Carpal tunnel release can be a risk factor for trigger finger: National Health Insurance data analysis.

PURPOSE: We aimed to compare trigger finger (TF) development between patients with carpal tunnel syndrome (CTS) treated with carpal tunnel release (CTR) and those treated conservatively, using the National Health Insurance Services data of Korea. We also aimed to investigate risk factors for post-CTR TF development. METHODS: We selected CTS patients with or without CTR (3543 patients in each group) between 2002 and 2015. Sex, age, follow-up duration after CTS diagnosis, and comorbidities associated with TF-development were matched using propensity score. We compared the rates of TF diagnosis and subsequent TF operations between groups. Thereafter, we selected patients with CTS undergoing CTR, for whom minimum follow-up exceeded five years. We compared sex, age, height, weight, and comorbidities associated with TF risk factors between the TF-occurrence and non-TF-occurrence groups. RESULTS: On comparing CTR-treated patients with those treated conservatively for CTS, CTR-treated patients presented with significantly higher rates of TF diagnosis (12.2%) and TF operations (4.7%) than patients without CTR (6.2% and 1.2%, respectively). Among 433 TF-diagnosed patients and 166 TF-operated patients after CTR, most were identified < 5 years after CTR, with 379 diagnosed (87.5%) and 147 operated (88.5%) patients. A total of 240 patients presented with newly developed TF over a five year period. Patients with subsequent TF exhibited a higher female sex rate and shorter height. None of the variables was significant risk factors for TF development in logistic regression analysis. CONCLUSION: We confirmed high incidences of post-CTR TF diagnosis and operations. TF develops most frequently in the first postoperative year.

Carpal Tunnel Syndrome: A National Survey to Monitor Knowledge and Operating Methods.

The aim of this article was to investigate the knowledge, management, and clinical practice of Italian physiotherapists concerning patients with carpal tunnel syndrome (CTS). A national cross-sectional survey consisted of 24 questions was administered from December 2019 until February 2020. A Chi-squared independence test was run to study any difference between subgroups of the sample and responses to the questionnaire. Five hundred and eight respondents completed the survey. Most respondents (n = 225/508; 44.3%) are under 29 years old, female (n = 256/508; 50.4%) and have been working as physiotherapists for less than 5 years (n = 213/508; 41.9%). Most of respondents correctly knows about the cause (n = 455/508, 89.6%), main signs and symptoms of CTS (n = 415/508, 81.70%) and administer education, manual therapy, myofascial techniques and therapeutic exercises (n = 457/508, 89.88%). Three hundred and sixty-four (71.68%) respondents were aware of the influence of psychosocial factors on the patient's outcomes. The survey showed greater adherence to evidences by physiotherapists holding a master's degree. The results are mostly comparable with other surveys structured all over the world on the same topic. Italian physiotherapists management of the CTS was not always in line with current evidence. Interventions such as education, manual therapy, therapeutic exercise, nerve and tendon glide techniques are widely used, while the orthotic is only offered by half of the sample.

Carpal Tunnel Syndrome in Autoimmune Rheumatic Diseases and Inflammatory Bowel Diseases: Retrospective Population Cohort Study.

OBJECTIVE: The relationship between autoimmune rheumatic diseases, inflammatory bowel diseases, and carpal tunnel syndrome is unclear. We aimed to survey the occurrence and characteristics of carpal tunnel syndrome in autoimmune rheumatic diseases and inflammatory bowel diseases, compared with the general population. METHODS: We used the Longitudinal Health Insurance Database 2015 from Taiwan's National Health Insurance Research Database. Patients diagnosed with autoimmune rheumatic diseases/inflammatory bowel diseases were identified. The incidence rates and surgical rates of carpal tunnel syndrome among individual diseases were calculated. The hazard ratios when compared with age and sex matched, and 1:1 ratio control groups were surveyed. RESULTS: A total of 2591 women and 701 men were identified. The incidence rate of carpal tunnel syndrome was highest in Crohn disease (1001 per 100,000 person-years, 95% confidence interval = 0-2747), followed by scleroderma and Sjögren syndrome. The incidence rate in the control group was 571 per 100,000 person-years (95% confidence interval = 314-829). Significantly increased adjusted hazard ratios were seen in Sjögren syndrome (1.44, 95% confidence interval = 1.09-1.90) and rheumatic arthritis (1.33, 95% confidence interval = 1.05-1.70). The overall surgical rate was 0.2% in patients with autoimmune rheumatic diseases/inflammatory bowel diseases and 0.3% in the control group, without a significant difference (P = 0.85). CONCLUSIONS: Patients with Sjögren syndrome and rheumatic arthritis are susceptible to carpal tunnel syndrome. Patients with autoimmune rheumatic diseases/inflammatory bowel diseases have similar surgical rates as general population.

