Carpal tunnel post op

Patient, man 78 years old, diabetes. First preop exams concluded very pronounced carpal tunnel syndrome. No motor and sensory conduction velocity could be measured in the left hand. The right hand had very low amplitude signal with motor conduction velocity 33 m/s, no measurable sensory signal. 

After bilateral carpal tunnel surgery there was no symptom improvement and continued function diminishment in his right hand. A new exam was performed on the right hand only, wich concluded detirioration of the condition. This time with no measurable signals at all in the right hand.

Echoneurography confirmes bilateral carpal tunnel syndrome. Median nerve cross sectional area 24 mm2 on the right side and 16-17 mm2 on the left, immidiatly proximal to the carpal tunnel inlet. Normal value <10 mm2. It also showes exactly the difference in post operative result, which you can see below.

Clearly visible nerve swelling and a remaining marked compression by fibrous structure at proximal edge of the carpal tunnel. Imaging during dynamic test, finger flexion/extention.

Short to long axis in plane twist. Same arm.

Opposite arm, same patient, same view. Short to long axis in plane twist. Minor residual compression. Much better post op result with accompanying symptom improvement and confirming echoneurography findings.

Carpal tunnel post op

Patient, man 78 years old, diabetes. First preop exams concluded very pronounced carpal tunnel syndrome. No motor and sensory conduction velocity could be measured in the left hand. The right hand had very low amplitude signal with motor conduction velocity 33 m/s, no measurable sensory signal.

After bilateral carpal tunnel surgery there was no symptom improvement and continued function diminishment in his right hand. A new exam was performed on the right hand only, wich concluded detirioration of the condition. This time with no measurable signals at all in the right hand.

Echoneurography confirmes bilateral carpal tunnel syndrome. Median nerve cross sectional area 24 mm2 on the right side and 16-17 mm2 on the left, immidiatly proximal to the carpal tunnel inlet. Normal value <10 mm2. It also showes exactly the difference in post operative result, which you can see below.

Clearly visible nerve swelling and a remaining marked compression by fibrous structure at proximal edge of the carpal tunnel. Imaging during dynamic test, finger flexion/extention.

Short to long axis in plane twist. Same arm.

Opposite arm, same patient, same view. Short to long axis in plane twist. Minor residual compression. Much better post op result with accompanying symptom improvement and confirming echoneurography findings.
Stäng meny