Abstract
Background Nerve compression syndromes are referred to as chronic irritation or pressure palsies
of peripheral nerves in areas of preformed anatomical constriction. Carpal tunnel
syndrome is the most common nerve compression syndrome, followed by cubital tunnel
syndrome. In addition, less frequent nerve compression syndromes of the upper extremities
that affect the
median, ulnar or radial nerves have been described. This review provides an overview
of current treatment options for nerve compression syndromes of the upper extremities.
Study Design Systematic overview.
Methods Based on established national (AWMF) and international guidelines as well as the
Cochrane Library, we performed a systematic literature search on PubMed (NLM), focusing
on
randomised controlled trials.
Results Over the research period (2012 – 2020), there were 43 randomised trials that investigated
surgical carpal tunnel release methods, 68 that compared different conservative
therapies and 12 that compared surgical versus conservative treatments. Furthermore,
eight studies analysed surgical techniques and four analysed conservative techniques
for cubital tunnel
syndrome. No randomised trials were conducted on the less common peripheral nerve
compression syndromes, but case reports and observational studies were conducted.
Conclusion For carpal and cubital tunnel syndromes, there are evidence-based diagnostic methods
as well as therapeutic recommendations based on randomised and controlled trials.
When
diagnosis is made after clinical examination and supported by radiological and electrophysiological
evaluation, surgical treatment is considered superior to conservative treatment. In
particular, excellent long-term results can be achieved by surgery for carpal and
cubital tunnel syndromes. More controlled studies are needed to establish evidence-based
therapeutic
recommendations for the less common nerve compression syndromes, which are somewhat
controversially and inconsistently defined.
Key words
Cubital tunnelsyndrom nerve compression syndrome - carpal tunnel syndrome - cubital
tunnel syndrome
