جستجوی مقالات مرتبط با کلیدواژه « عصب مدین » در نشریات گروه « پزشکی »

The brachial plexus is a complex network located in the neck and axilla region. Various variations of the brachial plexus have been reported, which are clinically significant.

Given that variations of the brachial plexus, especially involving the musculocutaneous and median nerves, are relatively common, the aim of this study is to report an anatomical variation of the brachial plexus related to the musculocutaneous and median nerves.

In this study, during the dissection of a 71-year-old male cadaver in the anatomy hall of the medical school at Torbat Heydarieh University of Medical Sciences, a variation in the median nerve was observed. In this case, the median nerve, which normally separates from the lateral and medial cords and descends in the arm to the cubital fossa without any connection to other nerves, after the coracobrachialis muscle was found to be connected to the musculocutaneous nerve.

A comprehensive understanding of variations in upper limb nerves can be crucial in interpreting and diagnosing various types of surgeries, especially those related to the reconstruction and rehabilitation of the brachial plexus.

It can be concluded that population areas such as urban and rural centers are vulnerable to air pollution in terms of social vulnerability and Nimroz and Hamoon counties have the lowest social vulnerability.

Carpal tunnel syndrome (CTS) is the most common peripheral nerve compression neuropathy that causes many social and occupational problems for individuals. The epidemiology of the disease has not been investigated in South Khorasan province; therefore, this study aimed to investigate the epidemiological and clinical symptoms and the relationship between the nerve and muscle findings of patients with CTS referred to the physical medicine clinic of Birjand University of Medical Sciences, Birjand, Iran, in 2023. In this descriptive and analytical study, 159 hands with CTS referred to the Physical Medicine Clinic of Imam Reza Birjand Hospital were examined in 2023. Demographic information, body mass index, history of previous diseases, dominant hand, affected hand, duration of involvement, and clinical symptoms, including night pain or pain during activity, numbness and tingling, and muscle atrophy of the thenar region were investigated, and recorded in the checklist. The severity of median nerve involvement in CTS syndrome was recorded using nerve conduction study and electromyography (NCS-EMG) with nemous electromyography divice and classifieds according to last guideline in Electrodiagnostic Medicine (2nd edition) book. The mean age of patients was 51.01±13.5 years, which was more common in women. It was more prevalent in the age group of 50-60 years. Numbness was the most common symptom. Frequency distribution of CTS severity had a significant relationship with age group, pain during sleep and work, paresthesia, and muscle atrophy (P<0.05). Necessary information should be given to health centers and housewives so that suspected patients can be referred to the centers for early treatment and prevention from the disease progression and additional burden on the health system.

The cuboid or square shaped wrist has been suggested in the previous studies as a predisposing factor for CTS. The aim of this study was to compare the conduction velocity and cross-sectional area of the median nerve in the wrist of healthy individuals with and without a cuboid wrist in ultrasonographic and electrodiagnostic studies.

In a analytic cross-sectional study, the volunteers at the beginning of the study, antero-posterior and medio-lateral diameters of their wrists were measured by calipers and those with a wrist-ratio greater than or equal to0.7were considered as a case group and individuals with lesser were considered as a control group. Then, the cross-sectional area of the median nerve at the entrance of the carpal tunnel was assessed by ultrasound and the conduction velocity of the nerve was assessed by electrodiagnostic tests in both groups.

In this study, 80 healthy hands were evaluated in two groups with and without cuboid wrist. The mean nerve conduction velocity in the median nerve was 47.15 m/s in individuals with a cuboid wrist and 51.93m/s in healthy individuals.The mean cross-sectional area of the median nerve in individuals with a cuboid wrist and in the control group was 10.6mm and 8.2mm, respectively.

The present study showed that the mean cross-sectional area of the median nerve in healthy individuals with a cuboid wrist is higher and the use of ultrasound in the diagnosis of CTS in these individuals may be associated with a false positive result. Therefore, it is necessary to consider the wrist-ratio and further evaluations in these people.

Carpal tunnel syndrome (CTS) is one of the most common neuropathies caused by entrapment of the median nerve in the wrist. The purpose of this study was to evaluate the electrodiagnostic changes before and after carpal tunnel release (CTR).

The present descriptive study was conducted in 24 patients (38 hands) with CTS in order to evaluate the electrodiagnostic changes before and 12 months after CTR and to investigate the relationship between electrodiagnostic changes and Boston score, DASH score, and Grip and Pinch strength. Data were analyzed using SPSS V20.

Electrodiagnostic study showed that the mean distal motor latency (DML) significantly decreased from 6.7 ±2.12 ms to 4.70 ±0.61 ms (P=0.0001) and the mean distal sensory latency (DSL) significantly improved (from 4.98 ±1.06 ms to 4.54 ±0.75 ms, P=0.012). Findings showed no significant differences in mean DML and DSL between right and left hands (P=0.378, P=0.233). There was a significant positive correlation between age and DML and DSL after CTR (r=0.475, P=0.001, and r=0.341, P=0.024, respectively). No significant correlation was observed between postoperative electrodiagnostic findings and Boston score, DASH score, and Grip score ({sss: P=0.931, fss: P=0.629}, P=0.169, P=0.1000, respectively).

