Carpal and cubital tunnel surgery:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
1996
|
| Schriftenreihe: | Hand clinics
12,2 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XVIII S., S. 185 - 461 zahlr. Ill., graph. Darst. |
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| adam_text | CARPAL AND CUBITAL TUNNEL SURGERY
CONTENTS
Preface xv
Kevin D. Plancher
Principles of Examination and Treatment
Anatomy, Function, and Pathophysiology of Peripheral Nerves
and Nerve Compression 185
Goran Lundborg and Lars B. Dahlin
The pathophysiology of peripheral nerve compression is complex. Clinieni
stages of such syndromes can be related to changes in intraneural microcir
culation and nerve fibre structure; alterations in vascular permeability and
edema formation; and subsequent deterioration of nerve function observed
in experimental studies. The double crush and reversed double crush
syndromes are related to disturbances in axonal transport. Basic knowl¬
edge about the pathophysiology of nerve compression is important for
clinicians treating such conditions.
Biomechanical Properties of Peripheral Nerves 195
Rupinder Grewal, Jiangming Xu, Dean G. Sotereanos, and
Savio L Y. Woo
Peripheral nerves are nonhomogenous, viscoelastic structures that exhibit
nonlinear tensile properties as well as stress relaxation. These properties
might explain the tolerance of nerves to stretch. Stretching nerves beyond
the threshold of safety may adversely affect their morphology, microcircu
lation, and conductive function. Many studies have characterized the me¬
chanical properties and defined the threshold of safety, laying the ground¬
work for understanding the biomechanics of the nerve under normal and
pathological conditions.
General Principles and Use of Electrodiagnostic Studies in Carpal
and Cubital Tunnel Syndromes: With Special Attention
to Pitfalls and Interpretation 205
Jeffrey W. Hilburn
This article is an intended guide for nonelectromyographers to under¬
standing the concepts and vocabulary of nerve physiology and pathology
and the performance of electrodiagnostic studies.
HAND CLINICS
VOLUME 12 • NUMBER 2 • MAY 1996 IX
The Role of Splinting and Rehabilitation in the Treatment of
Carpal and Cubital Tunnel Syndromes 223
Shelly M. Sailer
This article focuses on the hand therapist s treatment strategies for individ¬
uals with two common peripheral nerve compressions, carpal and cubital
tunnel syndrome. Nonoperative, conservative treatment and postoperative
care are discussed.
Carpal Tunnel Syndrome
The Pathophysiology of Carpal Tunnel Syndrome 243
Glenn Kerwin, Craig S. Williams, and John Gray Seiler III
Carpal tunnel syndrome (CTS) is the most frequently encountered periph¬
eral compressive neuropathy. Although the clinical diagnosis and treat¬
ment of CTS have been well defined, the pathophysiologic basis still is
not understood completely. This article summarizes current thought and
research pertinent to the pathophysiology of CTS.
Vitamin B6 (Pyridoxine) Therapy for Carpal Tunnel Syndrome 253
Mark D. Jacobson, Kevin D. Plancher, and William B. Kleinman
The role of vitamin B6 in the treatment of carpal tunnel syndrome (CTS)
has been supported by some authors. Other authors debate the usefulness
of vitamin B6 in carpal tunnel syndrome therapy. This article reviews
vitamin B6 actions, deficiency, and its role in carpal tunnel syndrome
treatment. The value of vitamin B6 therapy in idiopathic carpal tunnel
syndrome appears to be limited. Vitamin B6 may be useful in those
patients with a generalized neuropathy and chronic pain condition.
Anatomy of the Median Nerve at the Wrist:
Open Carpal Tunnel Release—Classic 259
David R. Steinberg and Robert M. Szabo
An understanding of the normal anatomy of the carpal tunnel and a
variety of associated anomalies is important for the physician treating
carpal tunnel syndrome. There are many strong arguments for open surgi¬
cal decompression of the median nerve where full visualization of the
transverse carpal ligament and contents of the carpal tunnel can be ex¬
pected. The authors describe their preferred operative technique and post¬
operative management for carpal tunnel release.
