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JAMA 2022 Jun 28. Epub 2022 Jun 28.

Senior Editor, JAMA.

JAMA 2022 Jun;327(24):2434-2445

Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University in St Louis School of Medicine, St Louis, Missouri.

Importance: Carpal tunnel syndrome, trigger finger, de Quervain tenosynovitis, and basilar (carpometacarpal) joint arthritis of the thumb can be associated with significant disability.

Observations: Carpal tunnel syndrome is characterized by numbness and tingling in the thumb and the index, middle, and radial ring fingers and by weakness of thumb opposition when severe. It is more common in women and people who are obese, have diabetes, and work in occupations involving use of keyboards, computer mouse, heavy machinery, or vibrating manual tools. Read More

Arch Rehabil Res Clin Transl 2022 Jun 29;4(2):100193. Epub 2022 Mar 29.

Department of Neurology, Loma Linda University (LLU) School of Medicine, Loma Linda, California.

Objective: To perform a pilot study to assess the efficacy of intraneural facilitation, a novel manual technique, in the treatment of carpal tunnel syndrome (CTS).

Design: Patients with clinical and electrodiagnostic evidence of CTS were randomized into intraneural facilitation or sham groups.

Setting: Electrodiagnostic laboratory in a university medical center. Read More

Ergonomics 2022 Jun 25:1-13. Epub 2022 Jun 25.

INAIL, National Institute for Insurance against Accidents ad Work, Rome, Italy.

The aim of this study is to analyse women's wrist and elbow acute work injuries together with cumulative trauma disorders, such as carpal tunnel syndrome (CTS) and epicondylitis. Five years records (2015-2019) on women's wrist/elbow acute work injuries and CTS/epicondilytis, from Italian National Compensation Authority, were collected and pooled all together as "dis-ac" (disorders + acute) events. A statistical analysis was performed in comparing the different female-dominated work sectors. Read More

Can J Cardiol 2022 Jun 22. Epub 2022 Jun 22.

Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. Electronic address:

In most Canadian provinces, eligibility criteria for public reimbursement coverage for tafamidis for treatment of transthyretin amyloidosis cardiomyopathy (ATTR-CM) include tissue biopsy confirmation of amyloidosis. Carpal tunnel syndrome requiring surgical release is common in ATTR-CM. We report our experience performing simultaneous transverse carpal ligament and tenosynovium biopsy during CTR, with all patients positive for amyloidosis, facilitating initiation of tafamidis. Read More

J Clin Med 2022 Jun 13;11(12). Epub 2022 Jun 13.

Department of Neurology, Jena University Hospital, Friedrich Schiller University, 07747 Jena, Germany.

In diabetic patients, controversies still exist about the validity of electrodiagnostic and nerve ultrasound diagnosis for carpal tunnel syndrome (CTS). We analyzed 69 patients with type 2 diabetes. Nerve conduction studies and peripheral nerve ultrasound of the median nerve over the carpal tunnel were performed. Read More

Curr Issues Mol Biol 2022 Jun 8;44(6):2646-2663. Epub 2022 Jun 8.

Clinical Department 9, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.

An association between obesity and carpal tunnel syndrome is found in many epidemiological studies. Therefore, there is a need to evaluate the physiopathological links that could explain the association between these two entities. Ectopic adipose tissue is responsible for metabolic syndrome and inflammation, and is a major risk factor for diabetes and cardiovascular diseases. Read More

J Cell Biochem 2022 Jun 23. Epub 2022 Jun 23.

Laboratory of Aquatic Molecular Biology and Biotechnology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan.

Acromegaly is a growth hormone (GH) excess pathological condition in humans. Acromegaly is associated with somatic disfigurement and a wide range of systemic manifestations such as arthritis, neuropathy, carpal tunnel syndrome, reproductive disorders, metabolic disorders, and gastrointestinal complications. The influence of excess GH on the cellular level could aid in understanding the root causes of acromegaly-related health complications. Read More

Zhongguo Gu Shang 2022 Jun;35(6):538-42

Department of Orthopaedics, People's Hospital of Wuxing District, Huzhou 313000, Zhejiang, China.

