ABSTRACT
A study was performed to analyze the efficacy of an instrumented carpal-compression device in the diagnosis of carpal tunnel syndrome. This device provides a direct measurement of the amount of applied pressure necessary to elicit symptoms of carpal tunnel syndrome. A positive test is indicated by the reproduction of numbness, tingling, or dysesthesia in the distribution of the median nerve within 30 seconds. The study group consisted of 30 patients in whom 48 hands had clinical symptoms and positive electrodiagnostic findings of carpal tunnel syndrome; 50 hands of 25 asymptomatic individuals were studied as controls. This study found that the instrumented carpal-compression test had an 89% sensitivity and a 96% specificity in diagnosing carpal tunnel syndrome. The instrumented device described in this study is lightweight and simple to use, and provides a rapid and inexpensive method of screening for carpal tunnel syndrome.
Subject(s)
Carpal Tunnel Syndrome/diagnosis , Manometry/instrumentation , Adult , Aged , Aged, 80 and over , Carpal Tunnel Syndrome/therapy , Equipment and Supplies , Female , Humans , Male , Median Nerve , Middle Aged , Pressure , Sensitivity and SpecificityABSTRACT
A new test, called the carpal compression test, consists of application of direct pressure on the carpal tunnel and the underlying median nerve. The results of the Tinel percussion test, the Phalen wrist-flexion test, and the new test were evaluated in thirty-one patients (forty-six hands) in whom the presence of carpal tunnel syndrome had been proved electrodiagnostically, as well as in a control group of fifty subjects. For the diagnosis of carpal tunnel syndrome, the carpal compression test was found to be more sensitive and specific than the Tinel and Phalen tests.
Subject(s)
Carpal Tunnel Syndrome/diagnosis , Median Nerve , Adult , Aged , Carpal Tunnel Syndrome/physiopathology , Carpal Tunnel Syndrome/surgery , Electromyography , Female , Humans , Isometric Contraction , Male , Middle Aged , Neural Conduction/physiology , Neurologic Examination/methods , Percussion , Posture , Reaction Time/physiology , Sensitivity and SpecificityABSTRACT
Sailboarding is an exciting sport, but it does involve some risk for injury. In this study of 21 knee injuries that occurred during sailboarding over a 2-year period, 12 were isolated medial collateral ligament (MCL) sprains, 4 were meniscus tears, and 5 involved joint instability. The MCL sprains were directly related to the use of the foot straps on the sailboard. Conservative treatment was successful for the MCL sprains; the meniscus tears were treated with arthroscopic surgery. Improved foot straps designed to release the foot more readily may help reduce knee injuries.
ABSTRACT
This paper reports an analysis for treatment of anterolateral rotatory instability by the Ellison procedure, a technique involving rerouting a portion of the iliotibial band posterior to the fibular collateral ligament. A detailed description of the operative procedure is presented. One hundred four patients were evaluated for subjective improvement. The average length of followup was 51 months (range, 24 to 100 months). Eighty-one patients (80%) had a good or excellent result, 15 patients (14%) were rated fair, and 6 patients (6%) were rated poor. Sixty-three patients returned for a detailed clinical examination (average followup was 53 months; range, 24 to 100 months). An excellent or good objective rating was achieved in 49 patients (78%). Ten patients (16%) were rated as fair, and four patients (6%) were rated as failures. We recommend the Ellison procedure for the recreational athlete as a safe and effective mode of treatment for anterolateral rotatory instability.
