tailieunhanh - Hội chứng thần kinh ở cổ tay

Các bệnh nhân với các neuropathies nén của các dây thần kinh phân cách và trụ ở cổ tay thường biểu hiện đau, dị cảm, và sự yếu kém trong tay và chữ số. Chẩn đoán những điều kiện này ngày càng trở nên phổ biến với sự quan tâm gia tăng cho "rối loạn chấn thương tích lũy" trong suốt thập kỷ qua. | Nerve Entrapment Syndromes in the Wrist Robert M. Szabo MD and David R. Steinberg MD Abstract The patient with compression neuropathies of the median and ulnar nerves at the wrist commonly presents with pain paresthesias and weakness in the hand and digits. Diagnosis of these conditions is becoming more widespread with the increased attention given to cumulative trauma disorders during the past decade. Successful management requires a thorough understanding of the pathophysiology of compression neuropathy and how it relates to the various diagnostic tests available today. The authors review the epidemiology etiology and evaluation of compression neuropathy and discuss common clinical presentations treatment recommendations and controversies surrounding carpal and ulnar tunnel syndromes. J Am Acad Orthop Surg 1994 2 115-123 Compression neuropathy at the wrist is not a single disease but rather a constellation of symptoms resulting from compression of either the median or the ulnar nerve caused by a disparity between the size of the corresponding tunnel and its contents. History and physical examination will localize the site of compression and direct further diagnostic studies. Once the cause is determined appropriate therapy can in most cases yield a successful outcome. Epidemiology Upper-extremity compression neuropathy remains one of the most frequently encountered disorders seen by orthopaedists and hand surgeons. Classically these syndromes have presented as either posttraumatic conditions or the gradual onset of paresthesias and pain in a patient typically female in late middle age. In the past decade these two forms have been surpassed by another presentation symptoms developed in the younger industrial worker in relation to repetitive motions. This syndrome is one of a group of nonspecific conditions termed cumulative trauma disorders. Workers compensation litigation and labor-management hostilities as well as psychological and economic factors are often an