Postoperative electrodiagnostic findings significantly improved, but there was no clear association between EMG NCV and the severity of postoperative clinical symptoms. Therefore, in order to evaluate the outcome of CTR, combination of clinical symptoms with electrodiagnostic findings is considered valuable.

Carpal tunnel syndrome is the most prevalent neuropathy caused by trapping and median nerve compression in the wrist. This study aimed at comparing the effects of minimal incision and double incision in treatment of patients with carpal tunnel syndrome.

This randomized controlled trial was performed in 50 patients with carpal tunnel syndrome attending Shahid Beheshti and Ayatollah Rouhani hospitals in Babol, Iran, candidates for surgery. The patients were divided into two groups using random number table to have either minimal incision (n=25) or double incision (n=25). All patients completed the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) and Visual Analogue Scale (VAS) before and three months after the surgery.

The patients included 40 (80%) males and 10 (20%) females. The mean age of the patients was 51.78±8.22 years old. The mean scores for paresthesia, numbness, pain, weakness, nighttime symptoms and functional status (according to BCTQ), and also mean VAS score significantly reduced after the intervention in both groups (P<0.001). The mean scores for these parameters were not significantly different between the two groups neither before nor after the treatment.

The results of treatment with minimal incision and double incision were not different, but minimal incision is suggested as a selective therapeutic approach due to smaller cut.

NeuroMobilization is one of the recent nonsurgical treatments for patients with carpal tunnel syndrome with a lot of discrepancies regarding its efficacy. The aim of the present study was a systematic review of the previous studies about effectiveness of neural gliding techniques for carpal tunnel syndrome patients.
Using the keywords Carpal tunnel syndrome, Median nerve, NeuroMobilization, and physiotherapy, a literature search was performed for the period 1998-2015, in Google Scholar, PEDRO, PubMed, and Science Direct databases.
Among the articles found, only the ones that had control groups and used neural gliding techniques were chosen. Therefore, out of 20 articles, nine were selected according to the inclusion criteria.
Although pain reduction, function and sensing improvement, and ability enhancement were noticed in patients with carpal tunnel syndrome, after applying neural gliding techniques in some studies, the efficacy was not clear and definite due to weak results in some other studies. Also, more comprehensive researches are needed with more study cases and longer follow-up time to resolve these discrepancies.

The early onset of rehabilitation has an important role in repair of peripheral nerve after injuries along with sensory and motor developments. Therefore, the purpose of this study was to compare the recovery rates in median and ulnar nerves and the effective factors in this improvement, year after rehabilitation. Sensory and motor functions were evaluated in 33 patients with Ulnar and Median nerve damages, who had been treated by the same surgeon and therapist, by two specialists. participants, %69.7 were males and %30.3 were females with the average age of 31years. Ulnar, was the nerve with the highest rate of injury (%54.5) and the rest %30.3 injuries were belong to the Median and %15.2 injuries occurred in both Ulnar and Median nerves. The average time interval of the surgery until the beginning of rehabilitation was 10 days. The recovery of sensory and motor function in median nerve injuries was greater in comparison to ulnar nerve damages. Comparing the average changes in ulnar and median nerves injuries in two male and female groups showed no significant difference. Based on the multi-variable Regression, the age was the most important factor in the recovery of the nerve injuries. This study showed that the recovery of the senses and movements in the case of Median nerve injuries was greater than ulnar injuries. The sensory improvement was the most important aspect in this injury treatment and it is also effective in other aspects of the recovery. If the time interval between the surgery and the beginning of rehabilitation was shorter, the outcome of the sensory improvement was better.

This study aimed to evaluate the diagnostic value of ultrasonographic median nerve cross-sectional area and median nerve-tunnel indices comparing to nerve conduction study (NCS) test in patients with carpal tunnel syndrome (CTS). eventy-one hand with clinical symptoms of CTS and fifty-five healthy hands were participated in the study. The cross sectional areas of the median nerve and carpal tunnel in proximal and distal of carpal tunnel were obtained by ultra sonography. The proximal and distal nerve/tunnel indices were obtained by calculating the ratio between the proximal and distal cross-sectional areas of the median nerve to those of the carpal tunnel. The mean of nerve-tunnel index in the distal and proximal were significantly different between patients with CTS and normal (p>0.001). The study showed no difference between the proximal and distal nerve/tunnel index and also between nerve-tunnel Index and median nerve cross-sectional area. Designated cut-off points of proximal nerve-tunnel index for mild, moderate and severe CTS was determined at 6.34, 6.36 and 6.76 with a diagnostic sensitivity of 47.4, 75.8 and 85.7%, respectively, while the cut-off point of distal nerve-tunnel Index was 6.58, 6.58 and 7.61with a diagnostic sensitivity of 47.4, 67.6 and 78.6%, respectively. The results showed that the nerve/tunnel index is not a reasonable replace for NCS technique, due to its low sensitivity and specificity, especially in mild cases. Also, our study showed no significant difference between using ultra sonography nerve-tunnel index and median nerve cross-sectional area in the diagnosis of CTS.

