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Background: Total knee arthroplasty (TKA) is associated with tremendous postoperative pain, and pain relief should concisely be considered. This study aims to compare the efficacy of preemptive periarticular multimodal drug injection versus placebo and oral celecoxib on postoperative pain control after TKA. Materials and Methods: This study is a randomized clinical trial on 146 patients candidate for TKA who were randomly allocated to three treatment groups, including (1) a cocktail consisting of bupivacaine, morphine, epinephrine, and ketorolac (n = 48), (2) only epinephrine (placebo group) (n = 49), and (3) 400 mg celecoxib orally (control group) (n = 49) using the Random Allocation software. The injections and oral therapy were performed within 15 min before the surgical procedure. The study's primary outcome was the Knee Society Score (KSS) calculated at baseline, within 6 weeks and 6 months postoperatively. Range of motion (ROM) and Visual Analog Scale (VAS) to assess pain intensity as the other primary outcomes were evaluated before the procedure, within 24 h, 48 h, and 6 weeks postoperatively. Results: The three studied groups were similar regarding demographic characteristics, including age (P = 0.33), gender distribution (P = 0.65), and involved knee side (P = 0.94). Baseline comparison of KSS (P = 0.39), VAS (P = 0.24), and ROM (P = 0.37) among the groups revealed insignificant differences. All the studied groups showed a statistically significant trend of improvement in KSS, VAS, and ROM (P < 0.001), while the comparison of the three groups in terms of KSS (P = 0.001), VAS (P < 0.001), and ROM (P < 0.001) revealed remarkable superiority of multimodal injection to the other treatments. Conclusion: Preemptive periarticular multimodal drug injection, including bupivacaine, morphine, epinephrine, and ketorolac, can cause considerable postoperative pain relief and better ROM achievement in comparison to placebo or oral celecoxib. [ABSTRACT FROM AUTHOR]

Objective The prevention of thumb joints flexion help cure de Quervain tenosynovitis. The thumb, therefore, is being immobilized in the abduction position by splinting. Thumb abduction can be away from the palm (palmar abduction) or from the fingers (radial abduction), which are done in two different planes. To the authors' knowledge, the literature has not specified which kind of thumb abduction has better treatment outcomes and functions. This study aimed to compare the immediate efficacy of palmar abduction and radial abduction splinting on the severity of pain, handgrip, palmar and lateral pinch strength, and hand function in people with de Quervain tenosynovitis. Materials & Methods In this quasi-experimental study, 30 volunteer patients (24 females) with de Quervain tenosynovitis referred to clinical centers were selected via convenience sampling. The participants were randomly assigned to three study groups (without the splint, palmar abduction splint, and radial abduction splint). The splints' height was two-thirds of the elbow. The splints were designed to immobilize the carpometacarpal and metacarpophalangeal joint of the thumb but allow the interphalangeal joint to move. One splint immobilizes the thumb in palmar abduction, while another immobilizes the thumb in radial abduction. The outcomes were studied and measured immediately after the intervention and in a single session. The intended outcomes included pain severity, handgrip strength, palmar and lateral pinch strength, and hand function measured with a visual analog scale, hand dynamometers, and the Jebsen-Taylor test, respectively. The repeated measures analysis of variance was performed for statistical analysis using SPSS software, version 16. Results All participants completed all study assessments. The results showed a significant reduction of pain, handgrip strength, lateral and palmar pinch, and hand function after using a thumb splint compared to without the splint condition (P<0.05). The pain severity in gripping objects was lower after using a palmar abduction splint than the radial abduction splint. Also, the strength reduction in taking objects by gripping, lateral pinch, and palmar was lower after using the palmar abduction splint than the radial abduction splint (P<0.05). Still, both splints were not significantly different in slowing the hand function in the Jebsen-Taylor test (P>0.05). Conclusion The positioning of the thumb in palmar abduction with splinting could be more effective for pain reduction and manipulation of objects with the hand and fingers. [ABSTRACT FROM AUTHOR]

