ISSN:1077-2855    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Abstract:Entrapment of the median nerve at the carpal tunnel is the most common entrapment neuropathy. Although nocturnal paresthesias are the most common initial manifestation of carpal tunnel syndrome, the patient may also note hand numbness, clumsiness, pain radiating up the arm, and weakness or atrophy of thenar eminence muscles. The most important step in treating carpal tunnel syndrome is the diagnosis. A thorough knowledge of the normal and aberrant anatomy of the structures surrounding the carpal canal and uncompromised visualization of the transverse ligament are crucial to avoiding complications during the surgical release. Since Sir James Learmonth first described the surgical release of the transverse carpal ligament in 1933, several variations of the technique have been described. Most recently, several innovative procedures involving the endoscope have been introduced in the literature. Endoscopic methods include the two-portal techniques of Chow, Resnick, and Brown; the proximal uniportal techniques of Okutsu, Agee, and Menon; and the distal uniportal approach of Mirza. Proponents of endoscopic carpal tunnel release claim a decrease in postoperative palmar tenderness, a more rapid restoration of grip strength, and an earlier return to work as the major advantages of those techniques. These benefits of endoscopic carpal tunnel release must be weighed against the limited surgical exposure with concomitant risks of incomplete ligament release and inadvertent neurovascular or tendon injury. This review discusses the details of the various surgical procedures, both open and endoscopic, as well as discuss the potential benefits and complications associated with each.

ISSN:1077-2855    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Abstract:Suprascapular entrapment is an uncommon clinical disorder. This article provides a discussion on the pertinent applied anatomy, clinical features, diagnostic testing, differential diagnosis, conservative management and technique of the operative procedure. The expected outcome is delineated.

ISSN:1077-2855    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Abstract:Radial nerve palsies are most commonly a result of trauma. However, the radial nerve is also vulnerable to entrapment just distal to the elbow in a region know as the radial tunnel. In this location, the posterior interosseous branch of the radial nerve is susceptible to nontraumatic compressive neuropathy. Entrapment of the posterior interosseous nerve may produce weakness, pain, or both. Such lesions are initially treated with rest and use of nonsteroidal antiinflammatory medications. Lesions refractory to initial therapy should be explored with decompression of the posterior interosseous nerve in the radial tunnel.

ISSN:1077-2855    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Abstract:The clinical and other relevant factors of 126 cases of thoracic outlet syndrome (TOS) are analyzed. A new clinical grading system is introduced, as well as a new classification of TOS based on clinical findings, neuroelectric tests results, stress tests, and radiographic data. The surgical technique of the anterior supraclavicular approach is described in detail, with emphasis on the ways and means of dealing with the normal and many anomalous structures encountered in 142 operations. The good outcome and infrequent complications of this diagnostic and management approach to TOS argue strongly for the author's recommendations of stringent patient selection for surgery and painstaking regards to details during surgery.

ISSN:1077-2855    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Abstract:Injury to, or compression of, the lateral femoral cutaneous nerve can produce a syndrome of numbness and painful paresthesias in the lateral thigh-meralgia paresthetica. An uncommon condition and one which is often misdiagnosed, meralgia will usually respond to non-operative treatment. If surgical treatment is required, the nerve may be decompressed or transected. The key to effective surgical treatment of meralgia is careful dissection and correct identification of the lateral femoral cutaneous nerve.

ISSN:1077-2855    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Abstract:Ulnar nerve entrapment at the elbow is the second most common upper extremity nerve entrapment. The choice of treatment is based on the presumed cause of compression, after obtaining a history and physical examination and ancillary tests. Treatment is conservative for mild cases and those related to repetitive stress disorder and surgical for patients who fail to respond to conservative management. Surgical decompression requires attention to various anatomical points of nerve compression. Of the five surgical operations for ulnar nerve compression at the elbow, the simplest is an in situ decompression. A medial epicondylectomy is especially useful when there is an anatomical deformity. The ulnar nerve can be transposed to the antecubital fossa using one of three techniques. Adherence to basic surgical technique has resulted in a satisfactory outcome in up to 95% of patients regardless of the procedure chosen. Incomplete decompression or creation of a new site of compression, neuroma formation, and subluxation can result in surgical failure.

ISSN:1077-2855    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Abstract:Tarsal tunnel syndrome is an uncommon entrapment neuropathy involving the posterior tibial nerve and/or its distal branches in the region of the medial ankle and foot. The etiology is often multifactorial, with trauma a contributing factor in more than 50% of patients. Signs and symptoms of tarsal tunnel syndrome are often confused with other conditions; the differential diagnosis includes lumbosacral radiculopathy, calcaneodynia, metatarsalgia, rheumatoid arthritis, plantar fasciitis, peripheral neuropathy, peripheral vascular disease, and Morton's neuroma. Treatment begins with the identification and removal of any repetitive local trauma, followed by the application of a medial arch support. Use of oral antiinflammatories and local steroid injection may be helpful. If conservative management fails, surgical decompression is indicated. A working knowledge of the anatomy of the tarsal tunnel is necessary to perform a thorough and safe posterior tibial, medial and lateral plantar and calcaneal nerve decompression. With surgery, 75% of patients can be expected to have significant improvement. Patients with space-occupying lesions generally do best; those who have undergone previous surgery, have a diagnosis of plantar fasciitis, or have an associated autoimmune disorder do less well.

ISSN:1077-2855    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:1077-2855    

出版商:OVID    

年代:2000

数据来源: OVID