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Kompressionssyndrome des N. medianus

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Nervenkompressionssyndrome

Zusammenfassung

Kompressionen des N. medianus kommen in erster Linie im Bereich des Handgelenkstunnels (Karpaltunnel) vor. Weiter proximal gelegene Kompressionen wie das Pronator- und Interosseus-anterior-Syndrom sind sehr selten und nicht unumstritten.

Das Karpaltunnelsyndrom ist das mit Abstand häufigste und wichtigste Kompressionssyndrom eines peripheren Nervs und nahezu als „Volkskrankheit“ zu bezeichnen.

Während in Deutschland bis vor 15 Jahren die operativen Eingriffe noch stationär vorgenommen wurden, hat sich in den letzten Jahren die operative Behandlung des KTS weitgehend in den ambulanten Bereich verlagert. Zurzeit werden in Deutschland weit über 120.000 Eingriffe jährlich durchgeführt. In den letzten Jahren haben sich neben der offenen Operation verschiedene endoskopische Verfahren etabliert.

Nach einer eingehenden Erörterung der diagnostischen Kriterien werden die zum Teil konkurrierenden konservativen und operativen Verfahren einschließlich der Indikationsstellungen beschrieben – auch im Hinblick auf ihre Evidenz. Auf typische Konstellationen wie KTS und Schwangerschaft, chronische Hämodialyse oder Besonderheiten bei Mammakarzinom wird gesondert hingewiesen, ebenso wie auf die häufige Begleiterkrankung Tendovaginitis stenosans. Ein besonderes Problem können Revisionseingriffe darstellen.

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Notes

  1. 1.

    1 Autor Henry W. S. Schroeder/Greifswald.

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  1. Bezirkskrankenhaus Günzburg Abt. Neurochirurgie, Günzburg, Deutschland

    Gregor Antoniadis Prof. Dr.

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    Hans Assmus Dr. med.

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    Gregor Antoniadis

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Assmus, H., Antoniadis, G. (2015). Kompressionssyndrome des N. medianus. In: Assmus, H., Antoniadis, G. (eds) Nervenkompressionssyndrome. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55212-0_7

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