Evaluation and Comparison of Changes in Ultrasonography before and after Carpal Tunnel release (original) (raw)

2018, Iranian Journal of Orthopaedic Surgery

Carpal tunnel syndrome (CTS) is one of the most common neuropathies caused by the trapping of the peripheral nerve resulting from the pressure of the median nerve in the carpal tunnel in the wrist. In 1854, the syndrome was defined by "Paget" as the result of pressure to the median nerve in the carpal tunnel, which is an uncompromising hole and connects the volar surface of the forearm to the palm. The carpal tunnel is limited from lateral by the cross-sectional arch of carpal bones at the level of the dorsal, hamate hook, triquetrum and pisiform in medial and scaphoid, trapezium and flexor carpi radialis muscle (1). While CTS is common among adults, it rarely occurs in children. The estimated prevalence of CTS among the general popula on is 1-5%, with a higher prevalence in women, compared to men (3:1 ra o) (2-4). High-resolution ultrasonography provides a direct view of the nerve under pressure and other structures of the soft tissue in the carpal tunnel (5-14). Given the high and excellent resolution and contrast, imaging by magnetic resonance imaging (MRI) is at the top of the list of imaging used to recognize mild degrees of pressure on the median nerve and recognize other causes of CTS, including flexor tendon tenosynovitis or spatial lesions. On the other hand, other advantages of ultrasonography (e.g., cost-effectiveness and lack of timeconsuming) have led to its application in the evaluation of carpal tunnel pathologies (4-15). A high-resolution ultrasonography with near-field probes that work at frequencies ranging at 7-10 MHz or higher can show the carpal tunnel and its contents similar to MRI (4, 5, 15) .

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