Although ultrasound measurements have been used in previous studies on carpal tunnel syndrome to visualize injury to the median nerve, whether such ultrasound data can indicate the severity of carpal tunnel syndrome r...Although ultrasound measurements have been used in previous studies on carpal tunnel syndrome to visualize injury to the median nerve, whether such ultrasound data can indicate the severity of carpal tunnel syndrome remains controversial. The cross-sectional areas of the median nerve at the tunnel inlet and outlet can show swelling and compression of the nerve at the carpal. We hypothesized that the ratio of the cross-sectional areas of the median nerve at the carpal tunnel inlet to outlet accurately reflects the severity of carpal tunnel syndrome. To test this, high-resolution ultrasound with a linear array transducer at 5–17 MHz was used to assess 77 patients with carpal tunnel syndrome. The results showed that the cut-off point for the inlet-to-outlet ratio was 1.14. Significant differences in the inlet-to-outlet ratio were found among patients with mild, moderate, and severe carpal tunnel syndrome. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.29 between mild and more severe（moderate and severe） carpal tunnel syndrome patients with 64.7% sensitivity and 72.7% specificity. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.52 between the moderate and severe carpal tunnel syndrome patients with 80.0% sensitivity and 64.7% specificity. These results suggest that the inlet-to-outlet ratio reflected the severity of carpal tunnel syndrome.展开更多
The distribution of sensory symptoms in carpal tunnel syndrome is strongly dependent on the degree of electrophysiological dysfunction of the median nerve. The association between carpal tunnel syndrome and ulnar nerv...The distribution of sensory symptoms in carpal tunnel syndrome is strongly dependent on the degree of electrophysiological dysfunction of the median nerve. The association between carpal tunnel syndrome and ulnar nerve entrapment is still unclear. In this study, we measured ulnar nerve function in 82 patients with carpal tunnel syndrome. The patients were divided into group I with minimal carpal tunnel syndrome （n = 35） and group II with mild to moderate carpal tunnel syndrome （n = 47） according to electrophysiological data. Sixty-one age- and sex-matched subjects without carpal tunnel syndrome were used as a control group. There were no significant differences in ulnar sensory nerve peak latencies or conduction velocities from the 4th and 5th fingers between patients with carpal tunnel syndrome and the control group. The ulnar sensory nerve action potential amplitudes from the 4th and 5th fingers were lower in patients with carpal tunnel syndrome than in the control group. The ratios of the ulnar sensory nerve action potential amplitudes from the 4th and 5th fingers were almost the same in patients with carpal tunnel syndrome as in the control group. These findings indicate that in patients with minimal to moderate carpal tunnel syndrome, there is some electrophysiological evidence of traction on the adjacent ulnar nerve fibers. The findings do not indicate axonal degeneration of the ulnar nerve.展开更多
Carpal tunnel syndrome (CTS) is the most common of all focal neuropathies. Electrodiagnostic (EXD) of CTS has advanced to include Combined Sensory Indexes (CSI) improving the specificity and sensitivity of EXD by empl...Carpal tunnel syndrome (CTS) is the most common of all focal neuropathies. Electrodiagnostic (EXD) of CTS has advanced to include Combined Sensory Indexes (CSI) improving the specificity and sensitivity of EXD by employing intra-hand comparative data. Ultrasound (US) is a popular tool for the assessment of CTS. Cross Sectional Area (CSA) is the most consistent US parameter, but as a single test, it has a similar false negative profile to EXD. This study describes a dual method of CTS interrogation by EXD and US with the results applied to a single numerical score;the Combined Median Score (CMS). This is the product of CSA of median nerve at Carpal Tunnel inlet and CSI. In a series of 100 suspected cases, standard EDX identified 89 positive cases, CSI identified 92 positives, CMS identified 95 positives. This new method further reduced the false negative rate in CTS.展开更多
