Carpal Tunnel Syndrome (Google eBook)

Front Cover
Springer Science & Business Media, Jan 1, 2008 - Medical - 432 pages
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Carpal Tunnel Syndrome, with its surgical profile, is a must for those specialising in this condition (hand surgeons, orthopaedic surgeons, plastic surgeons, physiatrists and hand physical therapists), for both experts and newcomers to this field. For the young surgeon just starting out, the book explains the technical modalities of surgical treatment for this condition and describes alternative non-surgical procedures. It also depicts the complications that can arise in treatment. For more experienced surgeons, this book is an instrument for deepening their knowledge of this condition and its management. It can be considered a moment for reflection on a condition that is erroneously considered simple to treat and easy to resolve. The surgical chapters compare various complications as well as various conservative and rehabilitative treatment options, thus underlining that this condition must not be underestimated. Incorrect treatment can have many negative ramifications: not only that the patient is dissatisfied but it can also lead to the handís functional loss and render the patient an invalid. This book is also intended for all physicians and medical students interested in this subject, presenting the broad range of problems caused by this condition and how best to manage them.
  

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Contents

History of Carpal Tunnel Syndrome
3
References
8
Anatomy of the Carpal Tunnel
10
References
12
Normal Anatomy and Variations of the Median Nerve in the Carpal Tunnel
13
Median Nerve
15
Median Nerve Branches
17
References
19
Complications and Results
206
The Modified Retinaculotome MDC
207
References
208
Closed Carpal Tunnel Release Technique with GRS
211
Control of Correct Position of the Guide
213
Surgical Technique
214
Postoperative Treatment
218
References
219

