Thirtyone patients on chronic hemodialysis developed carpal tunnel syndrome were reported. This syndrome was found in the side of the arterio-venus fistula in 24 hands and the opposite side in 20 hands. All patients complained paresthesia, dysesthesia, nocturnal pain in the hand.
The duration of hemodialysis at the time of the operation was 12 years on an average, ranging from 7 years to 22 years. At surgery, the median nerve was found to be compressed under the thicked transverse carpal ligament in all cases.
The histological examination of synovia and transverse carpal ligaments obtained at the time of operation revealed pale eosin stained fibrous degenerative material (H-E stain) among the fibrous connective tissue. Congo-red stain was positive. It's regarded as an amyloid material.
Surgical decompression of the median nerve at the wrist resulted in the immediate relief of the symptom.
