![]() ![]() It is more frequent in the upper limb than lower limp, because of more mobility in upper limb compared with lower limb. Distal of nerve was stimulated by nerve stimulator in all of them.Ĭompression neuropathy is a major cause of neural dysfunction. In all the cases, epineurotomy was performed. Hourglass-like constriction at one point in ten cases, and area hourglass constriction in 6 cases were seen. Twenty two had diabetes, 17 heart disease, 5 rheumatoid arthritis, 8 old colles, all the patients were operated by classic approach. The physician examined two point discrimination and grip power, electro diagnostic study which revealed denervation signs in all the patients. In the prepared questionnaire was asked about pain severity ranged from 1-10, paresthesia pre and post operation and total satisfaction after surgery. Each patient was checked separately by clinical and Para clinical methods. Fifty two cases were female and 28 were males. Mean age of these patients was 58 years (46-85). Among 210 patients whom referred to hand clinic, 80 patients were evaluated for thenar atrophy, paresthesia of first, second and third finger, (advanced CTS). This case series study was conducted at Al-Zahra university hospital (Isfahan University of Medical Sciences) in between 1997 to 2005. At this study, we present severe cases of CTS that operated and hourglass-like constriction was seen. Although, compression neuropathy of median nerve (CTS) is common but hourglass-like constriction is not common. A review of the literature showed that this problem has been reported previously for the main trunk of the radial nerve, and its branches posterior interosseous nerve and for the anterior interosseous nerve (branch of median nerve). Among the various causes of compressive lesion, the development of an hourglass-like constriction of the nerve is a rare phenomenon. Carpal tunnel syndrome most commonly caused by tenosynovitis of flexor, thickening of transverse carpal ligament. The nerve may be damaged by localized pressure or inflammation caused by surrounding tissue. Nerve compressions often are caused by mechanical or dynamic compression of a nerve segment and they occur more frequently in the upper limb than in the lower limb, the nerve compression is localized to regions where the nerve passes through the anatomically narrow tunnels. This problem has been reported previously for the radial nerve, posterior inter-osseous and anterior inter-osseous nerve. Compression neuropathy of nerves is relatively common, but among the various etiologies of compressive lesions, the development of an hourglass-like constriction of the nerve that is unrelated to any recognizably compressive structure is a very rare phenomenon. ![]()
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