Comparisons of electrophysiological and clinical findings between young and elderly patients with Carpal Tunnel Syndrome.

BACKGROUND: Few studies have been published on differences between young and old patients with Carpal Tunnel Syndrome regarding clinical and electrophysiological findings. We compared the findings in participants of two age ranges. METHODS: For one year from August 2016, we performed a two-group cross-sectional study in an outpatient clinic of physical medicine and rehabilitation at a University Hospital. Two samples of young and old women with a diagnosis of the syndrome without known risk factors affecting electrophysiological findings were selected. We measured sensory and motor amplitudes and latencies, the conduction velocity of the median nerve, severity, and recurrence of the manifestations, weakness, atrophy, and severity of the syndrome. RESULTS: We had two groups of 24 young (<35 years) and 24 old (>65 years) patients with CTS. Severity of symptoms was higher in young participants [Mean (SD) 3.0(0.6) vs. 2.0(0.8), P<0.001]. Muscular weakness was not different [young 2.6(0.88) vs. old 1.9(1.6), P=0.541]. Five young and nine old participants showed thenar wasting (P=0.104). The severity of CTS was similar (P=0.129). For the group young patients, mean sensory amplitude was higher [14.07(10.98) vs. 7.58(5.08), P=0.012], while mean latency was lower [3.86(0.57) vs. 5.15(1.17), P<0.001]. In motor studies, mean latency was more prolonged in the group old patients [3.86(0.57) vs. 5.15(1.17), P<0.001]. CONCLUSION: Clinical symptoms are more severe among young people, while the pathophysiological process is more intense in the elderly. Patients should not be clinically judged merely by subjective manifestations. Both diagnostic workup and treatment should be designed holistically with all the evidence taken into consideration.

Musculoskeletal disorders in hemodialysis patients: different disease clustering according to age and dialysis vintage.

Musculoskeletal disorders remain a major problem in hemodialysis patients. The aim of the study was to estimate the prevalence of musculoskeletal manifestations in hemodialysis patients and identify disease cluster profiles. We performed a cross-sectional study including all adult patients in the hemodialysis unit at Hotel-Dieu de France Hospital. We collected demographic characteristics, musculoskeletal symptoms, biologic parameters, and treatments. Musculoskeletal disorders were classified by a rheumatologist into predefined diagnostic categories. Prevalence was presented, and a cluster analysis was performed. Eighty-nine patients were included, mean age was 67.5 ± 12 years, and 43.8% were female. Dialysis vintage was 5.7 ± 5.37 years. Musculoskeletal symptoms were reported by 76.4% of the patients. Pain was the most frequent symptom (44.9%). The main diagnoses were osteoarthritis (53.9%) and fracture (27%). Musculoskeletal symptoms and disorders were significantly associated with dialysis vintage and age. Cluster analysis identified three patient profiles: younger with low calcium levels, younger but long dialysis vintage with osteoarthritis and carpal tunnel syndrome, and older with long dialysis vintage and fractures. The prevalence of musculoskeletal manifestations is high in the hemodialysis population and increases with dialysis vintage. Musculoskeletal disorders cluster according to age and dialysis vintage. Key Points• Musculoskeletal symptoms are highly prevalent among hemodialysis patients (76.4%).• All musculoskeletal disorders are associated with dialysis vintage and age.• Three clusters are identified among hemodialysis patients: young with low calcium levels, young but long dialysis vintage with osteoarthritis and carpal tunnel syndrome and old with long dialysis vintage with fractures.

