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Decreases carpal tunnel pressure
35%
1169/3305
Increases carpal tunnel pressure
45%
1484/3305
No effect on carpal tunnel pressure
8%
259/3305
Enlarges the carpal tunnel volume
11%
363/3305
Improves nerve conduction studies
0%
14/3305
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This question is based on the fact that carpal tunnel canal pressure varies with wrist position. Use of neutral wrist splints for carpal tunnel syndrome is most useful for improving noctural symptoms. The reason for this is the functional position of the wrist is approximately 30 degrees of extension, and the neutral splints can be functionally limiting when used during productive daytime hours. The reference by Gerritsen et al is a randomized controlled study of splinting versus surgery for carpal tunnel. They found a 80% success rate for surgery at final follow-up versus 54% for splinting at 3 months, which increased to 90% at 18 months for surgery and 75% for splinting. The reference by Omer is a review of carpal tunnel, and it covers the diagnosis, treatment, and follow-up care of these patients. They note the need for careful diagnosis to avoid unnecessary or inappropriate surgery. Weiss et al showed that carpal tunnel pressures are elevated when the wrist is in extension, and are lowest at near neutral. If one couples this with the inherent tunnel pressure increase from the disease itself, its easy to see that extension splinting is a double hit and can lead to increased symptoms.
2.3
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