<strong>Background/Aim:</strong> Carpal tunnel syndrome (CTS) is one of the most common compressive, canalicular neuropathies of the upper extremities, causing hand pain and impaired function. This clinica...<strong>Background/Aim:</strong> Carpal tunnel syndrome (CTS) is one of the most common compressive, canalicular neuropathies of the upper extremities, causing hand pain and impaired function. This clinical study was designed to compare the intraoperative median nerve distal motor latency (DML) versus the distal sensory latency (DSL) and sensory nerve conduction velocity (SNCV) during surgical treatment of CTS. <strong>Patients and Methods:</strong> A total number of 36 wrists in 30 patients with CTS diagnosed by preoperative median MNCS who underwent surgical intervention for median nerve release. Intraoperative measurements of motor distal latency (DML) and proximal latency, amplitude, and conduction velocity and distal sensory latency (DSL), amplitude, and conduction velocity of both the median and ulnar nerves before and after division of the flexor retinaculum (FR). <strong>Results:</strong> A significant decrease of the intraoperative median nerve distal motor latency (DML) after release (8.89 ± 0.93) in comparison with the preoperative median nerve DML (6.24 ± 1.06) with (p < 0.001*). But intraoperative distal sensory latency (DSL) and sensory nerve conduction velocity (SNCVM) show non-significant decrease (p = 0.161). <strong>Conclusion:</strong> Intraoperative monitoring of median nerve show rapidly improve Intraoperative motor nerve conduction than the sensory nerve conduction after release the FR during carpal tunnel surgery.展开更多
Background and Purpose: Carpal tunnel syndrome (CTS) is a common source of hand numbness and pain. The goal of this study was to compare longitudinal stretching of muscles and nerve to deep transverse friction massage...Background and Purpose: Carpal tunnel syndrome (CTS) is a common source of hand numbness and pain. The goal of this study was to compare longitudinal stretching of muscles and nerve to deep transverse friction massage for decreasing pain and improving hand function in patients with chronic CTS. Subjects and Methods: Thirty patients, 25 to 40 years old, were included in this study and randomized into two groups: the first group (36.8 ± 0.262) followed a physical therapy program group receiving stretching of wrist and hand flexors in combination with ultrasound, strengthening exercises of wrist and hand flexors, and wrist splint, three sessions per week for 12 weeks;and the second group (35.9 ± 0.225) followed the physical therapy program of deep transverse friction massage on the carpal tunnel site at the wrist joint, with using ultrasonic therapy, strengthening exercises of wrist and hand flexors and wrist splint, three sessions per week for 12 weeks. Outcome measures were range of motion (ROM), pain using visual analog scale (VAS), and hand grip strength measured with a sphygmomanometer. Results: There was a significant difference in both groups in all outcome measures compared to baseline. Over stretching group showed significant difference at the end of study in terms of range of motion of wrist flexion, extension and strength of handgrip when compared to deep friction massage group P < 0.05. However, there is no significant difference between groups in pain. Discussion and Conclusion: This study showed that the effect of stretching exercises is more beneficial than deep transverse friction massage in the treatment of patients with CTS in decreasing the compression of the median nerve in the tunnel.展开更多
Carpal tunnel syndrome(CTS) is a common peripheral entrapment neuropathy of the median nerve at wrist level, and is thought to be caused by compression of the median nerve in the carpal tunnel. There is no standard qu...Carpal tunnel syndrome(CTS) is a common peripheral entrapment neuropathy of the median nerve at wrist level, and is thought to be caused by compression of the median nerve in the carpal tunnel. There is no standard quantitative reference for the diagnosis of CTS. Greyscale sonography and sonoelastography(SEL) have been used as diagnostic tools. The most commonly agreed findings in grey-scale sonography for the diagnosis of CTS is enlargement of the median nerve cross-sectional area(CSA). Several authors have assessed additional parameters. "Delta CSA" is the difference between the proximal median nerve CSA at the pronator quadratus and the maximal CSA within the carpal tunnel. The "CSA ratio" is the ratio of CSA in the carpal tunnel to the CSA at the mid forearm. These additional parameters showed better diagnostic accuracy than CSA measurement alone. Recently, a number of studies have investigated the elasticity of the median nerve using SEL, and have shown that this also has diagnostic value, as it was significantly stiffer in CTS patients compared to healthy volunteers. In this review, we summarize the usefulness of grey-scale sonography and SEL in diagnosing CTS.展开更多
