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Anesth Pain Med 2020 Dec 26;10(6):e112291. Epub 2020 Dec 26.

Department of Anesthesiology, LSU Health Shreveport, Shreveport, LA, USA.

Context: Carpal tunnel syndrome (CTS) is the most frequent peripheral compression-induced neuropathy observed in patients worldwide. Surgery is necessary when conservative treatments fail and severe symptoms persist. Traditional Open carpal tunnel release (OCTR) with visualization of carpal tunnel is considered the gold standard for decompression. Read More

Anesth Pain Med 2020 Dec 24;10(6):e112070. Epub 2020 Dec 24.

Southcoast Health Physicians Group Pain Medicine, Wareham, Massachusetts.

Context: Ulnar nerve entrapment is a relatively common entrapment syndrome second only in prevalence to carpal tunnel syndrome. The potential anatomic locations for entrapment include the brachial plexus, cubital tunnel, and Guyon's canal. Ulnar nerve entrapment is more so prevalent in pregnancy, diabetes, rheumatoid arthritis, and patients with occupations involving periods of prolonged elbow flexion and/or wrist dorsiflexion. Read More

Rev Esp Cir Ortop Traumatol 2021 Jun 17. Epub 2021 Jun 17.

Servicio de Cirugía Ortopédica y Traumatología, Unidad de Mano y Muñeca, Hospital Universitario Marqués de Valdecilla, Santander, España; Universidad de Cantabria, Santander, España.

Introduction: The treatment of trapeziometacarpal osteoarthritis through the implantation of total trapeziometacarpal prostheses is in continuous expansion. The Isis® prosthesis is a trunk-conical threaded anchorage prosthesis. Our objective was to assess the functional results and survival of this implant for at least one year of follow-up. Read More

Reumatol Clin 2021 Jun 17. Epub 2021 Jun 17.

Biostatistics Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid 28222, Spain.

Introduction: Nerve conduction studies (NCS) have been considered as the gold standard in carpal tunnel syndrome (CTS) diagnosis, despite correlation between clinical symptomatology and NCS severity has shown to be poor. In fact, clinical symptoms precede NCS changes in months or years. Few papers have been published about the clinical response to treatment of clinically typical CTS, but with normal NCS (NNCS). Read More

Ann Chir Plast Esthet 2021 Jun 15. Epub 2021 Jun 15.

Service de chirurgie plastique et reconstructrice, Centre des Brûlés, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes, France.

Objectives: The carpal tunnel syndrome is rare in children. We performed a retrospective study of 10 children. The aim is to show that the diagnosis of carpal tunnel syndrome is difficult in children. Read More

Medicina (B Aires) 2021 ;81(3):318-322

Department of Orthopedic Surgery, Denver Health Medical Center, Denver, CO, USA.

Carpal tunnel syndrome is median nerve symptomatic compression at the level of the wrist, characterized by increased pressure within the carpal tunnel and decreased nerve function at the level. Carpal tunnel release decreases pressure in Guyon's canal, via open techniques, with symptom and two-point discrimination improvement in the ulnar nerve distribution. We hypothesize that endoscopic carpal tunnel release improves two-point discrimination in the ulnar nerve distribution as well. Read More

ESC Heart Fail 2021 Jun 17. Epub 2021 Jun 17.

Maruko Central Hospital, Nagano, Japan.

Wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) is caused by the deposition of wild-type transthyretin (TTR) amyloid fibrils in the heart. The age at diagnosis of ATTRwt-CM is reported to be approximately 70-80 years, and patients commonly present with non-disease-specific cardiac abnormalities, such as heart failure with preserved ejection fraction and diastolic dysfunction. The disease can be fatal if left untreated, with an approximate survival of 3-5 years from diagnosis. Read More

FP Essent 2021 Jun;505:11-17

F. Edward Hébert School of Medicine at the Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814.

Manual therapy, or manipulative therapy, is performed primarily by osteopathic physicians, chiropractors, and physical therapists to relieve pain and improve function. As safe prescribing of opioids has become a concern and nondrug therapies for pain management are used more widely, manual therapy has become an attractive treatment option for many patients. A variety of techniques are used, including myofascial release, strain-counterstrain, muscle energy, high velocity/low amplitude, Still, and others. Read More

Am J Ind Med 2021 Jun 14. Epub 2021 Jun 14.