Etiopathogenesis
21
Secondary Form
22
Summary of CTS Causes
25
The Pathophysiology of Median Nerve Compression
28
Pathophysiology
32
Stages of Compressive Nerve Injuries
38
Conclusion
39
References
40
IschemiaReperfusion Injury as a Common Etiology of Idiopathic Carpal Tunnel Syndrome Biochemical and Immunohistochemical Evidence
42
Biochemical Factors
43
Histologic Factors
45
Discussion
46
Carpal Canal Pressure Measurements Literature Review and Clinical Implications
49
Dynamic Evaluation
52
Endocanalar Pressure Wrist Posturing Splints Used During Activities of Daily Living
55
Conclusion
57
Clinical Implications
58
Diagnosis
60
Clinical Diagnosis
63
Neurophysiological Assessment of Carpal Tunnel Syndrome
69
The Neurophysiological Examination
70
Sensory Median to Ulnar and Median to Radial Nerve Fibers
71
Needle Electromyography
72
Conclusions
73
Diagnostic Imaging
75
Postsurgery Findings
77
Ultrasound Studies
78
References
80
Quantitative Assessment of Historical and Objective Findings A New Clinical Severity Scale of CTS
82
Historical Findings
84
Validation of the Measurement
85
Conclusions
87
Differential Diagnosis of Carpal Tunnel Syndrome
89
Carpal Tunnel Syndrome Rare Causes
95
Traumatic Lesions
96
Recurrent Focal Neuropathies
97
Endocrine Disorders
98
Blood Coagulation Disorders
99
References
100
Treatment
102
Conservative Care for Carpal Tunnel Syndrome
105
ExerciseModalities
107
Corticosteroid Injections
108
Conclusion
109
The Cutaneous Innervation of the Palm and Its Implications During Carpal Tunnel Release Surgery
111
Summary
113
Traditional Technique WristPalm Incision
115
Indications
116
Contraindications
119
Postoperative Care
120
Palmar Incision
121
Authors Preferred Technique
122
Additional Technical Procedure
127
Summary and Suggestions
128
References
129
Open Carpal Tunnel Release with a Short Palmar Incision and No Specialized Instruments Combined with a Rehabilitation Program for Early Return t...
130
Surgical Anesthesia
131
Immediate Postoperative Rehabilitation
132
ReturntoWork Intervals
133
References
134
The MiniInvasive Technique for Carpal Tunnel Release Open Approach with Converse Fiberoptic Light Retractor
135
MiniInvasive Technique
136
Comments and Conclusions
138
The Indiana Tome for Carpal Tunnel Release
140
Indications
141
Advice
145
References
146
Alternative Techniques and Variants Double Approach Proximal and Distal MiniIncisions
147
Discussion
149
References
150
Anatomic Landmarks for Endoscopic Carpal Tunnel Release
151
Technique
152
References
155
Endoscopic Carpal Tunnel Release
156
Alternative Chow Technique
164
Endoscopic Technique The Gilbert Technique or Technique by Two Different Portals
166
Indications and Contraindications
168
Conclusion
169
References
170
Endoscopic Carpal Tunnel Release
171
SinglePortal Technique Modified from Agee
172
Efficacy
174
Authors Recommendations
175
Endoscopic Carpal Tunnel Release Menons Technique
177
Surgical Anatomy
178
Surgical Technique
179
Postoperative Treatment
183
Discussion
184
The Distal Single Incision ScopeAssisted Carpal Tunnel Release ThirteenYear FollowUp Results
186
Results
189
Discussion
192
Conclusion
193
Carpal Tunnel Release with Limited Visualization
194
Indications Contraindications
198
Results
199
Closed Technique With Paine Retinaculotome and Modified Retinaculotome MDC
200
Indications and Contraindications
205
Carpal Tunnel Syndrome Release Using the Chiena Technique
220
Conclusions
225
Reconstruction of the Flexor Retinaculum
226
Function of the Flexor Retinaculum as a Flexor Tendon Pulley
227
Loss of Grip Strength After Carpal Tunnel Release
228
Methods of Reconstructing the Flexor Retinaculum
229
Personal Technique for Reconstruction of the Flexor Retinaculum
231
Results After the Reconstruction of the Flexor Retinaculum
235
Conclusions
236
References
237
Critical Appraisal of Transverse Carpal Ligament Reconstruction Theoretical Experimental and Clinical Considerations
239
Evaluation of Results of Ligament Reconstruction
240
Comparison of Grip Strength Evolution After Carpal Tunnel Release by Three Different Techniques
241
Results
242
Discussion
244
Conclusion
245
Median Nerve Compression Secondary to Fractures of the Distal Radius
247
References
251
Rehabilitation
253
Postoperative Treatment of Carpal Tunnel Syndrome After Median Nerve Decompression Open Field or Endoscopic Technique
254
Recovery of Finger Range of Motion and Differential Gliding Exercises for the Finger Flexor Tendons
256
Retrograde Massage and Increasing Venous Return
257
Shoulder Exercises
258
Splint Removal
259
Wrist Range of Motion Exercises
260
Median Nerve Gliding Exercises
261
Strengthening Exercises
262
Ergonomic Therapy Work Hardening
263
Conclusion
264
References
265
Complications
266
Carpal Tunnel Syndrome Surgical Complications
267
Analysis of the Complications
270
Conclusions
285
References
287
Complications Following Endoscopic Treatment
290
Conclusions
295
References
297
Role of Neurosensory Testing in Differential Diagnosis of Failed Carpal Tunnel Syndrome
299
Summary
306
Secondary Carpal Tunnel Surgery
307
Complications Following Carpal Tunnel Surgery Persistent Symptoms
308
Clinical Evaluation of the Patient with Failed Carpal Tunnel Release
313
Surgical Techniques in Secondary Carpal Tunnel Surgery
314
Conclusion
317
Hypothenar FatPad Flap
319
Rehabilitation
320
Results
321
Complications
322
Management of Recurrence of Carpal Tunnel Syndrome by Using the Abductor Digiti Minimi Muscle Flap to Cover the Median Nerve
324
Discussion
326
Protection of the Median Nerve with the Pronator Quadratus and Palmaris Brevis Muscle Flaps
327
Palmaris Brevis Muscular Flap
329
Discussion
331
References
332
Vein Wrapping of the Median Nerve
333
Preoperative Assessment
334
Results
336
Synovial Flap Plasty as a Treatment of Recurrent Carpal Tunnel Syndrome
338
Postoperative Management
341
Reverse Island Forearm Flaps for the Coverage of the Median Nerve in Recurrent Carpal Tunnel Syndrome
343
The Forearm Radial Artery Flap
345
The Retrograde RadialForearm Flap
349
The Forearm Ulnar Artery Flap
350
The Posterior Interosseous Flap
353
Clinical Case Reports
355
Results
356
Discussion
357
Conclusions
358
References
359
The Ulnar FascialFat Flap for the Treatment of Scarred Median Nerve in Recalcitrant Carpal Tunnel Syndrome
361
Surgical Technique
363
Results
365
Conclusions
367
References
368
Protective Covering of the Nerve by the Vela Quadra Flap
369
Conclusions
374
Free Vascularized Omental Transfer for the Treatment of Recalcitrant Carpal Tunnel Syndrome
376
Technique
377
Discussion
378
References
379
Evaluation of Results
380
Outcomes Assessment Protocols
381
Subjective Assessment Questionnaires PatientOriented
384
Conclusion
385
The SF36 Questionnaire
386
References
391
Carpal Tunnel Syndrome Multicenter Studies with Multiperspective Assessment Results of the Italian CTS Study Group
392
Dissociation Between ClinicalNeurophysiological Findings and Patient Symptoms
393
Evolution of Untreated Carpal Tunnel Syndrome
395
Symptoms and Neurophysiological Picture of Carpal Tunnel Syndrome in Pregnancy
396
Diagnostic Pathway and Differences Between the Populations Enrolled in the Northern Central and Southern Regions of Italy Background
397
The Usefulness of Segmental and Comparative Tests
398
References
399
Subject Index
401
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Page 399 - Keller RB, Soule DN, Wennberg JE, Hanley DF. Dealing with geographic variations in the use of hospitals: The experience of the Maine medical assessment foundation orthopaedic study group.

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