الفهرس 
AnatomyOnly 14 pages are availabe for public view
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Abstract
Hydrodissection is a minimally invasive procedure of
injecting fluid into anatomic spaces to facilitate
dissection and adhesiolysis in peripheral nerve entrapments.
ultrasound-guided injection of lidocaine and corticosteroids
in patients with CTS and proposed the concept of nerve
hydrodissection. Normal saline is injecting the material
between the MN and transverse carpal ligament and
underlying tendons, which may interrupt the adhesions of
MN and reduce the symptoms.
Median nerve hydrodissection is also useful in
preventing unintentional direct injection to the nerve. The
therapeutic effect of nerve hydrodissection is based on the
theory that separating the compressed nerve from nearby soft
tissue could decrease the risk of adhesion and chronic
constriction injury.
The near-nerve local insulin injection is thought to
promote neuronal growth and regeneration, and could be
important in restoring nerve function following metabolic or
vascular damage. Local insulin injection may be of great
potential benefit in the improvement of median nerve
functions and regeneration in diabetes mellitus patients with
mild to moderate CTS.The results of this clinical trial study showed that the
Hydrodissection (10 ml of normal saline) of the median
nerve is significantly effective in the treatment of mild to
moderate carpal tunnel syndrome in patients with diabetes
mellitus and alleviates the symptoms of CTS. Also the study
showed that the local insulin injection (10 IU of NPH) alone
is significantly effective in the management of mild to
moderate carpal tunnel syndrome of diabetic patients, which
shows significant response within two weeks of follow up.
The study shows that Hydrodissection is slightly superior to
insulin for treatment of CTS. Furthermore our current study
compares the failure rate of both treatment modalities which
implies that Hydrodissection group are less failure rate than
insulin group, but this difference is insignificant due small
sample size of both groups.