Carpal Tunnel Release with a Small Palmar Incision 271
W. P. Andrew Lee, Kevin D. Plancher, and James W. Strickland
The use of the carpal tunnel tome with a small palmar incision to release
the transverse carpal ligament is discussed. The technique is fully illus¬
trated, and the authors early clinical experience is reviewed.
Endoscopic Carpal Tunnel Release: Chow Technique 285
Thomas]. Fischer and Mill Hastings II
The first cases using the set of instruments designed by James C. Y. Chow,
MD, of Mount Vernon, Illinois, were performed in September of 1987 by
the developer. His was the first written introduction of the technique of
endoscopically assisted carpal tunnel release published by a US author.
This technique has been practiced widely for 5 years. Serious complica¬
tions can occur but may be avoidable.
CONTENTS
Endoscopic Carpal Tunnel Release: The Agee Technique 299
David S. Ruch and Gary G. Poehling
The authors describe their technique for endoscopic carpal tunnel release
using the Agee device. Technical points, illustrations, and postoperative
regimen are provided.
Carpal Tunnel Syndrome in the Work Place 305
Dean S. Louis, Edward R. Calkins, and Patrick G. Harris
When considering carpal tunnel syndrome in the work place, one has to
consider time lost from work, loss of productivity, medical costs, costs of
vocational rehabilitation, the increase cost of goods due to the increase in
workers compensation insurance, and the overall effect of compensability
to our country s economic competitiveness and our balance of payments.
Reoperation for Carpal Tunnel Syndrome 313
Tyson K. Cobb and Peter C. Amadio
Although primary carpal tunnel release is usually successful, reoperation
is needed in up to 3% of patients. Common indications of reoperation are
previous incomplete surgery and postoperative fibrosis. Although most
patients improve after reoperation, persistent systems are likely and failure
is more frequent than after primary carpal tunnel surgery. Risk factors for
failure following reoperation include the presence of an active Worker s
Compensation claim, pain in the ulnar nerve distribution, and the absence
of abnormality on preoperative EMG.
Complications of Nonoperative and Operative Treatment of
Carpal Tunnel Syndrome 325
James R. Urbaniak and Sanjay S. Desai
The popularity of treatment of carpal tunnel syndrome has resulted in a
significant number of complications. A rational plan of therapy is available
for each category of complications of carpal tunnel syndrome. This article
presents 14 of the most frequently encountered complications of treatment.
Prevention and management of these complications are discussed.
Revision Carpal Tunnel Surgery
Recalcitrant Carpal Tunnel: The Hypothenar Fat Pad Flap 337
Kevin D. Plancher, Richard S. Idler, Gary M. Lourie,
and James W. Strickland
The hypothenar fat pad flap (HTFPF) is a simple procedure that prevents
readherence of the nerve to the transverse carpal ligament/subcutaneous
tissue/skin complex. This fat pad flap also provides an improved tissue
environment for the neurolysed median nerve.
The Abductor Digiti Minimi Flap: Its Use in Revision
Carpal Tunnel Surgery 351
Saulius Spokevicius and Harold E. Kleinert
One of the few muscles or myocutaneous flaps in the hand available to
cover soft tissue defects without compromising significantly the hand s
function and appearance is the abductor digiti minimi muscle. A technique
that harvests the abductor digiti minimi flap with a small skin island from
the hypothenar eminence allows direct closure of the skin following ADM
transposition and makes it possible to directly monitor the blood supply
CONTENTS xi
to the muscle. This skin island is much smaller than others previously
reported.
