Summary
In order to analyze the pressure on the carpal tunnel in the acute phase after Colles' fractures 13 patients were studied. The initial pressure and the variation after injection of a local anesthetic into the fracture hematoma, as well as the effects of increased volar flexion of the wrist, were measured using a wick catheter technique. Comparisons were made with a control group of ten healthy volunteers. The pressure was significantly higher in the fracture group than in the control group, and it increased significantly after injection of a local anesthetic into the fracture hematoma. A correlation was found between high increases after local anesthetic injection and high initial pressure. The pressure increased linearly with volar flexion of the wrist. There was a correlation between high increases due to volar flexion of the wrist and high initial pressure. The trauma itself causes increased carpal tunnel pressure due to edema and bleeding. Injection of a local anesthetic solution increases the fluid content of the carpal tunnel and raises the pressure. Volar flexion of the wrist decreases the space in the carpal tunnel, which also increases the pressure.
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References
Bauman TD, Gelberman RH, Mubarak SJ, Garfin SR (1981) The acute carpal tunnel syndrome. Clin Orthop 156:151–156
Bora FW, Osterman AL (1982) Compression neuropathy. Clin Orthop 163:20–32
Chaise F, Witroët JA (1984) Mesures despressions intracanalaires dans le syndrome du canal carpien idiopathique non deficitaire. Rev Chir Orthop 70:75–78
Cooney WP, Dobyns JH, Linscheid RL (1980) Complications of Colles' fractures. J Bone Joint Surg [Am] 62:613–619
Frykman G (1967) Fracture of the distal radius including sequelae-shoulder-hand-finger syndrome, disturbance in the distal radio-ulnar joint and impairment of nerve function. Dissertation, Acta Orthop Scand [Suppl] 108
Gelberman RH, Hergenroeder PT, Hargens AR, Lundborg GN, Wayne HA (1981) The carpal tunnel syndrome. J Bone Joint Surg [Am] 63:380–383
Gelberman RH, Szabo RM, Mortensen WW (1984) Carpal tunnel pressures and wrist position in patients with Colles' fractures. J Trauma 24:747–749
Hayden JW (1964) Median neuropathy in the carpal tunnel caused by spontaneous intraneural hemorrhage. J Bone Joint Surg [Am] 46:1242–1244
Lundborg G, Gelberman RH, Minteer-Convery MA, Lee YF, Hargens AR (1982): Median nerve compression in the carpal tunnel — functional response to experimentally induced controlled pressure. J Hand Surg 7:252–259
Lynch AC, Lipscomb PR (1963) The carpal tunnel syndrome in Colles' fractures. JAMA 185:363–366
Maxwell JA, Kepes JJ, Ketchum LD (1973) Acute carpal tunnel syndrome secondary to thrombosis of a persistent median artery. J Neurosurg 38:774–777
Mc Clain EJ, Wissinger HA (1976) The acute carpal tunnel syndrome: nine case reports. J Trauma 16(1):75–78
Mubarak SJ, Hargens AR, Owen CA, Garetto LP, Akeson WH (1976) The wick catheter technique for measurement of intramuscular pressure. J Bone Surg [Am] 58:1016–1019
Olerud C, Lonnquist L (1984) Acute carpal tunnel syndrome caused by fracture of the scaphoid and the 5th metacarpal bones. Injury 16:198–199
Sponsel KH, Palm ET (1965) Carpal tunnel syndrome following Colles' fracture. Surg Gynecol Obstet 121:1252–1256
Weiland AJ, Lister GD, Villarreal-Rois A (1976) Volar fracture dislocations of the second and third carpometacarpal joints associated with acute carpal tunnel syndrome. J Trauma 16:672–675
William LF, Geer T (1963) Acute carpal tunnel syndrome secondary to pyogenic infection of the forearm. JAMA 185:409–410
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Kongsholm, J., Olerud, C. Carpal tunnel pressure in the acute phase after Colles' fracture. Arch. Orth. Traum. Surg. 105, 183–186 (1986). https://doi.org/10.1007/BF00433938
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DOI: https://doi.org/10.1007/BF00433938