Object: posttraumatic carpal tunnel syndrome. Aim: improve of the results of the treatment of posttraumatic carpal tunnel syndrome by improvement of diagnostic schemes and treatment with a glance of etiology and pathogenesis of disease. Methods: clinical, X-ray, electroneuromyography, ultrasonic researches, a magnetic-resonance tomography, statistics. It was found out that carpal tunnel syndrome was formed for 18 % of patients who had trauma of distal part of forearm and hand after six months. More frequently causes of carpal tunnel syndrome are the deformity of carpal tunnel which appearing in the result of residual dislocation of bone fragments and present of osteophytes (34,9 %), hypertrophy of the holder of the flexor muscle of fingers (25,6 %), posttraumatic tenosynovitis of the flexor muscle of fingers (18,6 %). The risk factors of onset of carpal tunnel syndrome in the condition of traumas of distal upper extremity were determined. There are high-energy trauma, fractures of two or more bones, open fractures with heavy trauma of soft tissue, dislocation of bone fragments more then 50% diameter of a radius, extension angular displacement more then 20°, prolonged immobilization of forearm and hand into position of palmar inflexion. Author determined that clinical finding of posttraumatic carpal tunnel syndrome differentiates prevalence of pain syndromes over sensitivity disturbances, spread of subjective sensations on the area of the innervation of median nerve, presence of complaint at day and nigh. The impossibility to perform provocative tests complicates diagnostics of carpal tunnel syndrome at an early period from trauma (6 months) that requires additional instrumental methods of research. Author shown the most information methods for diagnostics of posttraumatic carpal tunnel syndrome was electroneuromyography which allows affirm diagnosis in 91.7 % of cases. The ultrasonic researches are informative in 71 % of cases, a magnetic-resonance tomography – 40 % of patients. Based on the results of the use of these methods during diagnostics of carpal tunnel syndrome the most informative characteristics were determined. Changes of these characteristics are direct sighs of compression and ischemic lesions of median nerve and indirect sighs detecting main cause of intratunnel hypertension. Based on obtained data the diagnostic algorithm with use of required and addition methods was carried out. Results of operative treatment of the carpal tunnel syndrome are studied and the new method of operation – retinaculotomy with turn of retinaculum flexorum, which allows relapse of disease, is offered. Follow-up results of surgery were studied. Diagnostic algorithm with use of informative clinical and anamnesis values and data of toll methods was carried out. In the result of this the carpal tunnel syndrome was detected in 18 % of patients having fractures of distal part of upper extremity follow-up 6 and more months. Offered treatment’s tactics of posttraumatic carpal tunnel syndrome has allowed reach good results at 76.9% of patients. Results of the research were introduced into a medical practice of traumatology department of Utility company of health protection “Kharkiv Regional Clinical Traumatology Hospital”, department of orthopaedy and microsurgery of a hand of Transcarpathian Regional Clinical Hospital named A. Novak (Uzhgorod), Svaliava Central Regional Hospital, into an education process in the Uzhgorod National University and Kharkiv Medical Academy of Postgraduate Education (department of vertebrology, traumatology and anesthesiology. “Method of surgery treatment of carpal tunnel syndrome” was created and defended by patent (patent UA 41823 from 10.06.2009) and introduced into a medical practice of the traumatology departments of Utility company of health protection “Kharkiv Regional Clinical Traumatology Hospital” and Transcarpathian Regional Clinical Hospital named A. Novak (Uzhgorod). Traumatology and orthopaedy.
