Carpal tunnel and ulnar entrapment syndromes and their treatment

1. Big picture

Entrapment neuropathy means focal compression of a peripheral nerve at an anatomical narrow passage. The two classic upper-limb entrapment syndromes for the exam are:

1. Carpal tunnel syndrome Compression of the median nerve at the wrist.

2. Ulnar entrapment syndrome Usually compression of the ulnar nerve at the elbow in the cubital tunnel, or less commonly at the wrist in Guyon canal.

The fastest exam recognition:

Carpal tunnel = median nerve = nocturnal numbness of lateral 3½ fingers + thenar weakness. Ulnar entrapment = ulnar nerve = numbness of medial 1½ fingers + interossei weakness + Froment sign.

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