Carpal Tunnel Syndrome - Dr. Ze-Hui Han скачать в хорошем качестве

Carpal Tunnel Syndrome - Dr. Ze-Hui Han

Iowa Ortho hand surgeon Dr. Ze-Hui Han discusses symptoms and treatment options for Carpal Tunnel Syndrome. What is carpal tunnel syndrome and what is the transverse carpal ligament? Carpal tunnel basically, think about it as a tube. At the back wall, it's all the carpal bones and the front. It's a very tight transverse carpal ligament. It's like a sheath. This forms a tube. Inside there are nine tendons and one nerve, the medial nerve located very much on top. So, you have a tube, you have nine tendons and one nerve occupy this tube. If the pressure goes up, same thing, like a when you said over there for two hours. You can feel your leg, you know, you can't feel your feet – it’s because of the nerve got a pinched, so the information can’t be transferred. You don't feel it. That the reason. When the inside of this tube – the pressure goes up, you cause the damage, caused the problem for medial nerve. What are common signs and symptoms of Carpal Tunnel Syndrome? Certainly, you have numbness and tingling – and that's a basic thing. There is one very important thing - it's called ‘nocturnal symptoms.’ So, if you have a problem with this (symptom) and you wake up at the middle of the night and your hand in numb and you can't feel it. That’s the first symptom - nocturnal symptoms. Number two, a lot of people actually have a problem when they are holding their cell phones, when they holding the phone, after certain time - 5-10 minutes, their hand is getting numb. And another (symptom) is when they are driving. When they drive – they put a hand like this. There tell me that after a certain time, my hand is getting numb and getting painful. This is what I see from my patients. Most common symptoms. When should you see a doctor for these symptoms? If you start having numbness and tingling, you should pay attention to it. And there are two clinical symptoms I want to make sure you see doctor right away. Number one that you have persistent numbness, tingling. You feel numb or tingle all the time. That means you have a nerve pinched that you have symptoms all the time. You need to see a doctor. The second is to watch the center muscle, the thinner muscle. It’s a piece of muscle right next to your thumb. If you feel that muscle a little change, atrophy, anything – you need to see a doctor right away because thinner muscle atrophy is not going to come back. That's actually a good indication for the people to have surgery. What are treatment options for carpal tunnel syndrome? Always we start with conservative treatment. Conservative treatment can include modified activities will make sure you work environment doesn’t require wrist twisting and bending and ergonomic evaluation. Number two, you can use a wrist splint to keep the wrist straight at night to avoid the nocturnal symptoms. And number three is that sometimes I do a cortisone injection for the people, you know, for the older people or for the people with the pregnancy, you know, if they cannot have surgery, that's a conservative treatment the from our literature. You know, certainly, other sources they have some other reasons, but from our literature, the conservative treatment is used for those three conditions. Once we exhaust conservative treatment options, it's about the surgery. Indication for the surgery is number one again, like I said – one is a persistent numbness and tingling anything if they have intrinsic muscle atrophy, that needs to be taken care of with the surgery. And sometimes another indication is that if the patient had the nerve conduction test that they have a severe compression. And also, if the patient already having a long-term history, like five to six years, tried, everything not working with conservative treatment. That's another indication for the surgery too. Talk about surgical treatment for carpal tunnel syndrome. There are different kinds of surgical treatment, and now we talk about number one in that we use the traditional open technique. This is a very mature surgery. Our incision is only about half inch and the operation take about 30 minutes. You come in and go home the same day and this one take about a four to six week for the recovery. The good part of all this (surgery) is that you can see the nerve all the time. Better to avoid the complication that could, you know, nerve damage because (the nerve) is right underneath of your eyeballs. There is another option that people now talk about a lot is the endoscopic carpal tunnel release. I only do the traditional opening. The endoscopic – I trained during my fellowship. I do have some reservation for this surgery, but the surgery also has good indications, and the recovery is similar to the open surgery. The advantage for (endoscopic) is that you have less pain for first about four to six weeks after the surgery, but rest of the thing is very similar. For more information: https://www.iowaortho.com/service/han...