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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 1999 December;50(6):227-34
Carpal tunnel syndrome in chronic hemodialysed patients
Borgese S., Bolis G. U., Parrini M. M.
Background. Carpal tunnel syndrome is a common complication of chronic hemodialysis. Its pathogenesis is still debated and many different hypotheses have been proposed, among other: hemodynamic alterations, edema in the carpal tunnel, amyloid deposits due to high serum levels of ß 2M, uremic peripheric neuropathy.
Methods. In order to evaluate the standard surgical treatment (external neurolysis) in such subgroup of subjects, all the patients referring to the hemodialysis department of our hospital, were retrospectively investigated in order to select all the cases of carpal tunnel syndrome. Twelve patients were eligible: they were studied on the basis of the clinical reports and were questioned about the clinical history and subjective results of the surgical procedure (exteral neurolysis). An accurate objective examination was performed in each patient in order to evaluate the present clinical situation.
Results. Despite the objective examination showed a high percentage of unsolved problems (neurologic deficits, weakness, poor discrimination) the subjective evaluation was invariably positive. No significative side effect was reported during and after the surgical procedure.
Conclusions. Such simple operation is therefore indicated also in this particular subgroup of subjects.