Incidence of trigger digits following carpal tunnel release: A nationwide, population-based retrospective cohort study.

The onset of trigger digits after carpal tunnel release (CTR) have been reported inconsistently across different studies. The aim of this study is to assess the incidence of trigger digits after CTR using nationwide population cohort data.We conducted a retrospective cohort study using the Longitudinal Health Insurance Database 2000 (LHID2000) from the National Health Insurance Database (NHIRD) in Taiwan. The LHID2000 contained 1 million beneficiaries randomly selected from the year 2000 Registry for Beneficiaries in NHIRD. We identified 2605 carpal tunnel syndrome (CTS) patients received CTR from 2000 to 2010 (CTR cohort, n = 2605). For each CTR patient, 4 CTS patients without CTR were randomly selected in the control cohort from the general population frequency matched by age, sex, and diagnosed year (non-CTR cohort, n = 10,420). Both cohorts were followed up until the end of 2011 to investigate the occurrence of trigger digits. Adjusted hazard ratios (aHRs) with 95% confidence interval (CI) of trigger digits were estimated using the Cox proportional hazards model after controlling for age, sex, and comorbidities.The CTR cohort had a mean follow-up period of 5.58 ±â€Š3.18 years and the non-CTR cohort had a mean follow-up period of 5.90 ±â€Š3.10 years. The overall risk of trigger digits was 3.63-fold greater in the CTR cohort than in the non-CTR cohort (incidence rate: 12.6 vs 3.38/1000 person-years, aHR: 3.63, 95% CI, 2.97-4.44). The incidence of postoperative trigger digits was highest in the 1st 6 months (incidence rate: 27.9/1000 person-years, aHR: 9.65, 95% CI, 5.27-17.7) and then significantly decreased over time.CTR was significantly associated with the subsequent development of trigger digits, especially in the postoperative 6 months.

Postoperative Pain Management after Carpal Tunnel Syndrome Surgical Treatment: Comparing Practice with Guidelines.

The management of postoperative pain after carpal tunnel syndrome surgical treatment at a tertiary hospital was analyzed and compared with the guidelines for perioperative pain management. This retrospective study included 579 patients operated on for carpal tunnel syndrome at the Split University Hospital Center in Split, Croatia. The following key data were collected from patient medical records: age, gender, type and dosage of premedication, type and dosage of anesthesia, type and dosage of postoperative analgesia per each postoperative day. The procedures related to perioperative pain were analyzed and compared with the current guidelines for perioperative acute pain management. Study results showed that 99.6% of patients with carpal tunnel syndrome were operated under local anesthesia, of which 2.9% also received sedation. Analgesics were prescribed to 45% of patients after surgery, and according to patient charts, 39% of patients actually received postoperative analgesic(s). Generally, postoperative pain was treated on the fi rst postoperative day, mostly with nonsteroidal anti-inflammatory drugs. Only two patients received weak opioids for postoperative pain. Many recommendations from the guidelines for perioperative acute pain management were not followed. In conclusion, the guidelines should be followed and appropriate interventions used to improve postoperative pain management.

The surveillance of occupational diseases in Italy: the MALPROF system.