Werner syndrome (WS) is a rare hereditary disease, characterised by the clinical signs and symptoms of premature ageing. Patients with WS usually have difficult airway due to anatomic malformation of the oral cavity. General anaesthesia with endotracheal intubation poses a high risk for these patients. On the other hand, the risk associated with the peripheral nerve block is minimal. Here we report the successful management of a known case of WS by using a peripheral nerve block (axillary brachial plexus block) without any significant complications. The patient was a 39-year-old man, a known case of WS, admitted to the hospital with chief complaint of non-healing ulcers on his wrist and elbow due to the compression effect of the abnormal ulna bone on the overlying soft tissue. To the best of our knowledge, this is the first case report of using peripheral nerve block in the anaesthesia of a patient with WS. [ABSTRACT FROM AUTHOR]

Introduction: In recent years, outcome assessment related to orthopedic surgeries has increasingly focused on patient reported questionnaires. The Oxford Hip Score (OHS), self administered questionnaire, is a reliable, valid, and responsive instrument for assessing hip in patients undergoing Arthroplasty. Methods: The study involved 105 adult Persian speaking patients admitted for primary Total Hip Arthroplasty in two hospitals in Isfahan in Iran from September 2009 until April 2011. All of them filled out their scales (Persian OHS, WOMAC, and SF12) in preoperative examination. Results: Mean scores of OHS in first administrations was 42.7 ± 12.7. The Persian OHS overall score demonstrated high reproducibility (ICC,0.93, P < 0.001) and internal consistency (CA, 0.94). PersianOHS had high correlations with WOMAC total score (r = 0.86), function score (r = 0.86), and pain score (r = 0.79), the relationship between the Persian OHS and the WOMAC stiffness subscale was somewhat lower (r = 0.69). The correlation coefficient between the Persian OHS and the PCS of the SF 12 in our study was moderate (r = 0.58). Persian OHS had low correlation with MCS of the SF 12 (r = 0.40). Discussion: Persian OHS had high correlations with WOMAC total score, function score, and pain score. It had moderate correlation with PCS of the SF 12 and low correlation with MCS of the SF 12. Conclusions: Our study demonstrated the trans cultural adaptation and validation of the Persian OHS is a reliable and practicable instrument for assessment of function and pain in Iranian patients with hip osteoarthritis. [ABSTRACT FROM AUTHOR]

Hydatid disease is still endemic in several regions of the world and is caused by two species of tapeworms, Echinococcus granulosus and Echinococcus alveolaris. It primary involves liver and lung, and bone involvement is relatively rare (0.2-4%), where it is most commonly seen in the spine. The skeletal involvement is usually due to secondary extension such as hematogenous spread. The disease has usually a silent manifestation until a complication exists; so, many cases are diagnosed intraoperatively. Treatment of hydatid disease because of its bone involvement and spillage of fluid with subsequent contamination seeding is difficult, so it has a high mortality rate and many cases will recur. Therefore, we can prevent these occurrences if we treat hydatid disease completely and in the primary stage. Adjuvant medical treatment, if the diagnosis is known, prevents systemic spread and recurrence. Here, we present a primary recurrent hydatosis at the site of non-union humerus fracture. We have pointed out osseous hydatosis as one of the important differential diagnoses in destructive bone lesions and the necessity of its radical resection. [ABSTRACT FROM AUTHOR]

Intraosseous ganglia are benign cysts that usually can be seen in lower extremity; especially around ankle. These cysts have fewer incidences in upper extremity, mainly around the wrist. They are extremely rare in olecranon. These lesions are often asymptomatic. Patient was a 75-year-old man who had trauma many years ago. When he came to our clinic, he complained of severe pain around his elbow that he could not do ordinary activity. He had local tenderness in elbow and 30 degree limitation in extension. In radiography, lytic, multiloculated lesion existed in region of olecranon. After excisional biopsy was done, cavity was cleaned completely with curette and was filled with autogenous bone. At 10-year follow-up, the patient was completely asymptomatic. Control radiograph showed cavity filled completely by bone; there was no evidence of relapse. [ABSTRACT FROM AUTHOR]

