CONDITIONS TREATED
Entrapment neuropathy including neurogenic thoracic outlet syndrome
A number of different peripheral nerves may have their normal function impaired by entrapment, with abnormal compression causing loss of sensation, pain or limb function. For example, the ulnar nerve runs the length of the arm from the brachial plexus in the shoulder to the hand. It is often injured in an elbow fracture or dislocation as it is near the skin where it crosses the elbow.
As the nerves pass from the shoulder down the arm to the hand, they can be pinched in a number of tunnels and outlets, which give their names to a range of conditions, including:
Thoracic outlet syndrome
Produced by compression of brachial plexus as these nerves pass from the neck to the arm. Pressure on the nerve may result from movement of the collar bone (e.g. when fractured) or shoulder girdle or by swelling or abnormalities in the surrounding muscles. Commonly, this occurs in neck injury following road accidents and sometimes in young athletes such as basketball players where much of the activity is overhead. Some people develop a characteristic pattern of muscle wasting and altered sensation with or without pain caused by compression of the lower trunk of the brachial plexus. This is termed neurogenic thoracic outlet syndrome or Gilliatts syndrome.
Carpal tunnel syndrome
This is produced by entrapment of the median nerve which leads to numbness in the thumb, index, middle and half of the ring fingers.
Cubital tunnel syndrome
Compression of the ulnar nerve at the elbow may cause impaired movement or loss of sensation in the wrist and hand. Initial numbness may persist and eventually become associated with weakness in the hand and cause the two smallest fingers to curl up.