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    PBL 6

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    polog.jm610
    The document discusses management of carpal tunnel syndrome through primary and secondary prevention methods including ergonomic modifications, splinting, therapeutic exercises, steroid injections, and surgery. It notes potential complications of carpal tunnel release surgery and provides details on splinting, common exercises, injection procedures, and open and endoscopic surgical techniques. Risk factors, expected findings, and causes of stenosing tenosynovitis or trigger finger are also outlined.

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    PBL 6

    Uploaded by

    polog.jm610
    17 views13 pages
    The document discusses management of carpal tunnel syndrome through primary and secondary prevention methods including ergonomic modifications, splinting, therapeutic exercises, steroid injections, and surgery. It notes potential complications of carpal tunnel release surgery and provides details on splinting, common exercises, injection procedures, and open and endoscopic surgical techniques. Risk factors, expected findings, and causes of stenosing tenosynovitis or trigger finger are also outlined.

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    The document discusses management of carpal tunnel syndrome through primary and secondary prevention methods including ergonomic modifications, splinting, therapeutic exercises, steroid injections, and surgery. It notes potential complications of carpal tunnel release surgery and provides details on splinting, common exercises, injection procedures, and open and endoscopic surgical techniques. Risk factors, expected findings, and causes of stenosing tenosynovitis or trigger finger are also outlined.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    17 views13 pages

    PBL 6

    Uploaded by

    polog.jm610
    The document discusses management of carpal tunnel syndrome through primary and secondary prevention methods including ergonomic modifications, splinting, therapeutic exercises, steroid injections, and surgery. It notes potential complications of carpal tunnel release surgery and provides details on splinting, common exercises, injection procedures, and open and endoscopic surgical techniques. Risk factors, expected findings, and causes of stenosing tenosynovitis or trigger finger are also outlined.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 13

    M A N A G E M E N T

    U N N E L S Y N D R O M E
    O F C A R PA L T
    THERAPEUTIC AND PREVENTATIVE
    INTERVENTIONS for CTS
    Primary Prevention:
    Reduce the duration and frequency of exposure to forceful repetitive
    work:
    • job rotation
    • regular breaks
    • ergonomic modifications of activities
    THERAPEUTIC AND PREVENTATIVE
    INTERVENTIONS for CTS
    Secondary Prevention:
    As previous plus:
    • identify all relevant risk factors.

    For instance:
    • Surgery not indicated in cases of obvious reversible factors (eg
    pregnancy).
    • Treatment of an underlying metabolic or inflammatory disease may
    alleviate CTS manifestations.
    Pregnancy-safe treatment options

    Splinting
    • The first-line treatment is to immobilize the wrist in a neutral
    position to limit the range of flexion or extension.

    • Splinting gives the median nerve a break and can help alleviate
    swelling, which can allow mild to moderate nerve damage to
    heal.
    Therapeutic Exercise Program

    • Exercises may help reduce the pressure on the median nerve at the wrist. They may be incorporated with
    bracing and/or splinting, medication, and activity changes to relieve symptoms.

    • help tendons glide through the carpal tunnel can help improve joint range of motion and hand function.

    • Length of program: This exercise program for carpal tunnel syndrome should be continued for 3 to 4
    weeks, unless otherwise specified by your doctor or physical therapist. After your recovery, these
    exercises can be continued as a maintenance program.

    • Do not ignore pain

    • Ask questions
    Wrist extension stretch Wrist Flexion stretch

    Medial nerve glides


    Tendon glides
    Medication

    Carpal Tunnel Steroid Injection


    A mixture of 10 to 20 mg of lidocaine (Xylocaine) without epinephrine and 20 to 40 mg of
    methylprednisolone acetate (Depo-Medrol) or similar corticosteroid preparation is injected with a
    25-gauge needle at the distal wrist crease (or 1 cm
    proximal to it).
    Surgery, in severe cases

    Open Carpal Tunnel Release Endoscopic carpal tunnel release


    Complications

    • Injury to the palmar cutaneous or recurrent motor branch of the median nerve
    • Hypertrophic scarring
    • laceration of the superficial palmar arch
    • tendon adhesion
    • Postoperative infection
    • Hematoma
    • arterial injury
    • stiffness
    Thank you
    Stenosing Tenosynovitis
    Expected findings
     Symptoms of trigger finger usually start without any injury, although they may follow a
    period of heavy hand use. Symptoms may include:
    • Catching or locking sensation when the affected fingers are bent or straightened;
    • Pain or tenderness at the base of the affected finger/s or in the palm;
    • Nodule or bump present at the base of the affected finger/s;
    • Stiffness of the finger/s;
    • Clicking sensation when finger/s are attempted to move or bend; and
    • Swelling (usually mild) around the affected area.

    o Stiffness and catching tend to be worse after inactivity, such as when wake in the morning.
    fingers will often loosen up as move them.

    o CAUSES: A repeated movement or forceful use of the finger or thumb.


    • Rheumatoid arthritis
    • Gout
    • Diabetes
    • Grasping something, such as a power tool, with a firm grip for a long time.

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