BACKGROUND: Occupational diseases data can guide efforts to improve worker's health and safety. AIMS: To describe MALPROF, the Italian system for surveillance of work-related diseases collected by the subregional Department of Prevention. METHODS: The MALPROF system started in 1999 with contributions from Lombardy and Tuscany and spread in the following years to collect contributions from 14 out of the 20 Italian regions. MALPROF data were explored to follow-up work-related diseases and to detect emerging occupational health risks by calculating proportional reporting ratio (PRR), as in pharmacosurveillance. It classified work-related diseases according to economic sector and job activity in which the exposure occurred. Occupational physicians of the Italian National Health Service evaluate the possible causal relationship with occupational exposures and store the data in a centralized database. RESULTS: From 1999 to 2012, the MALPROF system collected about 112000 cases of workers' diseases. In 2010, more than 13000 cases of occupational diseases were reported. The most frequently reported diseases were hearing loss (n = 4378, 32%), spine disorders (n = 2394, 17%) and carpal tunnel syndrome (n = 1560, 11%). The PRR calculated for cervical disc herniation, a disease whose occupational origin has to be studied, in 1999-2010 was 2.47 [95% confidence interval (CI) 1.76-3.47] for drivers and 36.64 (95% CI 22.03-60.93) for air transport workers. CONCLUSIONS: MALPROF is a sensitive system for identifying possible associations between occupational risks and diseases, it can contribute to the development of preventive measures, to evaluate the effectiveness of preventive interventions and to stimulate research on new occupational risks and diseases.

Apertura de la herramienta manual y fuerza de aprehensión durante el corte de flores / Manual tool grip span and grip force during flower cutting

Objetivo: Analizar la relación entre la apertura de la herramienta manual de corte de flores y la fuerza ejercida por cada dedo de la mano operante durante el gesto de aprehensión. Métodos: Se desarrolló un experimento con 11 mujeres que realizaron el corte del tallo de una flor. Las operarias no sufrían del síndrome del túnel carpiano. Se calculó el diámetro de apertura de la herramienta cuando la fuerza de aprehensión en cada dedo era máxima al realizar el corte. Resultados: El principal hallazgo del estudio revela que los dedos ejercen el pico máximo de su fuerza de aprehensión cuando el valor del diámetro de apertura de la herramienta es igual para todos los dedos. Sin embargo, debido a las características formales de la herramienta comúnmente usada en el sector floricultor colombiano (palanca de primer orden), cada dedo realiza el pico máximo de la fuerza de aprehensión en diferentes instantes en el tiempo, desaprovechando la capacidad total de la fuerza de aprehensión. Conclusiones: Este hallazgo podría ser utilizado para mejorar la ventaja mecánica de las herramientas manuales de corte y reducir los factores de riesgo del síndrome del túnel carpiano debidos al sobresfuerzo

Objective: To analyze the association between grip span of a manual flower cutting tool and maximum peak force exerted by each finger in the operating hand during apprehension. Methods: An experiment was conducted in which 11 women performed the stem cut of a flower. These women did not suffer from carpal tunnel syndrome. Grip span was calculated when they exerted the maximum peak force with each finger. Results: The main finding of the study reveals that fingers exert the maximum peak force when the grip span values are the same for everyone. However, due to the shape of the tool commonly used in the Colombian flower industry (first order level), each finger reaches its maximum peak force at different times, bypassing the full capacity of each finger’s grip force. Conclusion: These findings could be used to improve the mechanical advantage of manual cutting tools to reduce risk factors for carpal tunnel syndrome due to overexertion

Efectividad de la acupuntura en el tratamiento del síndrome del túnel del carpo Las Tunas / Acupuncture Effectiveness in the Carpal Tunnel Syndrome Treatment Las Tunas

Se realizó un estudio de intervención con el objetivo de determinar la efectividad de la acupuntura en el tratamiento del Síndrome del Túnel del Carpo, en pacientes que fueron atendidos en el Policlínico Docente Manuel Piti Fajardo del municipio de Las Tunas, en el período comprendido desde enero hasta diciembre de 2008. La muestra la conformaron 50 pacientes mayores de 14 años. Se les aplicó un tratamiento con acupuntura diario en un total de quince sesiones, utilizando los puntos: IG-4, IG-11, ID-3, P-7 y TR-5, conjuntamente con la terapia medicamentosa. Los resultados fueron satisfactorios, la casi totalidad de los pacientes (49) tuvo una evolución clínica positiva, al disminuir los síntomas y signos. Las recaídas fueron mínimas luego de treinta días de aplicado el tratamiento, el consumo de medicamentos disminuyó de forma discreta y los efectos adversos al tratamiento acupuntural fueron mínimos. El tratamiento fue efectivo (AU)