The Use of Dermal Fat Grafts 357
Michael A. McClinton
Recurrent carpal tunnel syndrome is a difficult problem facing hand sur¬
geons today, and its incidence is rising. In selected cases, re exploration,
median nerve neurolysis, and dermal fat grafting are beneficial. The sur¬
geon should anticipate 30% to 50% absorption of the graft
Reconstruction of the Transverse Carpal Ligament to Restore
Median Nerve Gliding: The Rationale of a New Technique
for Revision of Recurrent Median Nerve Neuropathy 365
James M. Hunter
A method of surgical revision for recurrent median nerve neuropathy
following carpal tunnel release is discussed based on personal experience
with 122 cases over the past 5 years. Patient improvement after revision
surgery confirmed that pre existing pathology of the mesoepineurium and
its synovial tendon sheath and bursa had produced entrapment and trac¬
tion neuropathy of the median nerve. Based on the premise that the basic
problem was not a compression neuropathy, the median nerve and tendon
pathology was corrected and the transverse carpal ligament anatomically
revised.
The Synovial Flap as Treatment of the Recurrent Carpal Tunnel
Syndrome 379
Christhild Wulle
After an exact definition of the recurrent carpal tunnel syndrome, its
treatment, as described in the literature, is presented. To cover the median
nerve isolated from the extended scar tissue with a thin and well circulated
tissue, the author proposes and demonstrates the synovial flap. The follow
up of 27 cases operated since 1979 with a follow up time between 1 month
to 14 years shows 6 excellent, 16 good, 3 satisfactory and 2 bad results.
The Use of the Palmaris Brevis Flap in Recurrent Carpal Tunnel
Syndrome 389
Elliott H. Rose
The anatomy of the palmaris brevis is discussed. In failed cases of primary
carpal tunnel release, the addition of the highly vascular palmaris brevis
turnover flap as an adjunct to internal neurolysis discourages scarring
and provides a nutrient bed for axonal regeneration. Advantages and
disadvantages of the palmaris turnover muscle are reviewed.
Cubital Tunnel Syndrome
General Principles of Patient Evaluation and Nonoperative
Management of Cubital Syndrome 397
Richard S. Idler
Cubital tunnel syndrome is reported to be the second most common
entrapment neuropathy in the upper extremity. We can now easily ap¬
preciate how ulnar nerve pathology can occur at the elbow in the absence
of trauma. We can also appreciate the role of conservative management
in the treatment of a condition that previously was thought to be a
surgical disease.
xj| CONTENTS
Modified In Situ Decompression of the Ulnar Nerve at the Elbow 405
Harris Gellman and David S. Campion
Controversy continues to surround the treatment of ulnar nerve compres¬
sion at the elbow in the cubital tunnel. By performing extensive segmental
electrodiagnostic studies of the ulnar nerve through the cubital tunnel,
accuracy of diagnosis is improved. In those patients with documented
compression where the ulnar nerve enters the flexor carpi radialis, decom¬
pression of this area alone yields excellent results with rapid recovery.
Cubital Tunnel Syndrome: Treatment by Medial Epicondylectomy 411
Stuart H. Kuschner
Medial epicondylectomy is one of several options available for treatment
of cubital tunnel syndrome. Medial epicondylectomy preserves blood sup¬
ply to the nerve and allows early postoperative immobilization by remov¬
ing or releasing constricting structures including the root of the cubital
tunnel, the arcade of Struthers, and the medial epicondyle. Small nerve
branches that might be sacrificed in an anterior transposition procedure
are preserved when performing a medial epicondylectomy. Results are
comparable to other methods of treatment.
Subcutaneous Transposition of the Ulnar Nerve for Treatment of
Cubital Tunnel Syndrome 421
A. Lee Osterman and Craig A. Davis
Subcutaneous transposition of the ulnar nerve has been widely reported
as a successful surgical treatment for ulnar neuropathy at the elbow
attributable to a variety of causes. Accepted indications for anterior trans¬
position includes any anatomic lesion that interferes with or impinges on
the nerve along its native course. Diagnosis is based primarily on history
and physical findings. There is ample cause for optimism given that
adherence to basic principles has resulted in satisfactory results for 85%
to 95% of patients regardless of the procedure chosen.
Anterior Intramuscular Transposition of the Ulnar Nerve 435
Kevin D. Plancher, Jeffrey O. McGillicuddy, and William B. Kleinman
Anterior intramuscular transposition of the ulnar nerve is attractive for
its relative ease of dissection, simplicity, reliability, and low morbidity.
