Carpal tunnel syndrome is the most commonly reported nerve entrapment sydrome, but its pathophysilogy is not well understood. Possible connections between carpal tunnel sydrome and exposure to excessive manual works were investigated in a number
of
studies but not in Korean literatures. Thus we retrospectively studied 45 Korean patients with carpal tunnel sydrome in order to know the etiologic factors, checking the history of excessive manual works and clinical aspects of disease including
symptoms, signs, Phalen test, Tinel sign. Among 13 patients who had been operated, 10 patients had follow-up nerve conduction study (NCS) of median nerve and clinical evaluations two months later. The postoperative findings were compared with
preoperative findings to know the clinical and electrophysiologic changes after operation.
Twenty two patients (55.6%) were engaged in excessive manual works such as housewifery (manual washing), housemaid work, factory work, etc. Diabetes mellitus, pregnancy, and fracture of wrist joint were found in 1 patients (22%) respectively. As
for
sensory symptoms and signs, the most frequently affected finger was the middle finger. Phalen test was positive in 14 patients (31.3%) and Tinel sign in 24 patients (54.5%). Operation was done on 23 hands of 13 patients (in 10 patients both hands
were
operated; in 2 patients, left hand; and in 1 patients, right hand) Sensory symptoms disapperaed in 19 hands of 10 patients (82.6%), but in 4 hands of 3 patients (in 10 patients both hands were operated; in 2 patients, left hand; and in 1
patients,
right
hand). Sensory symptoms disappeared in 19 hands of 10 patients (82.6%). But in 4 hands of 3 patients (17.4%), symptoms were persistent. Two months after operation, nerve conduction study of median nerve was follwed up in 19 hands of 10 patients.
The
findings revealed that terminal latency improved in 14 hands of 8 patients (73.7%) and sensory nerve conduction velocity (finger-wrist segment) improved in 8 hands of 5 patients (42.1%).
In summary, excessive manual works, especially manual washing, and housewifery in Korea, are frequently related in carpal tunnel syndrome, and the third finger is the most frequently involved finger where sensory symptoms developed. Improvement
of
the
terminal latency of median nerve was the most common electrophysiologic changes after operation.
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