An intervention study aimed at determining the effectiveness of acupuncture for treating the carpal tunnel syndrome was carried out on patients assisted at Manuel Piti Fajardo Teaching Polyclinic of Las Tunas, from January to December, 2008. The sample was made up of 50 patients older than 14 years old. A treatment of daily acupuncture was applied for a total of 15 sessions, using the following points: IG-4, IG-11, ID-3, P-7 y TR-5, together with medication therapy. The results were satisfactory: almost all the patients (49) had a positive clinical evolution as signs and symptoms decreased. Relapses were minimal after 30 days of treatment, medication consumption decreased fairly and the side effects of acupuncture were also minimal. The treatment was effective (AU)

Carpal tunnel syndrome - an occupational hazard facing dentistry.

BACKGROUND: The authors wished to evaluate the comprehensive literature on carpal tunnel syndrome to discover work specific to carpal tunnel syndrome among dentists in order to determine whether there is any correlation with dentists having a higher prevalence of its occurrence. METHODS: A review of dental literature involving carpal tunnel syndrome was undertaken. Details appearing in the literature before 1995 was reviewed in a comprehensive manner and the literature after 1995 were reviewed electronically. RESULTS: The prevalence of carpal tunnel syndrome is higher in dental professionals involved in various aspects of dental specialties. CONCLUSIONS: Abnormal postures, including muscle imbalances, muscle necrosis, trigger points, hypomobile joints, nerve compression and spinal disk herniation or degeneration may result in serious detrimental physiological changes in the body. These changes often result in pain, injury or possible neuroskeletal disorders. CLINICAL IMPLICATIONS: Dentists have an increased risk of carpal tunnel syndrome and precautions and care should be exercised to prevent detrimental irreversible changes occurring.

Outcomes of open carpal tunnel decompression.

BACKGROUND: Carpal tunnel syndrome (CTS) is the commonest peripheral neuropathy in the UK. The aim of this study was to characterise the satisfaction and evaluate the symptoms of postoperative patients having undergone open carpal tunnel decompression. METHOD: A questionnaire comprising of 6 sections was sent to 241 eligible participants. Subjects were asked to provide their demographic information and to quantify preoperative and postoperative numbness and tingling. The target population was also asked to indicate areas of postoperative numbness and tingling on a Katz hand diagram. Symptom severity and quality of life scores were also assessed. RESULTS: This study received 89 usable responses. From analysis of the Katz hand diagrams if was possible to distinguish that 17 subjects (19.1%) had 'persistent' symptoms following carpal tunnel decompression and 72 subjects (80.9%) showed signs of symptomatic improvement. The 17 individuals with persistent symptoms were further assessed for significance between variables. Of these, most were of older age, mainly female, unemployed, with lower mental health and vitality scores. With significance testing, it was shown that lower mental health scores may contribute to a poorer response to surgery (p=0.096). CONCLUSION: Most subjects experienced a positive response to surgical intervention, however, it may be necessary to screen patients for signs of depression before undertaking any surgery. By taking a more holistic preoperative assessment and aiding patients to seek treatment for any mental health conditions, this study postulates that outcomes of open carpal decompression could be improved.

Carpal tunnel syndrome in manual tea harvesters.

OBJECTIVES: This study aims to present the physiopathological and surgical aspects of carpal tunnel syndrome (CTS) related to manual tea harvesting based on nerve conduction studies and clinical scoring systems. PATIENTS AND METHODS: Clinical and neurophysiological scores as well as clinical and occupational variables were statistically analyzed using Boston questionnaire, modified criteria of Italian CTS study group, and modified neurophysiologic grading system of Italian CTS study group in 56 agricultural laborers who underwent surgery due to severe CTS. RESULTS: A statistically significant correlation was found among the clinical stages of the patients and age, working duration and duration of symptoms. There was a statistically significant relationship among neurophysiologic grades of the CTS in patients and the duration of symptoms and functional outcomes before and after surgery. CONCLUSION: We concluded that manual tea harvesting might be an occupational risk factor for work-related CTS development. Surgical treatment of CTS among manual tea harvesters revealed satisfactory results.