BACKGROUND Carpal tunnel syndrome(CTS)is one of the most common peripheral nerve compressive neuropathies.The clinical symptoms and physical examinations of CTS are widely recognised,however,there is still debate arou...BACKGROUND Carpal tunnel syndrome(CTS)is one of the most common peripheral nerve compressive neuropathies.The clinical symptoms and physical examinations of CTS are widely recognised,however,there is still debate around what is the best approach for assessment of CTS.Clinical assessment is still considered the gold standard,however,controversies do exist regarding the need for investigations such nerve conduction studies(NCS)to aid with management decisions.AIM To correlate the severity of NCS results to a scoring system which included symptoms,signs and risk factors.METHODS This was a prospective correlation study.We scored patients’signs and symptoms using our CTS scoring system.This was then correlated with the findings of the NCS.The scoring system included-four symptoms(2 Katz hand diagrams–one for tingling and one for numbness;nocturnal paresthesia and bilateral symptoms)and four clinical signs(weak thumb abduction test;Tinel’s sign;Phalen sign and hypoalgesia in median nerve territory)and two risk factors(age more than 40 years and female sex).We classified the NCS results to normal,mild,moderate and severe.RESULTS There were 61 scores in 59 patients.The mean scores for the categories were as follows:6.75 for normal NCS;5.50 for mild NCS;9.17 for moderate NCS and 9 for severe NCS.All scores of 8 or more matched with NCS results of moderate and severe intensity apart from three scores which were greater than seven that had normal NCS.Eta score was 0.822 for the CTS score being the dependent value and the NCS category being the independent variable showing a strong association between the scoring system and the NCS group.CONCLUSION We feel that this simple scoring system can be used to predict and correlate the severity of NCS in patients with CTS.展开更多
Some diseases require medical mitigation following the diagnosis, and sometimes the situation means that the patient has to undertake strong medication. However, this medicine is designed pharmacodynamically to intera...Some diseases require medical mitigation following the diagnosis, and sometimes the situation means that the patient has to undertake strong medication. However, this medicine is designed pharmacodynamically to interact with other organs before they reach the intended organ. Some mitigation imposes challenges on the involved organ. While the main organ will be healed, some drugs’ footprints will be left out to other organs. These are called iatrogenic injuries. In the case of anastomosis, it requires the alteration of surgical methods or the origin of iatrogenic injury in the arm;thus, the knowledge of anastomosis is very important to the field of medical practice. In addition, carpal tunnel release becomes vital in curing carpal tunnel syndrome. The paper focuses on a case of a 42-year-old woman found to have a complication to her middle finger. This case becomes important for studying Berrettini anastomosis iatrogenic injury, which relates to carpal tunnel syndrome. The Berrettini branch is a complication that facilitates communication between the superficial ulnar and median nerve. The analysis also provides the electro-diagnostic evidence of Berrettini anastomosis on how it can give a position three-finger and thus contribute to a force explanation of the median neuropraxia. Lastly, the paper provides information on the implication of the Berrettini branch for surgical use. The implication of pictures in the digital era can be used to analyze the varied connection and length between the median nerve and ulnar section. It’s easy to locate the position of high risk of iatrogenic injury in the palm due to the consistent location of Berrettini communication branches. The precaution is that operations have to be conducted moderately for a clear vision as the carefully mitigated practice ensures protection from the destruction and injury of the surrounding structures.展开更多
