Sonographic short-term follow-up after surgical decompression of the median nerve at the carpal tunnel: a single-center prospective observational study

• Main Author: Tas, Süleyman
• Format: Doctoral or Postdoctoral Thesis
• Language: English
• Published: 2020
• Subjects: ddc:610; The Thumb; Thumb; DML
• Online Access: http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/53214; https://nbn-resolving.org/urn:nbn:de:hebis:30:3-532149; http://publikationen.ub.uni-frankfurt.de/files/53214/Dissertation_Tas_24.02.2020.pdf

The carpal tunnel syndrome (CTS) is a chronic compression of the median nerve in the carpal tunnel, a condition in which the nerve is constricted especially under the flexor retinaculum (FR). The disease predominantly appears between 40 and 83 years of age. Women are significantly more often affected than men. The same applies to overweight people in comparison to normal weight people. Abnormal sensations at night, including paresthesias and dysesthesias, are classical CTS symptoms, predominately involving the middle fingers, later also the thumb. Diagnosis of CTS usually proceeds by motor nerve conduction study (mNCS) and determination of the distal motoric latency (DML). In conformity with electrophysiology, peripheral nerve ultrasonography has also attained an important diagnostic informative value. In principle, there is an open surgical procedure and an endoscopic carpal roof cleavage. The goal of therapy is the complete open division of the flexor retinaculum (FR) in order to relieve the median nerve from compression. This work examines the morphological alterations of the median nerve at the site of the carpal tunnel after surgical decompression by means of high-resolution neurosonography in the scope of a prospective study. More than 100 patients were examined between October and December 2014 for planned decompressions surgery due to CTS. A total of 81 patients were prospectively included, 5 of which could not take part in the follow-up after six months and were excluded from this evaluation. A medical CTS case history, clinical examination findings, as well as a neurographic result were included. Patients with a relapse operation were not considered in this regard. Apart from a clinical examination and questioning of the patient three and six months after surgery, an electrophysiological examination and a high-resolution sonography of the median nerve were also carried out. Electroneurography and nerve sonography of the median nerve were applied to both hands. A prolonged distal motor latency of the ...