Show document

A+ | A- | | SLO | ENG

Title: VPLIV OPERATIVNE SPROSTITVE MEDIANEGA ŽIVCA NA ANATOMSKE ZNAČILNOSTI ZAPESTNEGA PREHODA Authors: ID Accetto, Pia (Author) ID Omejec, Gregor (Mentor) More about this mentor... Files: 1927$$koncna_oblika_magistrskega_dela-accetto_pia.pdf (1,72 MB) MD5: 0222EFB6BA1E8215BFFCBF174543BE6F   Language: Slovenian Work type: Bachelor thesis/paper Typology: 2.09 - Master's Thesis Organization: FIZIOTERAPEVTIKA - PHYSIOTHERAPEUTICA Abstract: Sindrom zapestnega prehoda (SZP) je najpogostejša utesnitvena nevropatija medianega živca in je pogostejši pri ženskah. Dejavniki tveganja so ponavljajoči gibi v zapestnem sklepu, ki povzročijo zadebelitev kit, njihovih ovojnic in posledično zmanjšanje svetline ZP. To povzroči utesnitev medianega živca in tipično simptomatiko, ki povzroča mravljinčenje v prvih štirih prstih, izrazitejše ponoči in zjutraj, ter ga oblažimo z otresanjem rok. Diagnozo postavimo na podlagi tipičnih simptomov, potrdimo pa meritvami prevajanja in ultrazvočne preiskave. Pri blagi do zmerni stopnji SZP je prva izbira konzervativno zdravljenje z uporabo opornic za zapestje in prste ponoči ter manj ročnega dela. Pri napredovali okvari ali neučinkovitosti konzervativnega zdravljenja svetujemo operacijo. Metode so številne, cilj vseh pa je prerezanje prečne palmarne vezi. V eksperimentalni del naloge smo vključili 25 preiskovancev in si zastavili dve hipotezi. Prva hipoteza trdi, da sprostitev medianega živca v ZP ne vpliva na širino ZP v njegovem proksimalnem in v distalnem delu. Delno smo jo potrdili, saj smo z našo raziskavo utemeljili, da operativna sprostitev medianega živca vpliva na širino v DZP predelu, a ne tudi v PZP. Tudi drugo hipotezo, da sprostitev medianega živca v ZP vpliva na ploščino prečnega preseka, na sploščenost, izbočenje in oddaljenost medianega živca od spodaj ležečih struktur, smo le deloma potrdili, saj so rezultati pokazali, da operativna sprostitev medianega živca vpliva le na njegovo sploščenost v zapestju, medtem druge izhodne spremenljivke pa so bile statistično neznačilne. Zaključili smo, da prerezanje prečne palmarne vezi povzroči številne anatomske in funkcionalne posledice, ki omogočijo regeneracijo živca, predvsem večjo mobilnost zapestnega loka med obremenitvijo, morda pa tudi pojav nekaterih težav pri manjšini pacientov, kot so bolečina in občutek nestabilnosti. Keywords: sindrom zapestnega prehoda, operativna sprostitev, ultrasonografska preiskava, anatomija, mediani živec, zapestni prehod Year of publishing: 2023 PID: 20.500.12556/ReVIS-10134  COBISS.SI-ID: 176340739  Publication date in ReVIS: 05.12.2023 Views: 674 Downloads: 44 Metadata:    Cite this work Plain text BibTeX EndNote XML EndNote/Refer RIS ABNT ACM Ref AMA APA Chicago 17th Author-Date Harvard IEEE ISO 690 MLA Vancouver : Copy citation

Share: Hover the mouse pointer over a document title to show the abstract or click on the title to get all document metadata.

Secondary language

Language:	English
Title:	The effect of carpal tunnel release on wrist anatomical characteristics
Abstract:	Carpal tunnel syndrome (CTS) is the most common compression neuropathy of the median nerve. Carpal tunnel syndrome is more common in women. Risk factors are repetitive movements of the wrist, which cause thickening of the tendons and their sheaths, and a consequent decrease in the brightness of the CT. This leads to entrapment of the median nerve and the typical symptoms, which include tingling in the first four fingers, more pronounced at night and in the morning, accompanied by shaking of the hands. The diagnosis is made on the basis of typical symptoms and confirmed by conduction studies and ultrasound. For mild to moderate CTS, conservative treatment with overnight wrist and finger splints and reduced manual work is the first choice. If the condition progresses or conservative treatment is ineffective, surgery is recommended. There are many methods, all of which aim to cut the transverse palmar ligament. The experimental part of the thesis involved 25 subjects and two hypotheses. The first hypothesis was that median nerve release in the CT does not affect the width of the CT in either its proximal or distal part, which was partially confirmed as our study concluded that operative median nerve release affects the width in the DCT region but not in the PCT. The second hypothesis, that median nerve release in the CT would affect the cross-sectional area, flattening, bulging and distance of the median nerve from the underlying structures, was only partially supported, as the results showed that surgical median nerve release only affected the flattening of the median nerve at the wrist, while the other baseline variables were not statistically significant. In the course of our study, we concluded that transverse palmar ligament transection has a number of anatomical and functional consequences that allow for nerve regeneration, in particular increased mobility of the wrist arch under stress, but also possibly the occurrence of some problems in a minority of patients, such as pain and a feeling of instability.
Keywords:	carpal tunnel syndrome, surgical decompression, ultrasonographic examination, anatomy, median nerve, carpal tunnel

Back