Anomalous muscles in carpal tunnel (CT) may cause carpal tunnel syndrome (CTS), and may be also associated with neurovascular abnormalities, altering the diagnosis and surgical interventions for CTS. The authors repor...Anomalous muscles in carpal tunnel (CT) may cause carpal tunnel syndrome (CTS), and may be also associated with neurovascular abnormalities, altering the diagnosis and surgical interventions for CTS. The authors report a case of bilateral Gantzer’s muscles (GMs) inserted into the tendons of flexor digitorum profundus within the CTs in an old male cadaver. The left GM was associated with enlarged lumbrical muscles in the CT and bifid median nerve (MN) communicating with ulnar nerve in the hand. The right GM was associated with perforation of MN branches in the hand by superficial palmar arch. This unreported coexistence of anomalous GMs and the associated neurovascular variations may have clinical relevance to etiology, diagnosis and treatment of CTS.展开更多
Objectives To get a more comprehensive recognition about carpal tunnel syndrome (CTS), especially the manual housework as its risk factor, and to facilitate early diagnosis and proper treatment. Methods 262 CTS pat...Objectives To get a more comprehensive recognition about carpal tunnel syndrome (CTS), especially the manual housework as its risk factor, and to facilitate early diagnosis and proper treatment. Methods 262 CTS patients (396 CTS hands) were analyzed retrospectively. A 1∶1 matched case control study of 61 woman pairs in relationship between manual housework and the occurrence of CTS was carried out. Results In 262 CTS patients, 84% were female, and the dominant hand was more frequently affected; repetitive and forceful movement of the hand and wrist might be associated with CTS. Typical clinical manifestations include pain and paresthesia in the median nerve territory, but 75.3% of our 396 CTS hands had all five digits involved. Conduction abnormalities appeared selectively in the median nerve distal to the wrist. In the case control study, for manual washing, rolling or kneading dough, and knitting woolen sweater, the odds ratios (OR) of CTS between high and low intensities were 3.86 (95% confidence interval 1.79-8.33, χ 2=11.76, P< 0.01), 6.25 (95% confidence interval 2.50-15.63, χ 2=15.21, P<0.01) and 1.13 (95% confidence interval 0.57-2.22, χ 2=0.125, P>0.05) respectively; and those between long and short duration (i.e. the number of years engaging in these manual housework) were 2.33 (95% confidence interval 0.63-8.64, χ 2=1.6, P>0.05), 1.88 (95% confidence interval 0.81-4.38, χ 2=2.13, P>0.05) and 1 (χ 2=0, P>0.05). Conclusions The diagnosis of CTS requires confirmation of illness history, symptoms and signs with objective electrodiagnostic tests. Manual washing and rolling or kneading dough might be associated with the onset of CTS.展开更多
基金supported by a grant from the Shanghai Key Laboratory of Peripheral Nerve and Microsurgery in China,No.14DZ2273300the Natural Science Foundation of Shanghai in China,No.13ZR1404600a grant from the National Key Basic Research Program of China(973 Program),No.2014CB542201
文摘Although ultrasound measurements have been used in previous studies on carpal tunnel syndrome to visualize injury to the median nerve, whether such ultrasound data can indicate the severity of carpal tunnel syndrome remains controversial. The cross-sectional areas of the median nerve at the tunnel inlet and outlet can show swelling and compression of the nerve at the carpal. We hypothesized that the ratio of the cross-sectional areas of the median nerve at the carpal tunnel inlet to outlet accurately reflects the severity of carpal tunnel syndrome. To test this, high-resolution ultrasound with a linear array transducer at 5–17 MHz was used to assess 77 patients with carpal tunnel syndrome. The results showed that the cut-off point for the inlet-to-outlet ratio was 1.14. Significant differences in the inlet-to-outlet ratio were found among patients with mild, moderate, and severe carpal tunnel syndrome. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.29 between mild and more severe（moderate and severe） carpal tunnel syndrome patients with 64.7% sensitivity and 72.7% specificity. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.52 between the moderate and severe carpal tunnel syndrome patients with 80.0% sensitivity and 64.7% specificity. These results suggest that the inlet-to-outlet ratio reflected the severity of carpal tunnel syndrome.
