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Carpal tunnel syndrome caused by space occupying lesions

 Ho Jung Kang  ;  Sung Hoon Jung  ;  Hong Ki Yoon  ;  Soo Bong Hahn  ;  Sung Jae Kim 
 YONSEI MEDICAL JOURNAL, Vol.50(2) : 257-261, 2009 
Journal Title
Issue Date
Adult ; Aged ; Carpal Tunnel Syndrome/diagnosis* ; Carpal Tunnel Syndrome/etiology* ; Carpal Tunnel Syndrome/pathology ; Female ; Gout ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Tenosynovitis ; Tomography, X-Ray Computed ; Wrist/pathology ; Wrist/surgery
Carpal tunnel syndrome ; space occupying lesion
PURPOSE: To evaluate the diagnosis and treatment of the carpal tunnel syndrome (CTS) due to space occupying lesions (SOL).

MATERIALS and METHODS: Eleven patients and 12 cases that underwent surgery for CTS due to SOL were studied retrospectively. We excluded SOL caused by bony lesions, such as malunion of distal radius fracture, volar lunate dislocation, etc. the average age was 51 years. There were 3 men and 8 women. Follow-up period was 12 to 40 months with an average of 18 months. the diagnosis of CTS was made clinically and electrophysiologically. in patients with swelling or tenderness on the area of wrist flexion creases, magnetic resonance imaging (MRI) and/or computed tomogram (CT) were additionally taken as well as the carpal tunnel view. We performed conventional open transverse carpal ligament release and removal of SOL.

RESULTS: the types of lesion confirmed by pathologic examination were; tuberculosis tenosynovitis in 3 cases, nonspecific tenosynovitis in 2 cases, and gout in one case. Other SOLs were tumorous condition in five cases, and abnormal palmaris longus hypertrophy in 1 case. Tumorous conditions were due to calcifying mass in 4 cases and ganglion in 1 case. Following surgery, all cases showed alleviation of symptom without recurrence or complications.

CONCLUSION: in cases with swelling or tenderness on the area of wrist flexion creases, it is important to obtain a carpal tunnel view, and MRI and/or CT should be supplemented in order to rule out SOLs around the carpal tunnel, if necessary.
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1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Ho Jung(강호정) ORCID logo https://orcid.org/0000-0003-0273-1264
Kim, Sung Jae(김성재)
Yoon, Hong Kee(윤홍기)
Jung, Sung Hoon(정성훈)
Hahn, Soo Bong(한수봉)
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