[Carpal tunnel syndrome: diagnostics and conservative treatment].

The Carpal tunnel syndrome is the most frequent entrapment neuropaphy of human. The Article is dedicated to diagnostics and conservative treatment this pathology. The early diagnostics and in time fixed treatment prevents the progress of the disease, raises the quality of life and allows to avoid surgical procedure. Big attention is given acupuncture reflexotherepy and infrared latherotherepy, which use raises the quality of the therapeutic influences.

Risk factors for operated carpal tunnel syndrome: a multicenter population-based case-control study.

BACKGROUND: Carpal tunnel syndrome (CTS) is a socially and economically relevant disease caused by compression or entrapment of the median nerve within the carpal tunnel. This population-based case-control study aims to investigate occupational/non-occupational risk factors for surgically treated CTS. METHODS: Cases (n = 220) aged 18-65 years were randomly drawn from 13 administrative databases of citizens who were surgically treated with carpal tunnel release during 2001. Controls (n = 356) were randomly sampled from National Health Service registry records and were frequency matched by age-gender-specific CTS hospitalization rates. RESULTS: At multivariate analysis, risk factors were blue-collar/housewife status, BMI > or = 30 kg/m2, sibling history of CTS and coexistence of trigger finger. Being relatively tall (cut-offs based on tertiles: women > or =165 cm; men > or =175 cm) was associated with lower risk. Blue-collar work was a moderate/strong risk factor in both sexes. Raised risks were apparent for combinations of biomechanical risk factors that included frequent repetitivity and sustained force. CONCLUSION: This study strongly underlines the relevance of biomechanical exposures in both non-industrial and industrial work as risk factors for surgically treated CTS.

[Diagnosis and therapy of carpal tunnel syndrome--guideline of the German Societies of Handsurgery, Neurosurgery, Neurology, Orthopaedics, Clinical Neurophysiology and Functional Imaging, Plastic, Reconstructive and Aesthetic Surgery, and Surgery for Traumatology]. / Diagnostik und Therapie des Karpaltunnelsyndroms--Leitlinie der Deutschen Gesellschaften für Handchirurgie, Neurochirurgie, Neurologie, Orthopädie unter Mitbeteiligung der Gesellschaften für Unfallchirurgie, Klinische Neurophysiologie und Funktionelle Bildgebung sowie Plastiche, Rekonstruktive und Asthetische Chirurgie.

Evidence-based supradisciplinary guideline that deals with the epidemiology, pathogenesis, symptoms, clinical and electrophysiological diagnosis, supplementary imaging investigations, differential diagnosis, conservative and surgical treatments, prognosis and course along with complications and revision surgery. The recommendations on investigation and treatment are based on a comprehensive literature search with critical evaluation and two consensus methods (expert group and Delphi technique) within the participating specialist societies. Besides this long version, a short version and a patient version can be viewed through the AWMF platform. The development of the guideline and the methodological foundations are documented in a method report. MAIN STATEMENTS: Apart from an accurate history and clinical neurological examination (including clinical tests), electrophysiological investigations (distal motor latency and sensory neurography) are particularly important. Radiography, MRI, high-resolution ultrasonography can be regarded as optional supplementary investigations. Among conservative treatment methods, treatment with a nocturnal splint and local infiltration of a corticosteroid preparation are effective. Oral steroids, splinting and ultrasound showed only short-term benefit. Surgical treatment is clearly superior to all other methods. Open and endoscopic procedures (when the endoscopic surgeon has sufficient experience) are equivalent. A routine epineurotomy and interfascicular neurolysis cannot be recommended. Early functional treatment postoperatively is important.

Work-related carpal tunnel syndrome: the facts and the myths.

