Compression Syndromes of the Median Nerve

Compressions of the median nerve primarily occur in the area of the wrist tunnel (carpal tunnel). More proximally located compressions such as the pronator and interosseous-anterior syndrome are very rare and not undisputed. The carpal tunnel syndrome is by far the most common and important compression syndrome of a peripheral nerve and can almost be described as a “common disease”. While in Germany up to 15 years ago the surgical interventions were still carried out inpatient, in recent years the surgical treatment of CTS has largely shifted to the outpatient area. Currently, well over 120,000 procedures are performed annually in Germany. In recent years, various endoscopic procedures have been established in addition to open surgery. After a detailed discussion of the diagnostic criteria, the sometimes competing conservative and surgical procedures, including the indications, are described—also with regard to their evidence. Typical constellations such as CTS and pregnancy, chronic hemodialysis or special features in breast cancer are pointed out separately, as well as the common accompanying stenosing Tenosinovitis. Revision procedures can be particularly problematic.