MCQ Orthopedics Answer 23

The Correct Answer is C

Carpel tunnel syndrome (CTS) is an entrapment neuropathy of the median nerve at the wrist, producing parathesias and weakness of the hands. The syndrome is caused by pressure on the median nerve where it and the flexor tendons of the fingers pass through the tunnel formed by the carpel bones and the transverse carpal ligament.

It usually begins with gradual onset of numbness, tingling, and pain in the hand and wrist. Symptoms are often present at night, during sleep, and when the wrists are flexed. The symptoms occur in the thumb and the index and middle fingers, and occasionally in part of the fourth finger. The fifth finger is never involved. The thenar compartment in innervated by the median nerve and may atrophy as the syndrome progresses. The gypothenar musculature is not involved. Physical signs of CTS include a positive Phalen’s maneuver, which is a provocation of symptoms by sustained wrist flexion. Symptoms can be precipitated by activities which require repeated flexion, pronation, and supination of the wrist, e.g., sewing, driving, operating computers and cash registers, and playing golf.

Ref:

1. Goldman L, Bennett JC (eds): Cecil Textbook of Medicine, ed 21. WB Saunders Co, 2000, p 1559.
   
2. Victor M, Ropper AH: Adams and Victor’s Principles of neurology, ed 7. McGraw-Hill, 2001, pp 1433-1434. (ABFM 2002)

Category: Orthopedics MCQs