Objective: To explore clinical effects of carpal canal endoscopy in treating patients with plantar fasciopathy who failed by conservative treatment.

Methods: From August 2018 to August 2019, 50 patients with plantar fascia were divided into two groups and 25 patients in each group. In carpal canal endoscopy group, included 11 males and 14 females, aged from 39 to 67 years old with an average of(57. Read More

Spinal Cord Ser Cases 2022 Jun 22;8(1):61. Epub 2022 Jun 22.

Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Introduction: Entrapment neuropathies, typically carpal tunnel syndrome and ulnar neuropathy, frequently occur in patients with spinal cord injury (SCI). Upper limb impairments due to entrapment neuropathy can be particularly debilitating in this population. Anterior interosseous nerve (AIN) neuropathy has not been previously described in the SCI population. Read More

Am J Cardiol 2022 Jun 18. Epub 2022 Jun 18.

The Heart Center, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark.

Advances in treatment warrant earlier diagnosis of cardiac amyloidosis (CA). Common cardiac and extracardiac manifestations of CA, such as pacemaker implantation and carpal tunnel syndrome (CTS), might provide screening opportunities for CA. However the association between CTS and CA in patients undergoing pacemaker implantation has not been well studied. Read More

BMC Musculoskelet Disord 2022 Jun 21;23(1):596. Epub 2022 Jun 21.

Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, 901 87, Umeå, Sweden.

Background: Cold exposure is an underrecognized occupational hazard that may increase the risk of peripheral nerve entrapment. The aim of this study was to determine if self-reported occupational exposure to contact and ambient cooling was associated with symptoms of carpal tunnel syndrome (CTS).

Methods: In this mainly cross-sectional study, surveys were conducted on a population-based sample of men and women between 18 and 70 years of age, living in northern Sweden. Read More

Work 2022 Jun 11. Epub 2022 Jun 11.

Department of Health Sciences, University of Milano, Milan, Italy, International Centre for Rural Health, Occupational Health Unit, Hospitals Santi Paolo e Carlo, Milan, Italy.

Background: In the arboriculture sector, some activities are still manually performed by forestry workers, which result consequently exposed to a high risk of developing muscle skeletal disorders. The Italian Compensation Authority reported an increase of work-related tendinopathies and carpal tunnel syndrome in loggers, but screening protocols are not available yet.

Objectives: The objectives were: a) to evaluate the prevalence of tendinopathies and carpal tunnel syndrome in a sample of loggers and b) identify a sound screening approach. Read More

J Orthop Sports Phys Ther 2022 Jun 19:1-48. Epub 2022 Jun 19.

Universidad de Castilla- La Mancha, Health and Social Research Center, Cuenca, Spain.

Objective: To estimate the screening performances of the most important provocation tests for diagnosing carpal tunnel syndrome (CTS).

Design: Diagnostic test accuracy systematic review with meta-analysis.

Literature Search: We systematically searched the MEDLINE, Scopus, Web Of Science and Cochrane databases from inception to November 2020. Read More

Indian J Radiol Imaging 2022 Mar 6;32(1):16-29. Epub 2022 Apr 6.

Department of Radiology, Kauvery Hospital, Chennai, Tamil Nadu, India.

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy caused by impairment of the median nerve due to compression as it passes through the carpal tunnel. The current gold standard in diagnosing CTS and nerve damage is by electrophysiological nerve conduction study (NCS). However, 10 to 25% of NCS results are falsely negative. Read More

Plast Reconstr Surg Glob Open 2022 Jun 14;10(6):e4378. Epub 2022 Jun 14.

Charleston Area Medical Center, Charleston, W.Va.

Various techniques exist for treating recurrent carpal and ulnar tunnel syndrome, but AxoGuard nerve wrap has shown promising results for treatment of compression neuropathies when used in conjunction with neurolysis and tenosynovectomy. Prior results demonstrate no safety concerns, and there have not been any reported cases of infection, persistent inflammation, or recurrent perineural fibrosis. A 41-year-old, right-hand-dominant woman experienced repeated bouts of carpal and ulnar tunnel syndromes, which were treated with a small intestine submucosa matrix wrap around the median and ulnar nerves in the wrist. Read More

Pain Res Manag 2022 8;2022:1975803. Epub 2022 Jun 8.