文摘The distribution of sensory symptoms in carpal tunnel syndrome is strongly dependent on the degree of electrophysiological dysfunction of the median nerve. The association between carpal tunnel syndrome and ulnar nerve entrapment is still unclear. In this study, we measured ulnar nerve function in 82 patients with carpal tunnel syndrome. The patients were divided into group I with minimal carpal tunnel syndrome （n = 35） and group II with mild to moderate carpal tunnel syndrome （n = 47） according to electrophysiological data. Sixty-one age- and sex-matched subjects without carpal tunnel syndrome were used as a control group. There were no significant differences in ulnar sensory nerve peak latencies or conduction velocities from the 4th and 5th fingers between patients with carpal tunnel syndrome and the control group. The ulnar sensory nerve action potential amplitudes from the 4th and 5th fingers were lower in patients with carpal tunnel syndrome than in the control group. The ratios of the ulnar sensory nerve action potential amplitudes from the 4th and 5th fingers were almost the same in patients with carpal tunnel syndrome as in the control group. These findings indicate that in patients with minimal to moderate carpal tunnel syndrome, there is some electrophysiological evidence of traction on the adjacent ulnar nerve fibers. The findings do not indicate axonal degeneration of the ulnar nerve.
文摘Carpal tunnel syndrome (CTS) is the most common of all focal neuropathies. Electrodiagnostic (EXD) of CTS has advanced to include Combined Sensory Indexes (CSI) improving the specificity and sensitivity of EXD by employing intra-hand comparative data. Ultrasound (US) is a popular tool for the assessment of CTS. Cross Sectional Area (CSA) is the most consistent US parameter, but as a single test, it has a similar false negative profile to EXD. This study describes a dual method of CTS interrogation by EXD and US with the results applied to a single numerical score;the Combined Median Score (CMS). This is the product of CSA of median nerve at Carpal Tunnel inlet and CSI. In a series of 100 suspected cases, standard EDX identified 89 positive cases, CSI identified 92 positives, CMS identified 95 positives. This new method further reduced the false negative rate in CTS.
文摘<strong>Background/Aim:</strong> Carpal tunnel syndrome (CTS) is one of the most common compressive, canalicular neuropathies of the upper extremities, causing hand pain and impaired function. This clinical study was designed to compare the intraoperative median nerve distal motor latency (DML) versus the distal sensory latency (DSL) and sensory nerve conduction velocity (SNCV) during surgical treatment of CTS. <strong>Patients and Methods:</strong> A total number of 36 wrists in 30 patients with CTS diagnosed by preoperative median MNCS who underwent surgical intervention for median nerve release. Intraoperative measurements of motor distal latency (DML) and proximal latency, amplitude, and conduction velocity and distal sensory latency (DSL), amplitude, and conduction velocity of both the median and ulnar nerves before and after division of the flexor retinaculum (FR). <strong>Results:</strong> A significant decrease of the intraoperative median nerve distal motor latency (DML) after release (8.89 ± 0.93) in comparison with the preoperative median nerve DML (6.24 ± 1.06) with (p < 0.001*). But intraoperative distal sensory latency (DSL) and sensory nerve conduction velocity (SNCVM) show non-significant decrease (p = 0.161). <strong>Conclusion:</strong> Intraoperative monitoring of median nerve show rapidly improve Intraoperative motor nerve conduction than the sensory nerve conduction after release the FR during carpal tunnel surgery.
