At length, nerve trunks penetrate some areas whith inextensibil character caused by repeted traumatizm which can determine traumatic scar fibrosis, a nerve compression syndrome. Compression syndromes are described in both legs, inferior and superior ( which are more common). The most common upper limb compression syndromes are: carpal tunnel syndrome and Guyon canal syndrome.
Carpal tunnel syndrome is caused by compression of the median nerve at the wrist. Frequently this disease is classified as “rheumatism” for which is necesarry to make repeated infiltration with cortisone.
Carpal tunnel consists of a trough of bone, covered by a ligament. He holds numerous anatomical structures: flexor tendons of the fingers, the median nerve.
The Reduction of the capacity of this channel (carpal ligament thickening, rheumatism, carpal bone fractures consolidated vicious, hematoma after trauma or anticoagulant therapy) or the increase in volume content (ganglion cyst, hypertrophic scars flexor tendon, tenosynovitis) cause median nerve compression. It is associated with relatively frequent presence of diabetes mellitus.
Clinically, the patient experiences paresthesia (numbness) in the first fingers, exacerbated during the night, and he/she can lose to the skilful manipulation of small objects. In advanced stages you can see muscle palm atrophy .
The only effective treatment is surgical and consists in decompression of the median nerve using microsurgical instruments and magnification. Guyon canal syndrome is the compression of the ulnar nerve at the wrist, for various reasons: synovial cyst, fractures, repeated micro-traumatism. Clinically, the patient shows the last 2 fingers numbness, abnormal sensitivity, strength and progressive decrease dexterity of finger movements. Surgery is the only effective treatment performed under general anesthesia and involves removing the causes that compress the ulnar nerve.
