Article

Carpal tunnel syndrome is the commonest entrapment neuropathy and is due to
combined compression and traction on the median nerve at the wrist. It is often
idiopathic. Although spontaneous resolution is possible, the usual natural
evolution is slow progression. Diagnosis is mainly clinical depending on symptoms
and provocative tests. An electromyogram is recommended preoperatively and in
cases of work-related disease. Medical treatment is indicated early on or in
cases with no deficit and consists of steroid injection in the canal or a night
splint in neutral wrist position. Surgical treatment is by section of the flexor
retinaculum and is indicated in resistance to medical treatment, in deficit or
acute cases. Mini-invasive techniques such as endoscopic and mini-open approaches
to carpal tunnel release with higher learning curves are justified by the shorter
functional recovery time compared to classical surgery, but with identical
long-term results. The choice depends on the surgeon's preference, patient
information, stage of severity, etiology and availability of material. Results
are satisfactory in 90% of cases. Nerve recovery depends on the stage of severity
as well as general patient factors. Recovery of force takes about 2-3 months
after the disappearance of 'pillar pain'. This operation has a benign reputation
with a 0.2-0.5% reported neurovascular complication rate.
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Langue : ANGLAIS