Background: Patients who suffer from traumatic peripheral nerve injuries receive temporary treatment after referring to hospital. Peripheral nerve repair surgery in some patients is done immediatly after damage but many of them get secondary nerve repair after longer periods of time. In this study we have compared the clinical and electrodiagnostic outcome among primary and secondary nerve repair. Methods: Patients with primary or secondary repair of median and ulnar nerves were enrolled in a non-randomized clinical trial prospective study. Information used in this study was collected from patients that passed a surgery to repair the peripheral nerve betwen years 2003 to 2010 in Alzahra and Ayatollah Kashani hospitals of Isfahan, Iran. Patients were followed by clinical and electrodiagnostic examination in the third, sixth, twelfth and eighteenth month after surgery and the outcome of recovery in their hand function (sensory and motor) were evaluated. Findings: 122 patients (64 men and 58 female) were enrolled in this study. 56 patients (45.9%) had a primary repair surgery and 66 patients (54.1%) had a secondary repair surgery. The age range were between 7 to 55 years (mean: 24.9 ± 8.9), with the mean of 25.6 ± 7.1 for primary group and 24.4 ± 9.8 for secondary group (P = 0.59). By using the Maan-Whitney test, primary group had better clinical sensory and motor recovery and also improvement in sensory NCV (Nerve conduction velocity) and EMG (Electromyogram) findings compared with secondary group (P < 0.05), but no significant difference was seen in motor NCV between 2 groups (P = 0.1). Conclusion: In this research we studied the result of primary and secondary repair in both median and ulnar nerve injuries. We concluded that clinical and electrodiagnostic outcome in primary nerve repair were better than secondary nerve repair, thus we suggest immediate repair after peripheral nerve injuries, when possible. [ABSTRACT FROM AUTHOR]

BACKGROUND: Although a variety of strategies have been employed for managing articular cartilage defects in the knee, overall outcomes have not been satisfactory. An alternative option may be autologous chondrocyte transplantation (ACT). However, as this method is still under investigation, here we assessed the efficacy of ACT for human knee defect cartilage repair. METHODS: In a randomized clinical trial study, eleven patients (mean age 31.09 years) were enrolled in the study with full thickness cartilage defects in the knee. Arthroscopically, healthy cartilage was obtained, chondrocytes expanded for 2-3 weeks and ACT performed. Clinical status was evaluated before ACT, 6 and 12 months after ACT using the Brittberg- Peterson functional assessment and modified Cincinnati rating score. Magnetic resonance imaging (MRI) findings were evaluated based on the scoring systems used by Sally Roberts and by Henderson. RESULTS: Modified Cincinnati rating indicated significant improvement of clinical score before ACT compared to 6 (p = 0.000) and 12 (p = 0.000) months after ACT (from 2.73 before ACT to 7.27, 8.36 and 9.5 at 6, 12, and 48 months after ACT, respectively). Brittberg-Peterson functional assessment indicated a decline from 79.27 to 25.82 and 19.27 at 6 and 12 months post ACT. Further, statistical test demonstrated significant differences 6, 12 and 48 months post ACT (p = 0.007). Evaluation of MRI revealed a score of 6.5 for Henderson criteria and a score of 2.5 for Robert criteria. CONCLUSIONS: Our study demonstrated that ACT of the knee provides an excellent treatment for full thickness cartilage defects with outstanding clinical and radiological outcomes. [ABSTRACT FROM AUTHOR]

Background: Flexor tendon entrapment of the digits is a disorder characterized by snapping or locking of the thumb or finger (with or without pain) and called trigger finger. In children, the thumb is involved more frequent than other digits. Flexor pollicis longus tendon involvement in this group is characterized by interphalangeal fixed flexion deformity. Surgery should be considered as the first choice of treatment if the disease is not resolved by the 12 months of age. This study tried to determine the results of surgical treatment of congenital trigger thumb. Methods: In this descriptive-analytic in Alzahra hospital, Isfahan, 33 children who had surgical treatment of congenital trigger thumb, had inclusion criteria of the study. Data was collected by special questionnaire and clinical examination and analyzed by SPSS software using chi-square and Student-t test. Finding: The mean age of diagnosis in this study was 3 years and the mean age of surgery was 3.5 year. 31 patients had complete cure after surgery but 2 patients had some degrees of limitation in extension of the thumb. The statistical analysis in this study revealed a correlation between the age of diagnosis and surgery and the final result of the surgery. Reccurence of disease was seen only in one child, 6 months after surgery. Other complications of the surgery such as infection, digital nerve damage, and bowstringing of the tendon were not seen in this study. Conclusion: Age of diagnosis and surgery are the most important factors effect on complete cure of the disease. In this study, there was a statistical correlation between the age of diagnosis and surgery and the result of surgery. [ABSTRACT FROM AUTHOR]

