ORIGINAL PAPER
Is ulnar nerve entrapment at wrist frequent among patients with carpal tunnel syndrome occupationally exposed to monotype wrist movements?
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Nofer Institute of Occupational Medicine, Łódź, Poland
(Department of Occupational Diseases and Environmental Health, Out-patient Clinic of Occupational Diseases)
Online publication date: 2016-12-30
Corresponding author
Magdalena Lewańska
Nofer Institute of Occupational Medicine, Department of Occupational Diseases and Environmental Health, Out-patient Clinic
of Occupational Diseases, św. Teresy 8, 91-348 Łódź, Poland
Int J Occup Med Environ Health. 2017;30(6):861-74
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ABSTRACT
Objectives: Association between carpal tunnel syndrome (CTS) and ulnar nerve entrapment at wrist remains controversial.
The aim of the study has been to investigate the prevalence of Guyon’s canal syndrome amongst patients diagnosed with
the CTS, occupationally exposed to repetitive wrist movements. Material and Methods: The retrospective analysis of 310 patients
(268 females, 42 males) representing the mean age of 52±7 years old hospitalized for the suspected occupational CTS
was performed. Results: In the analyzed cohort, 4 patients had undergone decompression of the Guyon’s canal in the right
limbs. Nerve conduction studies (NCS) in the ulnar nerves performed during the hospitalization of those patients did not show
any abnormalities. Nerve conduction studies revealed signs of the ulnar neuropathy (UN) at the wrist affecting exclusively sensory
fibers for 6 patients. Only those 4 patients who had undergone the operation suffered from clinical symptoms of the UN
before the surgery. In the case of the remaining patients, despite the NCS changes, signs suggestive of the UN at the wrist were
not detected. In the case of the patients with the occupational CTS, no signs of the ulnar nerve dysfunction were recorded. Conclusions: The frequency of ulnar nerve entrapment at the wrist among patients with the CTS is lower than that already
reported. The low prevalence of ulnar involvement (3.2%) for the CTS patients in our study may be related to the relatively
small number of the CTS hands with the severe changes in the NCS and/or other personal factor including anatomical variation
of the Guyon’s canal borders and its contents. Int J Occup Med Environ Health 2017;30(6):861–874