Double crush syndrome

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The double crush syndrome describes the damage to a nerve tract due to mechanical impairment in more than one place.


As early as 1979, the two physicians Upton and McComas published their theory that a nerve lesion would make the nerves more susceptible to damage or impairment as it progressed. In their investigations on patients with carpal tunnel syndrome , damage was often found in the area of ​​the nerve root and thus in the nerve course in front of the carpal tunnel. Hence the name "double crush", translated as "double bottleneck".


The mechanism of this syndrome is so far unclear. Although the syndrome is now considered certain, there are only speculations about the mechanism of action. Swelling or mechanical inflammatory stimuli could possibly be the cause of the nerve's sensitivity to further mechanical constrictions.


In neurosurgery provides this syndrome is a problem. The result of an operational extension with carpal tunnel syndrome is significantly worse when above the carpal tunnel is a really causal further bottleneck is. An operative correction of the upper constriction would therefore also be necessary in order to achieve a good result.

Individual evidence

  1. ^ A b A. L. Osterman: The double crush syndrome. In: Orthop Clin North Am. 1988 Jan; 19 (1), pp. 147-155, PMID 3275922
  2. C. Willu: recurrence after surgery carpal tunnel release. In: Langenbeck's archive for surgery . Volume 1998, 1998, pp. 641-646, doi: 10.1007 / 978-3-642-45774-6_132 , ISBN 978-3-642-45774-6