ORTHOPEDICS

Carpal tunnel treatment and nerve decompression

Earlier treatment of carpal tunnel syndrome has a better final prognosis.

CARPAL CHANNEL SYNDROME

Carpal tunnel syndrome is the most widespread compression pathology of the peripheral nerve in the human body, which occurs due to the pressure of the surrounding structures on the central nerve in the area of ​​the root of the hand.

The carpal tunnel consists of eight small bones of the wrist on the lower side, and the upper side is closed by a strong connective tissue, or ligament structure. Through this tunnel, from the forearm into the fist, the median nerve enters, but also the tendons of the muscles that move the fingers. The tendons are lined with a thin synovial sheath. (picture below)



WHY DOES CARPAL CHANNEL SYNDROME OCCUR?

This syndrome occurs primarily due to increased use of the wrist, or tendon overload in the carpal tunnel (eg excessive keyboard work, and is common in manual workers, surgeons, physiotherapists, masseurs, etc.), which significantly contributes to the development of carpal tunnel syndrome. .

Prevention of this syndrome, as part of maintaining quality of life, is unusually important. All the processes that affect the thickening of the tendon, swelling in the area of ​​the carpal tunnel or its narrowing, can lead to increased pressure on the nerve. Certainly, systemic diseases such as diabetes, rheumatoid arthritis, endocrine diseases, etc. should be ruled out, but also the suspicion of a tumor, accumulation of fluid in the body as a result of pregnancy or menopause, the consequences of taking certain medications and the like.

So called. posttraumatic carpal tunnel syndrome, on the other hand, is a condition caused by a fracture of the thumb bone at a typical site and results in premature compression of the central nerve due to altered anatomical relationships. Carpal tunnel syndrome is more common in women. It can occur on both hands, but the symptoms are usually more pronounced on the dominant hand. The development of symptoms usually begins as a transient tingling in the fingers during the night or in the morning and is later present throughout the day. Numbness of the first three fingers of the hand, swelling of the fingers (especially the thumb) and hand, decreased mobility, and later pain and muscle weakness, are the features of this canalicular syndrome.

If the condition is advanced, patients often lose objects due to muscle weakness, it is difficult to button buttons, bras, etc., and the pain is constant.



DIAGNOSTIC

Because the clinical picture of carpal tunnel syndrome may overlap with the clinical picture of cervical spine disease, a detailed specialist examination is necessary.

The diagnosis of carpal tunnel syndrome is made on the basis of clinical examination and electromyoneurography (EMNG), ie electrophysiological examination of the function of muscles and peripheral nerves, which may indicate their damage.

In addition to X-ray processing, magnetic resonance imaging of the hand can sometimes be done, which detects any soft tissue changes in the area.


TREATMENT

Understandably, earlier treatment of carpal tunnel syndrome has a better final prognosis.

If sensory loss and thumb muscle atrophy are present, the patient has a poorer prognosis. Treatment of carpal tunnel syndrome can be conservative and operative.

Unsuccessful conservative treatment, which often includes corticosteroid injections and splints, results in the need for surgical treatment. The operation is performed under local anesthesia, using the so-called. “Pale paths”, ie compression bandages which, by pressing on the blood vessels, enable better visualization during the procedure. The purpose of the operation is to cut the tendon sheath through which the nerve passes, and the final result of the procedure depends on the course of the operation and the experience of the doctor.

Even if the procedure is performed according to all the rules of the profession, sometimes after the operation there is a possibility of reduced finger mobility, reduced sensation and the possibility of minor infection.


RECOVERY

Recovery after surgery can take months, and above all it depends on the condition of the hand before the procedure, so patience in the postoperative period is important.

At the Ribnjak Polyclinic, complete services of physical therapy are available to you, as well as modern postoperative treatment with regenerative methods, such as the application of the PRP method.

By applying platelet rich plasma, faster healing in the incision area, accelerated flattening of swelling and pain reduction, and accelerated increase in finger mobility were demonstrated.




In short


Polyclinic Ribnjak is a unique institution in the Republic of Croatia. It unites different branches of medicine, all in order to stay true to its slogan “Health and Beauty. Together”. Orthopedics, advanced sports diagnostics, functional and kinesiological rehabilitation, cosmetic surgery and treatments are the services we provide on a daily basis, professionally and in accordance with the latest professional standards.






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