Background: Flexor tendon injures, especially in zone II, need primary repair. It is obvious that in case of not repairing it primarily or repair failure, one or two-stage flexor tendon reconstruction become necessary. The aim of this study was to determine the results of two-stage reconstruction of hand flexor tendons in zone II. Methods: In a cross-sectional study, all patients underwent two-stage reconstruction surgery of finger flexor tendon in Alzahra and Kashani hospitals in Isfahan from 2001 to 2007 were selected in a simple- sampling method. Age, sex, mechanism of injury, initial performed treatment, along with lesions (digital nerves or arteries), presence or absence of local and phalanges fractures, motion weakness sensory status of finger at the admitting time, indication for reconstruction, rate of improvement and ultimate satisfaction was recorded. Finding: Thirty one patients with average age of 26.09 ± 9.62 years that 71% of them were men were included in the study. Before operation, 87.1% of patients had weak finger range of motion; 3 months after operation, 67.7% of them had relatively weak range of motion at the end of study only; 25.8% of patients had very weak range of motion 6 moths after surgery (P < 0.001). 45.2% of patients were satisfied and none of them were unsatisfied or completely unsatisfied. Conclusion: Two-stage flexor tendon reconstruction in hand in zone two is the method of choice for secondary repair or managing tendon repair complications. [ABSTRACT FROM AUTHOR]

Introduction: Arthritis in trapeziometacarpal joint is one of the most common types of osteoarthritis which do not respond to conservative therapies in progressed cases and require surgical processes. The current study compares the two successful techniques, ligament reconstruction and tendon interposition (LRTI) versus hematoma distraction arthroplasty (HDA)., Methods: The current randomized clinical trial has been conducted on 56 patients with trapeziometacarpal joint osteoarthritis whom were randomly divided into two groups undergone surgical procedures of LTRI (n=28) and HDA (n=28). The patients were evaluated regarding hand function, pain intensity and pinching power using The Disabilities of the Arm, Shoulder and Hand (DASH), VAS and pulp pinching test, respectively, as well as radiological findings, including (proximal migration, lateral migration, and first web space) at baseline, within 3, 6 and 12 months postoperatively., Results: Pain intensity, pinching power, function based on DASH and radiological findings, including proximal and lateral migration and first web space significantly improved in a-year follow-up assessments ( P -value <0.001). The comparison of the techniques showed superior results of HDA regarding pinching power ( P -value =0.004) and DASH ( P -value =0.03)., Conclusion: Based on this study, both LTRI and HDA were accompanied by significant improvement in function, pinching power and decrease in pain among the patients with the first carpometacarpal (CMC) joint osteoarthritis; however, the outcomes of HDA were generally superior., Competing Interests: None., (IJBT Copyright © 2021.)

Background: Carpal tunnel syndrome (CTS) is characterized by complications such as pain, paresthesia, and numbness in the fingers. There are some surgical therapies for the management of severe carpal tunnel, but differences exist between the treatments available for creating the opposition. The current study was conducted to compare the effect of modified Camitz and BRAND techniques on thumb opposition in patients with severe CTS., Methods: A total of 40 patients with severe CTS who were candidates for opponensplasty were enrolled in this clinical trial study at Alzahra and Kashani hospitals, Isfahan, Iran, from 2014 to 2018. The patients were divided into two groups of modified Camitz and BRAND. Quick DASH-9 and Kapandji scores as well as pulp and side pinch and pronation angle were assessed before and after the surgeries., Results: Quick DASH-9 score, Kapandji score, pulp and side pinch and pronation angle significantly improved post-operatively ( P=0.0XXX , P=0.0XXX , P=0.0XXX , P=0.0XXX , and P=0.0XXX , respectively). But, no significant differences were seen in the mentioned variables between both groups pre and post-operative ( P>0.05 , for all the studied variables). No postsurgical complications were seen in any of the groups., Conclusion: The findings of the present study demonstrated that, both Modified Camitz and BRAND techniques are effective and safe techniques, yielding high improvements, but no serious complications. Both techniques can be considered for treatment of patients with severe CTS.

