Tendon Anomalies
Hi i wondered if anyone either as a patient or a medic has encountered tendon anomalies such as Linburg-Comstock (my index finger flexor tendon is attached at the thumb) affecting Carpal Tunnel Syndrome?
As a therapist I have a lot of people referred to me with CTS and have been keeping a record of those with Linburg-Comstock. I have found that 95 % of those pts have needed surgical decompression, and seem to have recovered well with no ongoing problems. Of those only a few had positive nerve conduction studies but were very symptomatic of CTS with no response to local injection. Just find it very interesting and will be continuing to monitor
I would wonder how many of those patients actually had CTS and how many something else which simply had similar symptoms and was also responsive to the rather complex intervention we think of as 'carpal tunnel decompression'. This is always the difficulty with a syndromic diagnosis - there is no way to be sure that two different clinicians are actually making the diagnosis in the same way. If you do have a substantial series you should publish it. JB
There is quite an extensive literature on anomalous muscles and tendons occupying space within the carpal tunnel and allegedly causing CTS. Linburg-Comstock in particular has not, so far as I know, been associated with CTS but I think it is quite possible that if you have one tendon anomaly then you might also be more likely to have others. All association studies with CTS are difficult because CTS is so common in any case. If you take any group of people chosen on the basis of some characteristic - red hair, green eyes, ingrowing toenails - and start looking for CTS you will find evidence of it in a surprising number of individuals, especially if you count minor neurophysiological changes as CTS. JB