Department of Physical Therapy, College of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia.

Background: Carpal tunnel syndrome (CTS) is the symptomatic compression neuropathy of the median nerve at the wrist level that may become a reason for upper limb disability, in the women and men population.

Objective: This study aimed to compare the efficacy of the neurodynamic technique (NT) and carpal bone mobilization technique (CBMT) incorporated with tendon gliding exercises (TGE) as an effect-enhancing adjunct while managing the participants with chronic CTS.

Methods: The study followed a two-arm parallel-group randomized comparative design. Read More

J Hand Surg Am 2022 Jun 15. Epub 2022 Jun 15.

Department of Orthopedics and Traumatology, Maltepe University, Istanbul, Turkey.

Purpose: The aim of this study was to evaluate electrodiagnostic studies and clinical outcomes after carpal tunnel release surgery in moderate and severe cases of carpal tunnel syndrome (CTS).

Methods: Seventy-two patients with moderate or severe CTS who underwent carpal tunnel release surgery (46 unilateral; 26 bilateral; total, 98 surgeries) between 2009 and 2014 were included in the study. The cases were divided into 2 groups according to electrodiagnostic results: those with moderate CTS and those with severe CTS. Read More

Medicine (Baltimore) 2022 Jun 17;101(24):e29479. Epub 2022 Jun 17.

Department of Orthopaedic Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Rationale: Pan-carpal dissociation is very rare injury and there is little information as to diagnosis, treatment, and prognosis of this injury.

Patient Concerns: A 35-year-man presented to our hospital with severe pain and swelling of the left wrist and forearm after slipping and falling while riding a motorcycle.

Diagnosis: The wrist simple radiographs demonstrated unrecognizable severe fracture-dislocation of the carpal bones concomitant with fractures of the radioulnar shaft. Read More

J Plast Reconstr Aesthet Surg 2022 May 2. Epub 2022 May 2.

Sapporo Diabetes and Thyroid Clinic, Sapporo, Japan.

Aims: Diabetes mellitus is considered an etiological factor for hand-related conditions that are grouped under the term "diabetic hand" (DH), which includes limited joint mobility, Dupuytren's contracture, carpal tunnel syndrome, and trigger finger. This study aimed to identify predictive factors and the clinical effects of DH development among patients with diabetes.

Patients And Methods: Consecutive Japanese adults with diabetes were prospectively recruited at a single outpatient center. Read More

J Bodyw Mov Ther 2022 Jul 18;31:102-112. Epub 2022 Mar 18.

Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, 1516, Cyprus. Electronic address:

Background: Little attention has been given to support the use of slider and tensioner neural mobilization (NM) techniques for upper quadrant pain (UQP). The purpose of this study was to systematically review the effectiveness of these techniques in patients with UQP.

Method: The PubMed, Cochrane Library and EBSCOhost were searched without chronological restriction to identify randomized clinical trials (RCTs) that assessed pain changes following NM in the upper quadrant. Read More

Med J Islam Repub Iran 2021 28;35:179. Epub 2021 Dec 28.

Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Carpal tunnel syndrome is a common condition that causes pain, sensory and motor symptoms in the hands, especially in the thumb, index, and middle fingers due to the compression of the median nerve in the carpal tunnel. The purpose of this research was to investigate the effect of the shock wave and phonophoresis in the improvement of clinical symptoms and function of patients with mild to moderate carpal tunnel syndrome. The present research has employed a double-blind randomized clinical trial on 60 patients in Isfahan, Iran. Read More

Am J Phys Med Rehabil 2022 Jul 4;101(7):685-692. Epub 2021 Oct 4.

From the Ankara Şereflikoçhisar State Hospital, Ankara, Turkey (HÖD); Kirşehir Ahi Evran University Education and Research Hospital, Kirşehir, Turkey (FT); Ankara City Hospital, Ankara, Turkey (HD); and High Specialization University, Ankara, Turkey (HRE).

Objective: The aim of the study was to compare the effectiveness of radial extracorporeal shock wave therapy and local corticosteroid injection on pain, function, and nerve conduction studies in the treatment of idiopathic carpal tunnel syndrome.

