ENTRAPMENT

NEUROPATHIES
Common sites of nerve entrapment :

Upper limb
Site of entrapment Example

Median nerve Wrist CTS

forearm anterior interossous syndrome

Ulnar nerve Elbow Tardy ulnar nerve palsy

Wrist Guyon’s canal syndrome

Radial nerve Arm Saturday night palsy

Suprascapular N. Shoulder Suprascapular nerve syndrome

Common sites of nerve entrapment :
Lower limb

Site of entrapment Example

Peroneal nerve Knee Crossed leg

syndrome

Tibial nerve Medial malleolus Tarsal tunnel

syndrome

Lat. Cutaneous nerve of Ant. sup. iliac Meralgia

thigh spine parathetica
Diagnosis of entrapment neuropathies
 History taking
 Clinical neurological examinations
 Investigations
Laboratory
Imaging
 Electro diagnosis
 Definition of CTS
A clinical syndrome manifested by
characteristic signs and symptoms
resulting from an entrapment neuropathy
of the median nerve at the wrist.

J South Orthop Assoc 8(3), 1999

 EPIDEMIOLOGY

CTS is the most frequently encountered

peripheral compressive neuropathy.
CTS is more prevalent in females than in
males.
CTS is most common in middle-aged
persons.

Steele, 2004
 Anatomy
The carpal tunnel is formed by the concave
anterior surface of the carpal bones and
covered by the flexor retinaculum.
Inside run the median nerve, flexor
tendons, and their synovial sheaths.

Steele, 2004
Carpal Tunnel Syndrome Anat.
CAUSE
Herbert, 2000
 Tarsal Tunnel Syndrome
Post Tib nerve gets entrapped near med
malleolus. Plantar tingling/burning as
opposed to pain/swelling of PTT. Not
whole foot like with diabetes.
+ Tinel test; can be loss of PP sensation, can
be toe clawing.
Tx: arch support if overpronated. Consider
NCV tests.
Tarsal Tunnel Syndrome
 Treatment Options
Physical therapy
• Ultrasound
• Interferential stimulation
Contrast soaks (10 mins warm, 30 secs ice
cold, repeat x2, end with cold)
NSAIDS
Injections