Transposition of the nerve into a shallow, muscular trough deep only to
the flexor pronator fascia is a logical, effective, and consistently reliable
method of treating cubital tunnel syndrome refractory to conservative
management.
Submuscular Transposition of the Ulnar Nerve 445
David B. Siegel
Anterior submuscular transposition is a technically demanding procedure
that mobilizes the ulnar nen e from the cubital tunnel, to the intermuscular
interval between the flexor pronator muscle group and the flexor dig
itorum superficialis muscle. All potential sites of compression, from the
arcade of Struthers to the fascial arch of the flexor digitorum superficialis
muscle origin must be identified and released. The procedure is indicated
in symptomatic cubital tunnel syndrome and is especially valuable in the
treatment of failed previous surgical release.
Cubital Tunnel Surgery: Complications and Treatment of Failures 449
Linda C. Jackson and Robert N. Hotchkiss
Failure of cubital tunnel surgery can be defined as failure to relieve
symptoms. Failures also include postoperative complications such as neu
CONTENTS Xiii
romas, sublaxations, elbow instability, and flexion contractures. The data
at this time do not suggest that one surgical technique is more likely than
others to fail.
Index 457
Subscription Information Inside back cover
CONTENTS
XIV
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| spelling | Carpal and cubital tunnel surgery Kevin D. Plancher, guest ed. Philadelphia [u.a.] Saunders 1996 XVIII S., S. 185 - 461 zahlr. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Hand clinics 12,2 Syndrome du canal carpien Syndromes de compression du nerf ulnaire Carpal Tunnel Syndrome surgery Carpal tunnel syndrome Ulnar Nerve Compression Syndrome surgery Karpaltunnelsyndrom (DE-588)4163349-0 gnd rswk-swf Chirurgie (DE-588)4009987-8 gnd rswk-swf Kubitaltunnel-Syndrom (DE-588)4316310-5 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Karpaltunnelsyndrom (DE-588)4163349-0 s Chirurgie (DE-588)4009987-8 s DE-604 Kubitaltunnel-Syndrom (DE-588)4316310-5 s Plancher, Kevin D. Sonstige (DE-588)129060038 oth Hand clinics 12,2 (DE-604)BV000019309 12,2 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=007224164&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Carpal and cubital tunnel surgery Hand clinics Syndrome du canal carpien Syndromes de compression du nerf ulnaire Carpal Tunnel Syndrome surgery Carpal tunnel syndrome Ulnar Nerve Compression Syndrome surgery Karpaltunnelsyndrom (DE-588)4163349-0 gnd Chirurgie (DE-588)4009987-8 gnd Kubitaltunnel-Syndrom (DE-588)4316310-5 gnd |
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| title | Carpal and cubital tunnel surgery |
| title_auth | Carpal and cubital tunnel surgery |
| title_exact_search | Carpal and cubital tunnel surgery |
| title_full | Carpal and cubital tunnel surgery Kevin D. Plancher, guest ed. |
| title_fullStr | Carpal and cubital tunnel surgery Kevin D. Plancher, guest ed. |
| title_full_unstemmed | Carpal and cubital tunnel surgery Kevin D. Plancher, guest ed. |
| title_short | Carpal and cubital tunnel surgery |
| title_sort | carpal and cubital tunnel surgery |
| topic | Syndrome du canal carpien Syndromes de compression du nerf ulnaire Carpal Tunnel Syndrome surgery Carpal tunnel syndrome Ulnar Nerve Compression Syndrome surgery Karpaltunnelsyndrom (DE-588)4163349-0 gnd Chirurgie (DE-588)4009987-8 gnd Kubitaltunnel-Syndrom (DE-588)4316310-5 gnd |
| topic_facet | Syndrome du canal carpien Syndromes de compression du nerf ulnaire Carpal Tunnel Syndrome surgery Carpal tunnel syndrome Ulnar Nerve Compression Syndrome surgery Karpaltunnelsyndrom Chirurgie Kubitaltunnel-Syndrom Aufsatzsammlung |
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