Certain conditions, such as menopause, thyroid disorders, kidney failure and lymphedema, may increase the chances of carpal tunnel syndrome. Carpal tunnel syndrome associated with pregnancy generally gets better on its own after pregnancy. This is common during pregnancy and menopause. Fluid retention may increase the pressure within the carpal tunnel, irritating the median nerve. Being obese is a risk factor for carpal tunnel syndrome. Some studies have shown a link between carpal tunnel syndrome and the use of anastrozole (Arimidex), a drug used to treat breast cancer. Rheumatoid arthritis and other conditions that have an inflammatory component can affect the lining around the tendons in the wrist and put pressure on the median nerve. Some chronic illnesses, such as diabetes, increase the risk of nerve damage, including damage to the median nerve. Women who have carpal tunnel syndrome may also have smaller carpal tunnels than women who don't have the condition. This may be because the carpal tunnel area is relatively smaller in women than in men. Carpal tunnel syndrome is generally more common in women. People who have smaller carpal tunnels may be more likely to have carpal tunnel syndrome. A wrist fracture or dislocation, or arthritis that deforms the small bones in the wrist, can alter the space within the carpal tunnel and put pressure on the median nerve. Although they may not directly cause carpal tunnel syndrome, they may increase the risk of irritation or damage to the median nerve. Risk factorsĪ number of factors have been associated with carpal tunnel syndrome. It may be that a combination of risk factors contributes to the development of the condition. Many times, there is no single cause of carpal tunnel syndrome. A wrist fracture can narrow the carpal tunnel and irritate the nerve, as can the swelling and inflammation caused by rheumatoid arthritis. It also provides nerve signals to move the muscles around the base of the thumb (motor function).Īnything that squeezes or irritates the median nerve in the carpal tunnel space may lead to carpal tunnel syndrome. It provides sensation to the palm side of the thumb and fingers, except the little finger. The median nerve runs from the forearm through a passageway in the wrist (carpal tunnel) to the hand. Permanent nerve and muscle damage can occur without treatment.Ĭarpal tunnel syndrome is caused by pressure on the median nerve. See your health care provider if you have signs and symptoms of carpal tunnel syndrome that interfere with your normal activities and sleep patterns. This may be due to the numbness in the hand or weakness of the thumb's pinching muscles, which are also controlled by the median nerve. You may experience weakness in the hand and drop objects. The numb feeling may become constant over time. Many people "shake out" their hands to try to relieve their symptoms. These symptoms often occur while holding a steering wheel, phone or newspaper, or may wake you from sleep. The sensation may travel from the wrist up the arm. You might feel a sensation like an electric shock in these fingers. Usually the thumb and index, middle or ring fingers are affected, but not the little finger. You may notice tingling and numbness in the fingers or hand. This results in bone misalignment and improper finger rotation.Ĭhronic Regional Pain Syndrome (CRPS) is a soft tissue reaction leading to prolonged pain and other vascular neural changes of the injured hand but it is a rare complication.Carpal tunnel syndrome symptoms usually start gradually and include: ComplicationsĬomplications after a metacarpal fracture include the non-union of the metacarpal bone when a fracture is neglected, when surgery is delayed, or in case of very unstable fractures. A closed reduction with percutaneous pining using K-wires is also a frequent option. Open reduction and internal fixation (ORIF) is performed in displaced fractures by performing a dorsal incision and placement of screws, plates and K-wires.Įxternal fixation is used in unstable fractures. Different methods are available for metacarpal fracture fixation depending on the fracture characteristics: The index metacarpal more often does need surgical treatment, as minimal anatomical changes in the finger alignment can alter the function of the entire hand. When conservative treatment fails to achieve bone alignment and healing surgery is necessary. Surgery is required in significantly displaced metacarpal fractures, open fractures, complex intra-articular fractures, and fractures with an angulation over 30 degrees.
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