文摘Background and Purpose: Carpal tunnel syndrome (CTS) is a common source of hand numbness and pain. The goal of this study was to compare longitudinal stretching of muscles and nerve to deep transverse friction massage for decreasing pain and improving hand function in patients with chronic CTS. Subjects and Methods: Thirty patients, 25 to 40 years old, were included in this study and randomized into two groups: the first group (36.8 ± 0.262) followed a physical therapy program group receiving stretching of wrist and hand flexors in combination with ultrasound, strengthening exercises of wrist and hand flexors, and wrist splint, three sessions per week for 12 weeks;and the second group (35.9 ± 0.225) followed the physical therapy program of deep transverse friction massage on the carpal tunnel site at the wrist joint, with using ultrasonic therapy, strengthening exercises of wrist and hand flexors and wrist splint, three sessions per week for 12 weeks. Outcome measures were range of motion (ROM), pain using visual analog scale (VAS), and hand grip strength measured with a sphygmomanometer. Results: There was a significant difference in both groups in all outcome measures compared to baseline. Over stretching group showed significant difference at the end of study in terms of range of motion of wrist flexion, extension and strength of handgrip when compared to deep friction massage group P < 0.05. However, there is no significant difference between groups in pain. Discussion and Conclusion: This study showed that the effect of stretching exercises is more beneficial than deep transverse friction massage in the treatment of patients with CTS in decreasing the compression of the median nerve in the tunnel.
文摘Carpal tunnel syndrome(CTS) is a common peripheral entrapment neuropathy of the median nerve at wrist level, and is thought to be caused by compression of the median nerve in the carpal tunnel. There is no standard quantitative reference for the diagnosis of CTS. Greyscale sonography and sonoelastography(SEL) have been used as diagnostic tools. The most commonly agreed findings in grey-scale sonography for the diagnosis of CTS is enlargement of the median nerve cross-sectional area(CSA). Several authors have assessed additional parameters. "Delta CSA" is the difference between the proximal median nerve CSA at the pronator quadratus and the maximal CSA within the carpal tunnel. The "CSA ratio" is the ratio of CSA in the carpal tunnel to the CSA at the mid forearm. These additional parameters showed better diagnostic accuracy than CSA measurement alone. Recently, a number of studies have investigated the elasticity of the median nerve using SEL, and have shown that this also has diagnostic value, as it was significantly stiffer in CTS patients compared to healthy volunteers. In this review, we summarize the usefulness of grey-scale sonography and SEL in diagnosing CTS.
文摘BACKGROUND Carpal tunnel syndrome(CTS)is one of the most common peripheral nerve compressive neuropathies.The clinical symptoms and physical examinations of CTS are widely recognised,however,there is still debate around what is the best approach for assessment of CTS.Clinical assessment is still considered the gold standard,however,controversies do exist regarding the need for investigations such nerve conduction studies(NCS)to aid with management decisions.AIM To correlate the severity of NCS results to a scoring system which included symptoms,signs and risk factors.METHODS This was a prospective correlation study.We scored patients’signs and symptoms using our CTS scoring system.This was then correlated with the findings of the NCS.The scoring system included-four symptoms(2 Katz hand diagrams–one for tingling and one for numbness;nocturnal paresthesia and bilateral symptoms)and four clinical signs(weak thumb abduction test;Tinel’s sign;Phalen sign and hypoalgesia in median nerve territory)and two risk factors(age more than 40 years and female sex).We classified the NCS results to normal,mild,moderate and severe.RESULTS There were 61 scores in 59 patients.The mean scores for the categories were as follows:6.75 for normal NCS;5.50 for mild NCS;9.17 for moderate NCS and 9 for severe NCS.All scores of 8 or more matched with NCS results of moderate and severe intensity apart from three scores which were greater than seven that had normal NCS.Eta score was 0.822 for the CTS score being the dependent value and the NCS category being the independent variable showing a strong association between the scoring system and the NCS group.CONCLUSION We feel that this simple scoring system can be used to predict and correlate the severity of NCS in patients with CTS.