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy in upper extremity in which the median nerve is compressed in the wrist and assessed based on subjective، physical، and electrophysiological findings. The objective of this study was to determine the correlation among subjective، physical examination، and electrophysiological studies. Twenty five patients with CTS (totally 40 hands) from mild to moderate severity were recruited. Subjective (symptom severity scale، functional status scale، and visual analog scale)، physical examination (Phalen’s test and median nerve tension test)، and electrophysiological (median nerve distal sensory and motor latency) studies were performed for all subjects. Higher intra-correlation was found among subjective findings than electrophysiological parameters. The inter-correlation between subjective and median nerve tension test ranged from low to moderate. Also، a low intra-correlation was found between electrophysiological findings. Furthermore، there was no significant correlation between the subjective and electrophysiological studies. Similar result was found between the median nerve tension test and the electrophysiological studies. Each aspect of the examination of the patients with CTS provides specific information of the diseases and cannot be replaced by one another. Therefore، it appears that any improvement in subjective and/or physical findings does not necessarily lead to an improvement in electrophysiological studies in median nerve in patients with CTS.

Different neuromuscular variations have been reported in the arm. In this case, a rare concurrent neuromuscular variation in right arm and a muscular variation in left arm are reported in a cadaver. Case report : During dissection of a cadaver, we found that the biceps brachii muscle had an additional head [third head] in both sides associated with a neural variation in the right side. In this case, the musculocutaneous nerve did not exist and was replaced by the branches of lateral root of the median nerve. Based on this report, it might be a major of significance for both anatomists and surgeons to reduce the prospective complications.

Introduction & Many of the Carpal Tunnel Syndrome (CTS) patients have sever median nerve involvement at the time of admission. Some of the CTS Patients complain about symptoms in ulnar nerve territory; some of recurrence of symptoms after Carpal canal release. The aim of this article is the presentation of a new surgical technique and its result in the CTS patients. In this study 24 patients and 36 CTS hands were operated upon by the new technique and their results were evaluated before and 6 months after their surgery. Median nerve involvement was bilateral in 50%, RT side in 33% and LT side in 17% of the patients. 62.5% of the patients were categorized in the sever type. Using Michigan's hand questionnaire, significant improvement occurred in hand Function. Only in one patients scar tenderness was continued, in majority of patients, preoperative symptoms were subsided after six months after the operation. Most of the CTS patient's who are upon operated have sever median nerve involvement. The use of incision in the modified classical technique enables neurolysis more proximally. Carpal tunnel roof reconstruction by Z plasty or flexor retinaculum flap, provided better median nerve gliding and lessen's symptom recurrence and the need for reoperation. The use of modified classical technique is safe and effective in CTS patient's surgical treatment.

The aim of this survey is to determine of emergency management of spaghetti wrist functional impairments due to these injuries which demands an adequate and accurate management of such injuries. All the Patients with Spaghetti wrist (33 Persons) due to sharp injuny that was operated by one surgeon, presenting to hand Rehabilitation center whom includeded in this study, all of them were managed with early intervention programs by one therapist for 10 weeks, and they were assessed with mono semmes – weinstein mono filament asterwards.The effects of sex, age, time of surgery and outcomes were assessed. Thirty-three Patients were included in this survey. In evaluation of median nerve in the given time, non of them were not tested and 40/31% of them had diminished quality of light touch. In ulnar nerve impairoment 43/7% had diminished protective touch and in Pinch Grip evaluation we found that both unlar and median nerve injuries has most affect in increasing the power. early surgery and early intervention has the best effect on spaghetti wrist Motor and sensory recovery found to be better in madian nevere injuries versus ulnar nerve ones.

Entrapment of median nerve can be developed at multiple sites along this nerve. One of the compression sites of median nerve is supracondylar area of humerous. Sometimes struther ligament or spur or both of them are the rare cause of entrapment syndrome of the median nerve. Struther ligament or spur can compress ulnar nerve and/or brachial artery. These cases may have median ulnar nerve or brachial artery symptoms and they are sometimes asymptomatic which can accidentlly be detected by radiography. Most commonly, these cases refer with median nerve compression syndrome and they complain about numbness and pain in their upper extremity. Sometimes pain radiates to shoulder and neck in the upper part and to hand in the lower part, that is mistakenly diagnosed as a sign of radiculopathy or other compression neuropathies. The present study is a case report of a 25-year-old man who referred with having pain and numbness in right upper extremity.