Design: A total of 72 patients who were diagnosed as having carpal tunnel syndrome were included in the study. The radial extracorporeal shock wave therapy group received radial extracorporeal shock wave therapy, the local corticosteroid injection group received local corticosteroid injection, and the control group only used a resting hand splint. Read More

Tech Hand Up Extrem Surg 2022 Jun 6. Epub 2022 Jun 6.

Department of Orthopaedic Surgery, HSC, The University of New Mexico, Albuquerque, NM.

Severe thenar muscle atrophy resulting in dysfunctional thumb abduction and opposition is a well-documented finding associated with long-standing severe carpal tunnel syndrome. This problem has been addressed in the past through various opposition tendon transfers. Historically, the Camitz procedure, or its modifications using the palmaris longus tendon, were recommended. Read More

Morphologie 2022 Jun 10. Epub 2022 Jun 10.

Speciality Registrar (Orthopaedics), Homerton University Hospital, London, UK.

The cross-section area is a crucial parameter to assess peripheral neuropathy. The ultrasonographic evaluation of cross-section area of median nerve is a low-cost and readily available tool for diagnosis and assessment. However, the intra-nerve dimensional variability and its normative reference value in a healthy subject are missing. Read More

Hand (N Y) 2022 Jun 13:15589447221096706. Epub 2022 Jun 13.

Vanderbilt University Medical Center, Nashville, TN, USA.

Magnetic resonance diffusion tensor imaging (DTI) can detect microstructural changes in peripheral nerves. Studies have reported that the median nerve apparent diffusion coefficient (ADC), a quantification of water molecule diffusion direction, is sensitive in diagnosing carpal tunnel syndrome (CTS). Five databases were searched for studies using ADC to investigate CTS. Read More

Hand (N Y) 2022 Jun 11:15589447211072219. Epub 2022 Jun 11.

Case Western Reserve University, Cleveland, OH, USA.

Background: No investigation has analyzed the time from injury to operative intervention and its effect on complications and functional outcomes in distal radius fractures. This investigation aimed to establish whether the time to surgical intervention from injury was associated with the observed rate of complications in distal radius fractures.

Methods: A retrospective review of all orthopedic trauma patients who came to our center was conducted from 2008 through 2014. Read More

Ann Plast Surg 2022 06;88(5 Suppl 5):S495-S497

From the Prisma Health/University of South Carolina School of Medicine, Columbia, SC.

Background: A thorough knowledge of normal and variant anatomy of the wrist and hand is fundamental to avoiding complications during carpal tunnel release. The purpose of this study was to document variations of the surface anatomy of the hand to identify a safe zone in which the initial carpal tunnel incision could be placed. The safe zone was identified as the distance between the radial side of hook of hamate and the ulnar edge of the origin of the motor branch of the median nerve (MBMN). Read More

Handchir Mikrochir Plast Chir 2022 Jun 10;54(3):236-243. Epub 2022 Jun 10.

BG Unfallklinik Ludwigshafen Klinik für Hand-, Plastische und Rekonstruktive Chirurgie, Schwerbrandverletztenzentrum, Klinik für Plastische Chirurgie der Universität Heidelberg.

Carpal tunnel syndrome (CTS) is one of the most common compression neuropathies. The therapeutic concept should be tailored to each patient individually, with initial non-surgical treatment being the standard of care for early CTS. Primary surgical intervention should be considered in more advanced diseases stages, in case of concomitant pathologies (including space-occupying lesions, complex regional pain syndrome or diabetic neuropathy), if non-surgical strategies have failed or in pregnancy-related CTS. Read More

J Hand Surg Am 2022 Jun 6. Epub 2022 Jun 6.

Department of Surgery and Perioperative Care, Dell Medical School, University of Texas at Austin, Austin, TX.

Purpose: The utility of electrodiagnostic tests (EDx) for patients with a high pretest probability of idiopathic median neuropathy at the carpal tunnel (IMNCT) based on characteristic symptoms and signs is debated. Decision-making and care strategies could be informed by a better understanding of factors associated with surgeon recommendations for electrodiagnostic testing.

Methods: Ninety-one upper-extremity surgeons participated in an online, survey-based experiment. Read More