Hand surgery
NERVE COMPRESSION SYNDROMES – THE CENTRE FOR PERIPHERAL NERVE SURGERY
The trigger for nerve compression syndrome cannot always be clearly identified. There is often a bottleneck in the nerve canal which, together with other factors, leads to the damaging pressure on the nerve. Constricted and pinched nerves react sensitively. Especially in the hand. It is here and in the forearms that our nerves run in a very confined space. From an anatomical point of view, the possibility of a constriction syndrome occurring at this point is particularly high.
Nerve compression syndromes make touching, feeling and gripping a particular challenge; the hand and forearm react with tingling, numbness and discomfort. Even muscle atrophy, nerve damage and paralysis can occur as a result of nerve compression syndromes. Anyone whose hands are constantly in use can be affected.
The ETHIANUM has its own centre for peripheral nerve surgery specifically for nerve compression syndromes. Our specialists specialise in the treatment of constriction syndromes such as carpal tunnel syndrome, Loge de Guyon syndrome, pronator syndrome, sulcus ulnaris syndrome, supinator ligament syndrome and Wartenberg syndrome.
Rest, positioning splints and wrist cuffs are the first therapeutic approaches in the treatment of hand tightness syndromes. After a thorough examination, a high-resolution magnetic resonance imaging scan will provide decisive indications as to whether surgery is necessary for nerve compression syndrome. You can read more about how this works and which treatment methods are suitable for which syndrome here.
Contact
In the hand surgery department at the ETHIANUM, we will discuss the options for conservative or surgical treatment of nerve compression syndromes with you. Talk to the expert for hand surgery, Prof Dr Germann, in person. You can make an appointment for a consultation with our specialist with just a few clicks using our contact form or by giving us a call.
The extensive range of nerve compression syndromes
Sensory disorders in the hand – carpal tunnel syndrome and treatment
Carpal tunnel syndrome is the most common nerve compression syndrome. It manifests itself as a kind of cramp somewhere in the wrist. The fingers hurt and it pulls upwards into the arm. The symptoms increase at night in particular, while the inside of the wrist hurts during the day. The fingers then tingle or go numb. Prolonged twisting movements and unusual strain can aggravate the symptoms of this bottleneck syndrome into acute symptoms. Around 70% of all women are affected by this constriction of the median nerve. If left untreated, carpal tunnel syndrome can lead to muscle atrophy and permanent loss of sensation. In milder forms, carpal tunnel syndrome can be treated conservatively. If the neurologist measures a reduced conductivity of the median nerve, surgery for carpal tunnel syndrome is the treatment of choice. This can prevent lasting nerve damage. During this procedure, the nerve canal is widened.
Fingers tingle or cannot be spread – Loge de Guyon syndrome and treatment
Loge de Guyon syndrome is characterised by tingling in the little finger and ring finger. It also leads to problems when spreading or joining the fingers. The cause of Loge de Guyon syndrome is a bottleneck between the pea bone and the process of the hook bone at the carpus. This causes pressure on the ulnar nerve. This bottleneck syndrome is often triggered by too much pressure on the ball of the hand. Prolonged heavy support can also lead to Loge de Guyon syndrome. If conservative treatment by relieving and immobilising the nerve does not provide lasting relief, surgical decompression is recommended for Loge de Guyon syndrome. This procedure removes the pressure on the constricted nerve structures.
One-sided strain – pronator syndrome and treatment
Pronator syndrome is often triggered by rotational movements. Strains such as heavy carrying and blunt injuries can also trigger this nerve compression syndrome. Usually caused by certain one-sided activities, pronator syndrome leads to a significant enlargement of the forearm muscle. This pronator teres muscle then constricts the median nerve. This leads to sensory disturbances such as pain or tingling in the middle fingers and the palm of the hand. This constriction is treated conservatively by immobilisation using a splint. In a surgical procedure for pronator syndrome, the median nerve is exposed to make more space for the nerve canal.
Unpleasantly electrifying – sulcus ulnaris syndrome and treatment
Ulnar sulcus syndrome is a constriction of the ulnar nerve in a nerve canal on the inside of the elbow. This is also known as the “musician’s bone”. Ulnar sulcus syndrome is characterised by an unpleasant, electrifying sensation on the inside of the elbow when the arm is strained. These unpleasant sensations can also occur permanently if ulnar sulcus syndrome is not treated. They are usually accompanied by motor disorders such as a weakening of the hand. Conservative treatment of ulnar sulcus syndrome involves a padded bandage. Surgical intervention by our hand surgeons creates more space for the nerve in the canal.
Nocturnal pain – supinator ligament syndrome and treatment
Supinator ligament syndrome is caused by pressure damage to the radial nerve, which runs along the outside of the forearm. The pressure point is near the elbow. Supinatorlogen syndrome is characterised by pain on the outside of the forearm. This is initially reminiscent of a tennis elbow. However, supinatorlogen syndrome often causes pain at night. And even when the arm is kept still. Supinatorlogen syndrome is treated almost exclusively by surgery. The supinator canal is split open and thus widened.
The three stages of lunate bone necrosis are treated by immobilisation, pressure relief, transplantation of bone material from the radius and partial and full fusion of the wrist. The aim of all surgical methods for lunate bone necrosis is to achieve resilience and permanent freedom from pain.
When the wrist pinches – Wartenberg syndrome and treatment
Wartenberg syndrome is characterised by pressure damage to the radial nerve. Symptoms often include pain and sensory disturbances in the area of the extensor side of the wrist. This is usually caused by pressure on the radial nerve above the wrist. Wartenberg syndrome is usually treated with outpatient surgery. The pressure on the radial nerve is removed.
