title: Postoperative relieve of abnormal vasoregulation in carpal tunnel syndrome.
abstract: OBJECTIVE
  To study the skin temperature changes as a sign of altered blood flow regulation due to abnormal sympathetic nerve function in carpal tunnel syndrome (CTS) and the efficacy of carpal tunnel release (CTR) operation in the alleviation of those signs and other symptoms of CTS.
  
  
  METHODS
  Forty-one healthy hands (n=41) of 22 volunteers and 22 hands (n=22) with clinically diagnosed carpal tunnel syndrome of 16 patients were examined. A series of infrared photos of the hands of each subject were taken and stored by using digital infrared thermography (DIRT) before and 6 months after the CTR. The temperatures of the finger tips from digit 1 (D1) to digit 5 (D5), the center point of thenar (Th) and hypothenar (Ht) eminences were measured, the median nerve index (MI=(D1-D2)+(D1-D3)+(D2-D3)) and the temperature differences between the median and the ulnar nerve distribution area (MED.ULN=(D1-D5)+(D2-D5)+(D3-D5)+(Th-Ht)) were calculated. Absolute values were used when calculating the temperature differences between different points.
  
  
  RESULTS
  All the CTS patients were released from the CTS symptoms, i.e. numbness and pain after the operation, and the results of nerve conduction studies (NCS) were all back to normal. The MI and MED.ULN in CTS hands were significantly smaller before CTR compared to those of healthy control subjects (MI: p<0.001, MED.ULN: p<0.005), and those after CTR (p<0.005 for both parameters). The results also showed that all finger tips of the affected hand including those innervated by the ulnar nerve were cooler before but warmer after the operation. Before the operation, the non-CTS hands of the CTS patients, were also colder (although the difference was not significant) than the healthy control subjects but approached the same level after the CTR operation of the CTS hands.
  
  
  CONCLUSIONS
  The results of DIRT measurements suggest that the blood flow regulation in CTS is abnormal possibly because of disturbed sympathetic vasomotor regulation and that the circulation gets normal together with the alleviation of the other symptoms of CTS as recorded 6 months after CTR operation.
authors.affiliation: Department of Physiology, University of Kuopio, P.O.B. 1627, Kuopio FIN-70211, Finland. zhiyong.ming@uku.fi
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Ming
authors.forename: Jouko
authors.initials: J
authors.lastname: Siivola
authors.forename: Seppo
authors.initials: S
authors.lastname: Pietikainen
authors.forename: Matti
authors.initials: M
authors.lastname: Närhi
authors.forename: Osmo
authors.initials: O
authors.lastname: Hänninen
mesh_terms: D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000503:physiopathology / Q000601:surgery*; D019299:Decompression, Surgical; D005260:Female; D006225:Hand / Q000098:blood supply; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology*; D012881:Skin Temperature / Q000502:physiology; D013564:Sympathetic Nervous System / Q000503:physiopathology; D009435:Synaptic Transmission / Q000502:physiology; D014655:Vascular Resistance / Q000502:physiology*; D014666:Vasomotor System / Q000503:physiopathology