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Orthopaedics Injuries Around the Fore Arm & Wrist bf1ffc2f

All are true regarding carpal tunnel syndrome except

A
Pregnancy is the most common cause
B
More common in women
C
Median nerve is compressed
D
Symptoms often appear at night
High-Yield Explanation
Ans. is 'a' i.e., Pregnancy is the most common cause * Carpal tunnel syndrome is the most common and widely known entrapment neuropathy in which the body's peripheral nerve is compressed or traumatized. Carpal tunnel syndrome occurs when the median nerve is compressed in the carpal tunnel below flexor retinaculum. The carpal tunnel is a narrow rigid passage way of ligament and bones at the base of hand, in front of distal part of wrist. Carpal tunnel houses the median nerve and 9 tendons (4 FDS, 4 FDP & FPL).Causes of carpal tunnel syndrome* There are many causes of carpal tunnel syndrome: -1) Idiopathic: - This is the most common cause.2) Pregnancy and menopause3) Metabolic : - Gout, Diabetes mellitus4) Endocrine: - Hypothyroidism, Myxedema, Acromegaly, Hyperparathyroidism.5) Deposition disorder:- Amyloidosis, Sarcoidosis, Rheumatid arthritis, Leukemia, CRF, Mucopoly-saccharoidosis.6) Alcoholism7) Local causes: - Malunited colies fracture, osteo-arthritis of the carpal bones, synovitits of flexor tendon sheath, hematoma.Clinical features of carpal tunnel syndrome* Carpal tunnel syndrome is more common in women and occurs between 35-50 years.* Symptoms usually start gradually, with frequent burning, tingling, paresthesia and numbness in the distribution of median nerve, i.e., lateral three & half of fingers and lateral 2/3rd of palm.* The symptoms often first appear during night, since many people sleep with flexed wrists. (Flexion decreases the space in carpal tunnel which results in increased pressure over median nerve).* Sensory symptoms can often be reproduced by percussing over median nerve (TineVs sign) or by holding the wrist fully flexed for a minute (Phalen's test).* As the disease progresses, clumsiness of hand and impairment of digital function develop.* Later in the disease, there is sensory loss in median nerve distribution and obvious wasting of thenar eminence.

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