COMPRESSION NEUROPATHIES OF THE UPPER EXTREMITY
Journal Title: Medycyna Sportowa - Year 2007, Vol 23, Issue 6
Abstract
Compressive neuropathies are one of the most frequent cases of upper extremity dysfunction. These are the diseases of the nervous system affecting peripheral nerves and resulting in their permanent or transient dysfunction. Carpal tunnel syndrome is the most frequent upper extremity neuropathy. It is estimated that about 1% of the general population suffers from carpal tunnel syndrome. Based on the data collected in the United States, we can say that among 1000 people there are 0.99-3.5 cases presenting with CTS yearly. Despite a relatively high prevalence, compressive neuropathies of the upper extremities still constitute a serious problem from the clinical point of view. Immediate diagnosing (including history taking, a thorough physical examination and additional examinations), implementation of conservative treatment (pharmacotherapy, physiotherapy, local steroid injections and in some cases – temporary plaster cast immobilisation), finally an adequate decision concerning surgical procedure, let us obtain positive results of the treatment, limiting the period of disability to work and the percentage of sequela. Differential diagnosis allows to determine which nerve is responsible for the symptoms and to localise compression. Moreover, concomitant compression syndromes at the cervical spine level should be excluded.Too late diagnosis may result in severe dysfunction of the unaffected part of the upper extremity. In case of negligence, sensory and motor function impairment may be accompanied by vegetative disorders. Sometimes, a sustained compression causes irreversible anatomical changes within the nerve. In such cases, it is often impossible to obtain satisfactory treatment results, despite immediate implementation of conservative and surgical treatment. Nowadays, traditional tools and the increasingly popular arthroscopic techniques are utilised in surgical treatment. Arthroscopy is particularly useful in the treatment of CTS and ulnar groove syndrome.High prevalence and high percentage of severe dysfunctions of unaffected parts of upper extremities indicate a serious clinical problems that must not be neglected.
Authors and Affiliations
Karol Szyluk, Andrzej Jasiński, Wojciech Widuchowski, Bogdan Koczy, Jerzy Widuchowski
Keywords
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