Carpal tunnel syndrome is a medical disease, not an injury, although symptoms may occur in association with certain physical activities of the upper extremity. The concept of work-related carpal tunnel syndrome has grown to such proportion as to be problematic for society, having spawned health care industries to support a cultural concept and a largely mythical medical paradigm. Because of these social and economic forces, cultural perceptions and expectations have adjusted to this flawed medical model. Success in improving patient management and making the best use of sound medical evidence depends on the concurrent use of educational strategies addressing social influences and attitudinal changes of practicing physicians, patients, and third-party administrators. The promotion of evidence-based medicine is key. This article discusses these controversies and suggests ways of managing carpal tunnel syndrome.

Carpal tunnel syndrome. A new feature in the natural history of TOS?

OBJECTIVE: To ascertain whether carpal tunnel syndrome (CTS) in patients affected with toxic oil syndrome (TOS) is associated with conditions and diseases considered risk factors for CTS in the general population and/or with certain clinical manifestations of TOS. METHODS: We conducted a case-control study to compare 89 TOS patients residing in Madrid diagnosed with CTS from 1981 through July 2001 (cases) against 638 TOS patients not affected with CTS (controls). Risk factors for CTS and clinical manifestations of TOS were analyzed. RESULTS: Multivariate logistic regression analysis yielded the following odds ratios (95% confidence interval): 3.32 (1.47-7.50) for TOS-related neuropathy; 2.85 (1.14-7.13) for TOS-related thromboembolic events; 2.63 (1.36-5.06) for female gender; 0.43 (0.24-0.80) for TOS-related scleroderma; 0.26 (0.12 0.59) for smoking; and, in women, 2.53 (1.06-5.70) for fibrositis and 1.84 (1.04-3.20) for miscarriages. CONCLUSION: Our study findings support the hypothesis that CTS in TOS patients is more linked to certain clinical manifestations of TOS, mainly neuropathy, than to conditions and diseases considered risk factors for CTS in the general population.

[The carpal tunnel syndrome in the oil toxic syndrome]. / El síndrome del túnel del carpo en el síndrome del aceite tóxico.

BACKGROUND: The toxic oil syndrome (TOS) is an autoimmune disease caused by the ingestion of aniline-denatured rapeseed oil. The carpal tunnel syndrome (CTS) is an entrapment neuropathy due to the median nerve entrapment, which is associated with both occupational activities and autoimmune diseases. The objective of this work was to know the frequency and characteristics of CTS in TOS patients. PATIENTS AND METHODS: Between December 1977 and July 2000, 744 TOS patients were evaluated. The inclusion criteria were: the clinical records for patients diagnosed between May 1981 and November 1997; and for patients diagnosed between December 1997 and July 2000, symptoms with the classical or likely pattern according to the Katz's hand diagram and one of the following findings: a) abnormal electromyogram, and b) hypalgesia in the median nerve territory and positive Tinel and/or Phalen signs. RESULTS: A total of 70 patients (63 women, 90%) were diagnosed; 48 of them had been diagnosed before 1997 and 22 subsequently. The mean age of patients was 47.6 (20-78) years. In 36 patients (51.4%), a bilateral CTS was present. Fifty-six patients (81.4%) had a diagnostic EMG, and 31 (44.2%) were obese, 13 (18.6%) diabetic, and 4 (6%) had hypothyroidism. Most of these cases (48; 68.6%) were housewives. CONCLUSIONS: TOS patients have a high frequency of CTS; therefore, this condition must be suspected in patients with associated obesity and diabetes mellitus.

Experiencia clínico quirúrgica en 100 casos de síndrome de túnel carpiano / Clinic surgical experience in 100 cases of carpal tunnel syndrome

Se revisan 100 casos de atrapamiento de nervio mediano al nivel de canal carpiano operados entre 1997 y 1999, en el Hospital Regional de Talca. Se describe relación etaria y predominancia por sexo, además del perfil laboral. Además se describe la técnica quirúrgica, lo mismo que las complicaciones y evolución post quirúrgica. Se correlacionan datos clínicos con resultados electrofisiológicos. Se hace hincapié en lo frecuente de ésta patología y además de su presentación atípica