[Carpal tunnel syndrome and amyloid tenosynovitis in patients undergoing chronic hemodialysis. Evaluation and treatment apropos of 130 cases].
Over a 12-year period (1979-1991), 130 carpal tunnel syndromes were diagnosed in 89 haemodialysed renal failure patients, representing 17% of all haemodialysed patients followed over the same period. 6% of patients had been haemodialysed for less than 5 years (mean duration of dialysis: 10.4 years). 25% of cases had a trigger finger and 21 out of 89 patients had amyloid arthropathy. No precise relationship was detected between the side of the carpal tunnel syndrome and the side of the arteriovenous fistula. In 130 cases, release of the median nerve and wide tenosynovectomy of the flexor tendons were performed under pneumatic tourniquet except in the case of a prosthetic shunt. Tenosynovial amyloid deposits were found in 84% of cases. The mean postoperative follow-up was 40 months (range: 6 to 120 months). Postoperatively, the acroparaesthesiae disappeared in 93% of cases. 79% of cases with a sensory defect obtained sensory recovery, versus 27% of cases with a motor deficit for motor recovery. In 20% of the 130 cases, decreased digital mobility was observed postoperatively due to extension of the tenosynovitis to the fingers. Four cases of recurrence were observed.
Allieu
Y
Y
Service de Chirurgie Orthopédique II, Hôpital Lapeyronie, Montpellier.
Chammas
M
M
Idoux
O
O
Hixson
M
M
Mion
C
C
D000328:Adult; D000368:Aged; D000686:Amyloidosis / Q000209:etiology / Q000601:surgery*; D001166:Arteriovenous Shunt, Surgical; D002349:Carpal Tunnel Syndrome / Q000209:etiology / Q000601:surgery*; D002408:Catheters, Indwelling; D005260:Female; D005500:Follow-Up Studies; D006225:Hand; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008475:Median Nerve / Q000503:physiopathology / Q000601:surgery; D008875:Middle Aged; D010292:Paresthesia / Q000601:surgery; D006435:Renal Dialysis / Q000009:adverse effects; D012678:Sensation Disorders / Q000601:surgery; D013717:Tenosynovitis / Q000209:etiology / Q000601:surgery*