severity and location of the compression. Conservative treatments such as physical therapy, bracing, or anti-inflammatory medications may be recommended for milder cases. Severe or persistent symptoms may require surgical intervention to relieve the pressure on the ulnar nerve.
Tarsal Tunnel Syndrome (TTS) is a compressive neuropathy of the tibial nerve as it passes through the tarsal tunnel, a fibro-osseous canal formed by the medial malleolus and the talus bones on the inner ankle. The tibial nerve and its branches provide sensory innervation to the sole of the foot and motor function to several muscles in the lower leg and foot.
In TTS, increased pressure or compression within the tarsal tunnel leads to entrapment of the tibial nerve or its branches, resulting in pain, numbness, tingling, or burning sensations along the distribution of the affected nerves. Common causes include space-occupying lesions (e.g., ganglion cysts, varicosities), trauma, tenosynovitis, or systemic conditions like diabetes and rheumatoid arthritis.
Diagnosis typically involves a thorough clinical examination, including the patient's history, physical examination, and specialized tests such as nerve conduction studies and electromyography (EMG). Treatment options may include conservative measures like immobilization, orthotics, nonsteroidal anti-inflammatory drugs (NSAIDs), or corticosteroid injections. In severe cases or when conservative treatments fail, surgical decompression of the tarsal tunnel might be necessary to alleviate symptoms and prevent further nerve damage.