文摘Some diseases require medical mitigation following the diagnosis, and sometimes the situation means that the patient has to undertake strong medication. However, this medicine is designed pharmacodynamically to interact with other organs before they reach the intended organ. Some mitigation imposes challenges on the involved organ. While the main organ will be healed, some drugs’ footprints will be left out to other organs. These are called iatrogenic injuries. In the case of anastomosis, it requires the alteration of surgical methods or the origin of iatrogenic injury in the arm;thus, the knowledge of anastomosis is very important to the field of medical practice. In addition, carpal tunnel release becomes vital in curing carpal tunnel syndrome. The paper focuses on a case of a 42-year-old woman found to have a complication to her middle finger. This case becomes important for studying Berrettini anastomosis iatrogenic injury, which relates to carpal tunnel syndrome. The Berrettini branch is a complication that facilitates communication between the superficial ulnar and median nerve. The analysis also provides the electro-diagnostic evidence of Berrettini anastomosis on how it can give a position three-finger and thus contribute to a force explanation of the median neuropraxia. Lastly, the paper provides information on the implication of the Berrettini branch for surgical use. The implication of pictures in the digital era can be used to analyze the varied connection and length between the median nerve and ulnar section. It’s easy to locate the position of high risk of iatrogenic injury in the palm due to the consistent location of Berrettini communication branches. The precaution is that operations have to be conducted moderately for a clear vision as the carefully mitigated practice ensures protection from the destruction and injury of the surrounding structures.
文摘Anomalous muscles in carpal tunnel (CT) may cause carpal tunnel syndrome (CTS), and may be also associated with neurovascular abnormalities, altering the diagnosis and surgical interventions for CTS. The authors report a case of bilateral Gantzer’s muscles (GMs) inserted into the tendons of flexor digitorum profundus within the CTs in an old male cadaver. The left GM was associated with enlarged lumbrical muscles in the CT and bifid median nerve (MN) communicating with ulnar nerve in the hand. The right GM was associated with perforation of MN branches in the hand by superficial palmar arch. This unreported coexistence of anomalous GMs and the associated neurovascular variations may have clinical relevance to etiology, diagnosis and treatment of CTS.
文摘Objectives To get a more comprehensive recognition about carpal tunnel syndrome (CTS), especially the manual housework as its risk factor, and to facilitate early diagnosis and proper treatment. Methods 262 CTS patients (396 CTS hands) were analyzed retrospectively. A 1∶1 matched case control study of 61 woman pairs in relationship between manual housework and the occurrence of CTS was carried out. Results In 262 CTS patients, 84% were female, and the dominant hand was more frequently affected; repetitive and forceful movement of the hand and wrist might be associated with CTS. Typical clinical manifestations include pain and paresthesia in the median nerve territory, but 75.3% of our 396 CTS hands had all five digits involved. Conduction abnormalities appeared selectively in the median nerve distal to the wrist. In the case control study, for manual washing, rolling or kneading dough, and knitting woolen sweater, the odds ratios (OR) of CTS between high and low intensities were 3.86 (95% confidence interval 1.79-8.33, χ 2=11.76, P< 0.01), 6.25 (95% confidence interval 2.50-15.63, χ 2=15.21, P<0.01) and 1.13 (95% confidence interval 0.57-2.22, χ 2=0.125, P>0.05) respectively; and those between long and short duration (i.e. the number of years engaging in these manual housework) were 2.33 (95% confidence interval 0.63-8.64, χ 2=1.6, P>0.05), 1.88 (95% confidence interval 0.81-4.38, χ 2=2.13, P>0.05) and 1 (χ 2=0, P>0.05). Conclusions The diagnosis of CTS requires confirmation of illness history, symptoms and signs with objective electrodiagnostic tests. Manual washing and rolling or kneading dough might be associated with the onset of CTS.
