Carpal Tunnel

Syndrome
Oktavia Putri Masnaly
Carpal Tunnel Syndrome (CTS)
• Merupakan gangguan neuropati umum terhadap nervus medianus di
dalam Carpal Tunnel pada pergelangan tepatnya di bawah fleksor
retinakulum
• disebabkan oleh karena melakukan pekerjaan dengan gerakan
berulang-ulang dan dengan posisi yang menetap pada jangka waktu
yang lama dan dapat mempengaruhi saraf serta suplay darah ke
tangan dan pergelangan tangan.
Etiologi

• Faktor Mekanik • Faktor vaskuler (Penyakit

(trauma) kolagen vaskular)

• Faktor non mekanik (Herediter, Infeksi, Metabolik,

Endokrin, Neoplasma, Degeratif, Iatrogenik)
Patofisiologi
Faktor Penebalan Menekan
Berulang &
mekanik & fleksor N.Medianu
retinakulum lama
vaskular s

Aliran Tekanan
Nutrisi
Anoksia darah vena intravaskul
Terganggu
⬇⬇ er ⬆⬆

Endotel Kebocoran Edema

Fibrosis
rusak Protein epineural

Atrofi &
Serabut
diganti
jar.ikat saraf rusak
 Diagnosis
Anamnesis
• Gangguan sensoris
• Paresthesia pada ibu jari, jari
telunjuk, jari tengah, dan sepertiga
jari manis.
Diagnosis
Anamnesis
• Nyeri pada daerah pergelangan tangan (memberat
pada malam hari, berkurang apabila penderita
menggerak-gerakan tangannya, memijat, meletakkan
tangannya pada posisi yang lebih tinggi, dan dengan
banyak istirahat.
 Diagnosis
Anamnesis
• Gejala lain yang juga dapat dijumpai : pembengkakan,
kekakuan pada pergelangan tangan sampai jari-jari tangan
terutama pada pagi hari.
• Gangguan Motorik
• Mengeluh jari-jarinya akan menjadi kurang terampil, kesulitan
dalam menggenggam, kelemahan pada tangan, atrofi pada
otot-otot thenar.
Pemeriksaan Fisik

•Flick sign. •Thenar wasting. •Wrist extension test.

Pemeriksaan Fisik

• Phalen's • Tinel's sign.

test.

• Menilai kekuatan dan ketrampilan serta kekuatan otot secara

manual maupun dengan alat dinamometer.
 • Luthy's sign (bottle's sign).
Pemeriksaan Fisik

• Torniquet test.
• Pressure test.

• Pemeriksaan sensibilitas.
Pemeriksaan Penunjang

• Pemeriksaan neurofisiologi (elektrodiagnostik)

• Pemeriksaan EMG dapat menunjukkan adanya fibrilasi,
polifasik, gelombang positif dan berkurangnya jumlah
motor unit pada otot-otot thenar.
• Kecepatan Hantar Saraf(KHS).
• Pemeriksaan Radiologis
• Pemeriksaan Laboratorium
Penatalaksanaan

• Konservatif
• Wrist splint
• NSAID dan injeksi steroid
• Ultrasound
• Mobilisasi saraf
• Teknik mobilisasi saraf meliputi gerakan berulang dari
segmen yang mengalami gangguan, serta kombinasi
gerakan dari segmen sisi distal dan proksimalnya
• Pembedahan
• Teknik bedah baik open insicion maupun endoscopic.
THANK YOU
T H A N K S
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