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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In nerve entrapment syndromes in the upper extremity, the surgeon must first become a diagnostician. When the symptoms of entrapment are bilateral, diabetes mellitus and cervical arthritis are found in a significant statistical number over the general population. These diseases can result in incomplete relief of symptoms, even after decompression of the entrapment. In Upton's double crush theory, proximal nerve impingement can cause increasing symptoms distally and this can account for some failures following carpal tunnel surgery. Bilateral carpal tunnel patients are often predisposed by anatomically small carpal tunnel canals, cervical arthritis, or diabetes mellitus. Usually, with a precise diagnosis and a careful treatment plan, excellent results can be achieved with removal of the anatomic constriction or mechanical block.
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PMID:Compression neuropathies in the anterior forearm. 379 70

In this series of 1,000 cases of carpal tunnel syndrome (888 patients) there is a statistically significant incidence of bilaterality in patients with cervical arthritis. There is also a statistically significant increase in the incidence of diabetes mellitus over the general population. These findings lend further support to Upton's Double Crush hypothesis. Further, the double crush syndrome predisposes to bilateral carpal tunnel syndrome and may be an important prognostic factor. It may also be an explanation for some of the failures following carpal tunnel surgery and lead surgeons to look for other associated systemic diseases or mechanical blocks, when attempting to alleviate recalcitrant symptoms.
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PMID:The relationship of the double crush to carpal tunnel syndrome (an analysis of 1,000 cases of carpal tunnel syndrome). 403 4