Downstate School of Public Health, State University of New York (SUNY), Brooklyn, New York, USA.

Background: Our objective was to examine occupational risk factors for musculoskeletal disorders of the shoulders, elbows, wrists, and hands among railroad maintenance-of-way (MOW) workers. Little systematic research on musculoskeletal disorders has been conducted in this occupational group.

Methods: In total, 3995 active members of the Brotherhood of Maintenance of Way Employes Division (BMWED) completed a standardized survey focusing on disorders caused by hand-transmitted vibration. Read More

Brain Res 2021 Jun 8;1767:147558. Epub 2021 Jun 8.

School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Center of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China. Electronic address:

Functional and structural brain alterations have been noted in carpal tunnel syndrome (CTS), the most common entrapment peripheral neuropathy. Previous studies were mainly focused on somatosensory cortices. However, the changes of white matter diffusion properties in nonsensorimotor cortices remain uninvestigated. Read More

Mil Med 2021 Jun 11. Epub 2021 Jun 11.

Military Medical Research and Development, Danish Defence Medical Command, Brabrand, DK 8220, Denmark.

Median nerve entrapment is a frequent disorder encountered by all clinicians at some point of their career. Affecting the distal median nerve, entrapment occurs most frequently at the level of the wrist resulting in a carpal tunnel syndrome. Median nerve entrapment may also occur proximally giving rise to the much less frequent pronator teres syndrome and even less frequent anterior interosseous nerve syndrome, which owing to the paucity of cases may prove challenging to diagnose. Read More

GMS Interdiscip Plast Reconstr Surg DGPW 2021 5;10:Doc04. Epub 2021 May 5.

Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany.

Mucopolysaccharidosis is a rare and congenital autosomal recessive lysosomal storage disorder of glycosaminoglycans. An enzyme defect leads to cell, tissue and organ dysfunction. Carpal tunnel syndrome and trigger finger are the results of mucopolysaccharid deposition. Read More

Indian J Orthop 2021 May 1;55(Suppl 1):267-272. Epub 2020 Jun 1.

Department of Orthopaedics, School of Medical Sciences and Research, Sharda University, Greater Noida, Uttar Pradesh 201 306 India.

Introduction: Fibrolipomatous hamartoma (FLH) is a benign tumorous condition of adipose tissue. It is a slow growing, rare tumour involving peripheral nerves with uncertain aetiology. The clinical presentation varies as per presenting severity. Read More

Hand (N Y) 2021 Jun 10:15589447211014603. Epub 2021 Jun 10.

University of Cincinnati College of Medicine, OH, USA.

Background: A paucity of literature exists specifically examining self-inflicted (SI) gunshot wounds (GSWs) to the hand and wrist, which impart greater energy and have a higher risk of adverse events than non-self-inflicted (NSI) GSWs.

Methods: We retrospectively reviewed records of patients who presented to our plastic surgery service after sustaining acute GSWs involving the hand and wrist between 2016 and 2018.

Results: We identified 60 patients who sustained GSWs involving the hand and wrist; 17 (28%) were SI, and 43 (72%) were NSI. Read More

J Wrist Surg 2021 Jun 3;10(3):196-200. Epub 2021 Jan 3.

Departments of Orthopaedic Surgery and Radiology, School of Medicine, New York University, New York.

 The etiology of carpal tunnel syndrome (CTS) is multifactorial. Static mechanical characteristics of CTS have been described, but dynamic (muscular) parameters remain obscure. We believe that musculature overlying the transverse carpal ligament may have an effect on carpal tunnel pressure and may explain the prevalence of CTS in manual workers. Read More

Int J Clin Pract 2021 Jun 9:e14482. Epub 2021 Jun 9.

Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.

Introduction: Platelet-rich plasma (PRP) injection is effective for mild-to-moderate carpal tunnel syndrome (CTS), and physicians have been using PRP injections to treat CTS. However, the predictive factors of PRP injections have not been evaluated. This retrospective study sought to identify the predictive factors of PRP injections in patients with moderate CTS. Read More

Hand (N Y) 2021 Jun 9:15589447211017229. Epub 2021 Jun 9.

