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Carpal Tunnel Syndrome (CTS)

Wednesday, August 1, 2012

Carpal tunnel syndrome (CTS) is one of the interference with the arm due to the narrowing of the carpal tunnel, either due to edema of the fascia of the tunnelĂ‚’s roof and causeds abnormalities in the small bones of the hand resulting in suppression of the median nerve. National Health Interview Study (NIHS) estimates that the prevalence of self-reported CTS among the adult population is at 1:55% (2.6 millions).

Incidence of CTS in the population 3% in women and 2% in men with the highest prevalence in older women aged over > 55 years, usually between 40-60 years. The cause of CTS is suspected because by trauma, infection, endocrine disorders, and others (some unknown cause). The use of excessive and repetitive hand allegedly associated with this syndrome. CTS can be about middle age, women more prevalence than in men, especially in the dominant hand and pregnancy. At the initial stage ussually affect sensory nerves, paresthesias form, numbness or electric shock like feeling (tingling) in the radial site of the finger and half finger, although sometimes be felt in all fingers. When the disease progresses the pain can be worse with an increasing frequency of attacks one often even able to settle. Sometimes the pain may be felt until top hand and neck, while the generally limited paresthesia in the distal wrist area. Perceived grievances, especially at night. Can also be found swelling and stiffness in the fingers and hands especially in the morning. Furthermore the patients complain of her fingers became less skilled such as picking up small objects. On physical examination The Phalen's test and Tinel's sign show positive result and the EMG examination elicite the presence of fibrillation, polifasik, positive wave and a reduced number of motor units in thenar muscles. Treatment of the underlying condition often improves the symptoms. use of antiinflammatory drugs for wrist arthritis, and reduction of the triggering repetitive wrist movement, use of a wrist splint that holds the wrist in the neutral position may improve symptoms. Nonsteroidal anti-inflammatory drugs and Local injections with lidocaine and long-acting corticosteroids into the carpal tunnel can give striking relief. When conservative treatment fails surgical prosedure will be the last choice.

http://digilib.umm.ac.id/files/disk1/417/jiptumm-gdl-drmochbahr-20844-1-carpalt-e.pdf

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