Post Operative Carpal Tunnel Syndrome (CTS)

February 1 2005 Mitch R. Mally
Post Operative Carpal Tunnel Syndrome (CTS)
February 1 2005 Mitch R. Mally

History and Subjective Complaints: 53- year-old male factory worker/forklift operator complains of bilateral hand numbness, burn­ing, tingling and loss of grip strength in the thumb, index and ring fingers, bilaterally. Noc­turnal aggravation of the hands resulted in a workers compensation case. Over the course of 9 years, the patient failed operative recov­ery: 4 left CTS surgeries, 3 right CTS surger­ies and, subsequently, failed 2 ulnar nerve transposition surgeries. Company safety per­sonnel refers patient to Dr. Mally. Objective findings: Carpal ligamentous instability, scar tis­sue proliferation at the palmar crease, bilaterally, decreased sen­sation on aesthesiometer, 2-point discrimination and depth perception, decrease in bilateral grip strength, positive bilat­eral Tinel's, Phalen's, Wormser's and Median Nerve Compresssion test. Nerve Conduction Velocity's (NCV) posi­tive; bilateral median nerve latencies. X-Ray: Radiographic carpal tunnel projection (X-POSER™) revealed left 66% carpal tunnel occlusion and right 75% carpal tunnel occlusion. Diagnosis: Bilateral Carpal Instability; Bilateral Car­pal Tunnel Syndrome; Bilateral Carpal Subluxation Treatment: Specialized manipulative decompression of involved carpals bilaterally (Mally Technique), 2 weeks of intensive care with cold laser (830-850 nm). Nutrition: Anti-inflammatory vitamins (bromelain, pa-pain, trypsin, chymotrypsin, bioflavonoids) and vi­tamin B6. Rehab: 6 weeks of reconstruction and work harden­ing Addendum: Failed post-op CTS is very high with connective tissue hyperplasia the highest cause of failure. Misdiagnosis leads to erroneous results and, in this case, permanent disabil­ity and loss of employment. According to the patient, after a short 5 treatments by Dr. Mally, he reports a 98% improvement in feeling and strength. At MMI (Maximum Medi­cal Improvement), no residuals and returns to gainful employment. | For more product and seminar information, e-mail Dr. Mally at [email protected].