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Carpal tunnel syndrome (CTS) is a nerve compression syndrome associated with the collected signs and symptoms of compression of the median nerve at the carpal tunnel in the wrist. Carpal tunnel syndrome usually has no known cause, but there are environmental and medical risk factors associated with the condition. [1] [6] CTS can affect both wrists.
Carpal tunnel as seen on MRI. The carpal bones that make up the wrist form an arch which is convex on the dorsal side of the hand and concave on the palmar side. The groove on the palmar side, the sulcus carpi, is covered by the flexor retinaculum, a rigid band of fibrous tissue, thus forming the carpal tunnel.
The procedure is used as a treatment for carpal tunnel syndrome and according to the American Academy of Orthopaedic Surgeons (AAOS) treatment guidelines, early surgery is an option when there is clinical evidence of median nerve denervation or the patient elects to proceed directly to surgical treatment. [5]
Carpal tunnel syndrome is a common nerve condition that happens when the median nerve — which runs from your forearm through your wrist into the palm of your hand — becomes pressed or squeezed ...
Carpal tunnel surgery has a clinical success rate of 75-90%. [26] Success is most frequently measured with the Boston Carpal Tunnel Questionnaire, physical examination (sensory function, motor function, pain, electrodiagnostic, trophic function), and patient self-assessments.
The eight carpal bones may be conceptually organized as either two transverse rows, or three longitudinal columns. When considered as paired rows, each row forms an arch which is convex proximally and concave distally. On the palmar side, the carpus is concave and forms the carpal tunnel, which is covered by the flexor retinaculum. [2]
The development of carpal tunnel syndrome was of particular interest for other idiopathic tardy nerve palsies. Carpal tunnel served as a model for how nerves could be squeezed by narrow anatomic compartments and soon other tunnel syndromes were conceptualized, such as cubital tunnel syndrome, and tarsal tunnel syndrome. [87] [88] [83]
The pisiform bone is most recognizable as an unassuming palmar projection forming the heel of human hand. [2]The pisiform bone, along with the hamulus of the hamate, defines the medial boundary of the carpal tunnel [2] because the pisiform body acts as one of the four attachments points of the flexor retinaculum. [3]