Emory University, Atlanta, GA, USA.

Background: Recent studies suggest increased complications when surgery closely follows corticosteroid injection. The purpose of this study was to understand the occurrence of surgical site infection (SSI), wound complications, and reoperation rates after carpal tunnel release (CTR) when corticosteroid injections were given within 180 days preoperatively.

Methods: Data were collected from the Truven MarketScan database from 2009 to 2018. Read More

Case Reports Plast Surg Hand Surg 2021 May 19;8(1):76-80. Epub 2021 May 19.

Department of Hand Surgery and Microsurgery, Azienda Ospedaliero Universitaria Modena, Modena, Italy.

Complete dislocations of the trapezoid are very uncommon injuries. The authors present a case of open palmar trapezoid fracture-dislocation with significant displacement of the fracture, acute carpal tunnel syndrome and other concomitant carpometacarpal injuries. A review of the literature search for palmar trapezoid dislocations and treatments was performed. Read More

J Hand Surg Am 2021 Jun 5. Epub 2021 Jun 5.

Department of Orthopaedics, University of Pittsburgh, Pittsburgh, PA. Electronic address:

Purpose: A growing body of evidence supports ultrasound (US) as an alternative first-line confirmatory test for carpal tunnel syndrome (CTS). Recent studies have demonstrated a correlation of US cross-sectional area with electrodiagnostic (EDX)-determined severity; however, it is unclear whether patient sex affects the cutoff values used for determining severity. The purpose of this study was to determine if patient sex affects US graded severity when using EDX as the reference standard. Read More

J Bone Joint Surg Am 2021 Jun 7. Epub 2021 Jun 7.

Division of Plastic and Reconstructive Surgery, Department of Surgery, Oregon Health & Science University, Portland, Oregon.

Background: As carpal tunnel syndrome often precedes other signs of systemic amyloidosis, tenosynovial biopsy at the time of carpal tunnel release may facilitate early diagnosis and treatment. However, evidence-based guidelines for amyloidosis screening during carpal tunnel release have not been established. We sought to develop a predictive model for amyloidosis after carpal tunnel release to inform screening efforts. Read More

Clin Rehabil 2021 Jun 6:2692155211014702. Epub 2021 Jun 6.

Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.

Objective: This meta-analysis aimed to compare the efficacy and safety of ultrasound-guided (US-guided) versus landmark-guided (LM-guided) local corticosteroid injection for carpal tunnel syndrome (CTS).

Methods: Database including Pubmed, Embase, and Cochrane Library were searched to identify relevant randomized controlled trials (RCTs). The outcomes mainly included Boston Carpal Tunnel Questionnaire (BCTQ): Symptom Severity Scale (BCTQs), Functional Status Scale (BCTQf); and electrophysiological indexes: distal motor latency (DML), sensory distal latency (SDL), compound muscle action potential (CAMP), sensory nerve action potential amplitude (SNAP), and sensory nerve conduction velocity (SNCV). Read More

Cardiol Ther 2021 Jun 4. Epub 2021 Jun 4.

Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Amyloidosis caused by systemic deposition of transthyretin (TTR) is called ATTR amyloidosis and mainly includes hereditary ATTR (ATTRv) amyloidosis and wild-type ATTR (ATTRwt) amyloidosis. Until recently, ATTRv amyloidosis had been considered a disease in the field of neurology because neuropathic symptoms predominated in patients described in early reports, whereas advances in diagnostic techniques and increased recognition of this disease revealed the presence of patients with cardiomyopathy as a predominant feature. In contrast, ATTRwt amyloidosis has been considered a disease in the field of cardiology. Read More

J Educ Health Promot 2021 27;10:48. Epub 2021 Feb 27.

Department of Physical Medicine and Rehabilitation, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Background: The objective was to evaluate an innovative physical medicine and rehabilitation (PMR) course for undergraduate students of Tehran University of Medical Sciences and their attitude and knowledge change following course participation.

