Artikel
Dynamic Carpal Tunnel. Association of the incursion of the lumbrical muscles in the carpal tunnel as an etiological factor
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Autoren
-
Ramon De Bedout
- H san Ignacio, Bogota, Colombia
| Veröffentlicht: | 6. Februar 2020 |
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Gliederung
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Objectives/Interrogation: The carpal tunnel syndrome is the most common peripheral nerve entrapment pathology.
But there is a group of patients where, at the time of the examination, their clinical signs are not clear enough for diagnosis and the tests and exams cannot confirm it.
Patients can be part of the group of manual workers of repetitive activities.The worker is sent to medical control, usually with temporary suspension of their routine activities. This means that when assessed by the doctor, there will be no clear signs of compression of the median nerve.
Is there any relation to the incursion of the lumbrical muscles in the carpal tunnel as a dynamic etiological effect of this?
Methods: A study, using ultrasound, was made in workers between 20 and 60 years of age, and had no previous pathologies. The workers consulted a carpal tunnel clinic and were evaluated by the clinical signs.
They underwent an ultrasound examination (Siemens, sonoline-versa with a 10Mhz transducer) in three planes like this:
- 1.
- level of the carpal radio joint
- 2.
- transverse plane on the body of the lunate
- 3.
- transverse plane at the level of the hook of the Hamate
And each of these was taken at two different times:
A-Carpal tunnel with neutral wrist and extended fingers
B-Carpal tunnel with neutral wrist and fingers in forced flexion
Results and Conclusions: Findings: A study was made of 118 wrists into two groups: first group of 59 wrists with carpal tunnel symptoms and a second group of 59 wrists in workers without carpal tunnel symptoms. The ultrasonography study was done to each one of them in three levels and in two positions and it was reported as negative positive in each level of the observation.
In the first group: level I all negative,level II 22 positive (37.28%), level III 38 positive (64.4%).
In the second group: level I all negative, Level II 5 positive (8.47%), level III 15 positive (25.4%)
Discussion: The low insertion of the lumbrical muscles, which can be the etiological factor for a dynamic carpal tunnel. We recommend a study with ultrasound in those patients who have an evident symptomatology but is not clearly verifiable by conventional methods. the study with ultrasound should be of great importance.
