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Nerve entrapment: update. 2015

David T Tang, and John R Barbour, and Kristen M Davidge, and Andrew Yee, and Susan E Mackinnon
St. Louis, Mo. From the Division of Plastic and Reconstructive Surgery, Washington University School of Medicine.

OBJECTIVE After reading this article, the participant should be able to: 1. Understand the pathophysiology of chronic nerve compression. 2. Describe the evaluation of a patient presenting with compression neuropathy. 3. Discuss the current controversies in the management of compression neuropathies. 4. Describe the treatment of common compression neuropathies, including carpal and cubital tunnel syndromes. CONCLUSIONS Nerve entrapment syndromes are common in the general population, and are managed by a wide variety of medical and surgical specialists. A thorough understanding of the pathophysiology of nerve compression and appropriate clinical workup are critical in the overall management of these conditions. There remain several topics of controversy regarding the surgical management of nerve entrapment syndromes, including multiple points of nerve compression, carpal tunnel release under local anesthesia, open versus endoscopic decompression surgery, the "best" operation for primary cubital tunnel surgery, and revision decompression surgery. This article attempts to provide a concise summary of the advances in the basic and clinical science of peripheral nerve entrapment.

UI MeSH Term Description Entries
D009408 Nerve Compression Syndromes Mechanical compression of nerves or nerve roots from internal or external causes. These may result in a conduction block to nerve impulses (due to MYELIN SHEATH dysfunction) or axonal loss. The nerve and nerve sheath injuries may be caused by ISCHEMIA; INFLAMMATION; or a direct mechanical effect. Entrapment Neuropathies,Nerve Entrapments,External Nerve Compression Syndromes,Internal Nerve Compression Syndromes,Nerve Compression Syndromes, External,Nerve Compression Syndromes, Internal,Compression Syndrome, Nerve,Compression Syndromes, Nerve,Entrapment, Nerve,Entrapments, Nerve,Nerve Compression Syndrome,Nerve Entrapment,Neuropathies, Entrapment,Neuropathy, Entrapment,Syndrome, Nerve Compression,Syndromes, Nerve Compression
D010808 Physical Examination Systematic and thorough inspection of the patient for physical signs of disease or abnormality. Physical Exam,Examination, Physical,Physical Examinations and Diagnoses,Exam, Physical,Examinations, Physical,Exams, Physical,Physical Examinations,Physical Exams
D012086 Reoperation A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery. Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D002349 Carpal Tunnel Syndrome Entrapment of the MEDIAN NERVE in the carpal tunnel, which is formed by the flexor retinaculum and the CARPAL BONES. This syndrome may be associated with repetitive occupational trauma (CUMULATIVE TRAUMA DISORDERS); wrist injuries; AMYLOID NEUROPATHIES; rheumatoid arthritis (see ARTHRITIS, RHEUMATOID); ACROMEGALY; PREGNANCY; and other conditions. Symptoms include burning pain and paresthesias involving the ventral surface of the hand and fingers which may radiate proximally. Impairment of sensation in the distribution of the median nerve and thenar muscle atrophy may occur. (Joynt, Clinical Neurology, 1995, Ch51, p45) Compression Neuropathy, Carpal Tunnel,Entrapment Neuropathy, Carpal Tunnel,Amyotrophy, Thenar, Of Carpal Origin,Median Neuropathy, Carpal Tunnel,Carpal Tunnel Syndromes,Syndrome, Carpal Tunnel,Syndromes, Carpal Tunnel
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016067 Nerve Transfer Surgical reinnervation of a denervated peripheral target using a healthy donor nerve and/or its proximal stump. The direct connection is usually made to a healthy postlesional distal portion of a non-functioning nerve or implanted directly into denervated muscle or insensitive skin. Nerve sprouts will grow from the transferred nerve into the denervated elements and establish contact between them and the neurons that formerly controlled another area. Nerve Crossover,Neurotization,Crossover, Nerve,Crossovers, Nerve,Nerve Crossovers,Nerve Transfers,Neurotizations,Transfer, Nerve,Transfers, Nerve
D019299 Decompression, Surgical A surgical operation for the relief of pressure in a body compartment or on a body part. (From Dorland, 28th ed) Surgical Decompression,Decompressions, Surgical,Surgical Decompressions
D020430 Cubital Tunnel Syndrome Compression of the ULNAR NERVE in the cubital tunnel, which is formed by the two heads of the flexor carpi ulnaris muscle, humeral-ulnar aponeurosis, and medial ligaments of the elbow. This condition may follow trauma or occur in association with processes which produce nerve enlargement or narrowing of the canal. Manifestations include elbow pain and PARESTHESIA radiating distally, weakness of ulnar innervated intrinsic hand muscles, and loss of sensation over the hypothenar region, fifth finger, and ulnar aspect of the ring finger. (Joynt, Clinical Neurology, 1995, Ch51, p43) Ulnar Nerve Compression, Cubital Tunnel,Ulnar Nerve Entrapment, Elbow,Cubital Tunnel Syndromes,Syndrome, Cubital Tunnel,Syndromes, Cubital Tunnel,Tunnel Syndrome, Cubital,Tunnel Syndromes, Cubital

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