Materials And Methods: Ninety-one medical students filled the knowledge, attitude, and satisfaction forms pre- and postintervention. Nineteen medical students, two faculty physiatrists, two residents, two physical therapists, and two occupational therapists participated in the focus groups. Read More

Toxicol Appl Pharmacol 2021 Aug 1;425:115600. Epub 2021 Jun 1.

Université Clermont Auvergne, INSERM U1107, NEURO-DOL, CHU Clermont-Ferrand, Direction de la recherche clinique et de l'innovation, F-63000 Clermont-Ferrand, France. Electronic address:

Among postmenopausal women with estrogen receptor-positive breast cancer, more than 80% receive hormone therapy including aromatase inhibitors (AIs). Half of them develop chronic arthralgia - characterized by symmetric articular pain, carpal tunnel syndrome, morning stiffness, myalgia and a decrease in grip strength - which is associated with treatment discontinuation. Only a few animal studies have linked AI treatment to nociception, and none to arthralgia. Read More

Sci Rep 2021 Jun 2;11(1):11645. Epub 2021 Jun 2.

Alnylam Pharmaceuticals, 300 3rd St., Cambridge, MA, 02142, USA.

Hereditary transthyretin-mediated (hATTR) amyloidosis is an underdiagnosed, progressively debilitating disease caused by mutations in the transthyretin (TTR) gene. V122I, a common pathogenic TTR mutation, is found in 3-4% of individuals of African ancestry in the United States and has been associated with cardiomyopathy and heart failure. To better understand the phenotypic consequences of carrying V122I, we conducted a phenome-wide association study scanning 427 ICD diagnosis codes in UK Biobank participants of African ancestry (n = 6062). Read More

Hand (N Y) 2021 Jun 2:15589447211017225. Epub 2021 Jun 2.

University of Miyazaki, Japan.

Background: The purpose of the present study was to evaluate the usefulness of the median nerve stenosis rate (MNSR) measured on sagittal sonographic images of the median nerve in the diagnosis of carpal tunnel syndrome (CTS).

Methods: The study population consisted of 45 hands from 37 patients with idiopathic CTS (CTS group), and 60 hands from 35 asymptomatic healthy subjects (control group). Carpal tunnel syndrome was diagnosed by clinical findings and positive electrophysiological study results. Read More

Diagnostics (Basel) 2021 May 9;11(5). Epub 2021 May 9.

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu 300, Taiwan.

This study aimed to investigate the effect of different injectate volumes on ultrasonographic parameters and the correlation to clinical outcomes under perineural dextrose injection (PDI). In this post hoc analysis of the randomized, double-blinded, three-arm trial, ultrasound-guided PDI with either 1 mL, 2 mL, and 4 mL 5% dextrose water was administered, respectively, in 14, 14, and 17 patients. Ultrasound outcomes included mobility, shear-wave elastography (SWE), and cross-sectional area (CSA) of the median nerve; clinical outcomes were Visual Analog Scale (VAS) and Boston Carpal Tunnel Questionnaire (BCTQ) score. Read More

JBJS Case Connect 2020 Oct-Dec;10(4):e2000193

1Resident of the Orthopaedics Department, Centro Hospitalar Universitário do Porto-Hospital de Santo António, Porto, Portugal 2Orthopaedic Surgeon, Centro Hospitalar Universitário do Porto-Hospital de Santo António, Porto, Portugal.

Case: We report the case of a patient with bone tuberculosis (TB) of the wrist, whose initial manifestation mimicked the typical clinical presentation of carpal tunnel syndrome. This misdiagnosis lead to surgical mistreatment. After no clinical improvement, thorough study was carried out, and bone TB was diagnosed. Read More

Int J Clin Pract 2021 Jun 1:e14371. Epub 2021 Jun 1.

Department of Neurology, School of Medicine, Imam Khomeini Hospital, Golestan Hospital, Ahvaz Jundishapur University of Medical sciences, Iran.

Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Current physical therapy treatment options show limited effects or low-quality evidence, especially in the long-term. To date, there has been little research to look at the effects of treating the cervical spine for decreasing symptoms distally to the carpal tunnel. Read More