User:Saltrabook/Clinical diagnostic guidelines/Carpal Tunnel Syndrome

Definition

The compression of the median nerve in the carpal tunnel, Besides n median contains the carpal tunnel of the hand 9 flexors

Occurrence

The prevalence of the disease in the population indicated slightly varying from 1-5%, with a higher prevalence in women (approximately 3:1)

Risk Factors

Individual reasons: The disease is most common in women and in the age group 40-60 years, but with slightly different pattern for women and men. Family history, obesity, pregnancy, certain medical conditions (myxedema, rheumatoid arthritis, diabetes mellitus, connective tissue) and former håndledsfraktur play a role. Håndledstendinitis thought to be a cause, which is based on clinical experience and is not epidemiological shown. On the whole, considered conditions resulting in reduction of the space in the carpal tunnel, posing an increased risk of suffering Employment-related reasons: There is evidence of a higher risk of CFS by job that involves a combination of force and repetitivitet. Repetitive work alone may constitute a risk. It also demonstrated an increased risk of exposure to hand-arm vibrations, but the specific causation is here uncertain, since exposure to vibration almost always occur simultaneously with exertion. Direct pressure on the carpal tunnel is also a cause of the disorder. There is insufficient evidence that specific wrist postures and even computer work associated with an increased risk for the disorder. The cut of meat, filleting of fish, packing work, certain installation, logging, drilling concrete examples of operations which implies a risk of KTS 3.2

Clinical description

Reference is made to the section on Carpal Tunnel Syndrome

Causation

In assessing the possible causal relationship includes description of the different job with emphasis on the extent of the exercise of force, repetitive hand movements, as well as exposure to vibrating tools. The temporal factors are assessed both in terms of number of years of stress, the daily exposure and the relationship between exposure and onset of the disease. There is no scientific evidence to indicate certain levels of exposure, but there are workers context provided guidelines for recognition, see below

Treatment and prognosis

The treatment is physical therapy, rail and possible operating division of flexorretinaklet of the carpal tunnel. The forecast is considered good after the operation. Pt. can usually return to work after 6 weeks if the following preventive measures are observed. If the condition is primarily caused by hand-arm vibration, the operation does not have as good results, due to degeneration of nerves also fingers

Prevention 

If the disease is considered due to the working conditions, the following should be considered: Change of job roles, job rotation. Upgrading and training may be necessary so that multiple job functions can be disputed. Reduced working time and pace in a tilbageslusningsfase after sick leave. Changes in working practices and the use of aids. Compliance with the useful lives of hand-arm vibrating tool. Replacement of the old tool is of great importance for the degree of Vibration exposure The patient can continue in his profession if the above observed The disease is covered by the list of occupational diseases and is recognized when there is a combination of strenuous and repetitive work, exposure to hand-arm vibrations, following tenosynovitis or direct pressure on the nerve. In practice, there must be strenuous and monotonous work, a large part of the working day. For Vibration exposure, the same exposure levels as for the recognition of vibration injury (Mb. Raynaud)