Background: Several researchers have investigated the clinical outcomes in patients with rotator cuff tear who compared open and arthroscopic surgeries; however, there are limited studies that have compared the outcomes of arthroscopic and open rotator cuff repair. This study was aimed to compare the clinical outcomes of the patients who underwent rotator cuff repair using either arthroscopic or open repair techniques., Materials and Methods: This is a prospective cohort study in which 51 patients who underwent either open or arthroscopic rotator cuff repair were studied. Twenty-six patients underwent open repair, and 25 patients had an arthroscopic repair. Patients were followed for 6-36 months. The outcome of the two groups was evaluated using the Universal California Los Angles (UCLA) score., Results: The mean tear size was 4.93 ± 2.3 cm 2 in the open surgery group and 4.99 ± 2.3 cm 2 in the arthroscopic group ( P = 0.93). All patients showed significant improvement in their scores for pain, active forward flexion, active abduction, and function at the time of follow-up. Improvement in scores within each group was significant, but the comparison of the two techniques was not statistically significant in pain, active abduction, active forward flexion, and UCLA, but in function, the open surgery group was superior ( P < 0.05)., Conclusion: This study revealed that short-term outcomes for arthroscopic and open cuff repair are similar, except in function, which was significantly better in the open surgery., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Advanced Biomedical Research.)

Background: The aim of this study was to evaluate the effect of extracorporeal shockwave therapy (ESWT) on pillar pain after carpal tunnel release., Materials and Methods: In this prospective randomized controlled trial, forty patients with pillar pain for at least 1 month after carpal tunnel release surgery were randomly assigned in two groups. ESWT group received four sessions of ESWT at weekly intervals, and patients in the control group received sham ESWT treatment at the same intervals, involved sound but no energy. At baseline, 1 st month, and 3 rd month, hand function (using Brief-Michigan Hand Outcome Questionnaire) and pain score were assessed and compared between groups., Results: At baseline, pain score and hand function score were similar in both groups. After 1 st month, pain score in ESWT and control groups was 3.7 versus 4.7, respectively ( P = 0.066), and hand function score was 60.7 versus 52.2, respectively ( P = 0.032). After 3 months, pain score in ESWT group was significantly lower than the control group (1.6 versus 3.6, respectively, P < 0.0001), hand function score in ESWT group was significantly better than the control group (75.4 vs. 63.7, respectively, P < 0.0001). Trend of decrease in pain score between groups was significantly different, but trend of increase in hand function score was not significantly different., Conclusion: After ESWT, hand function and pain score in patients with pillar pain improved faster compared to control patients. Hence, ESWT can be used as a safe and effective noninvasive technique in patients with pillar pain after carpal tunnel release., Competing Interests: There are no conflicts of interest.

Background: The best treatment for scaphoid nonunion fractures is still controversial. The main aim of this study was to determine the results of the modified Matti-Russe method of surgery on scaphoid nonunion., Materials and Methods: In this prospective interventional study, 30 patients with nonunion scaphoid fracture recruited from clinics of the Isfahan University of Medical Sciences between October 2007 and March 2011 underwent the modified Matti-Russe method of surgery. Union rate was evaluated four and six months after the procedure. Mayo wrist score (MWS) was calculated for the subjects six months after surgery., Results: Mean age of the subjects was 25.9 ± 7.8 years, ranging from 16 to 35 years. Twenty-seven (90%) were men, and three (10%) were women. Four and six months after surgery, 10 (33%) and 26 (86.7%) subjects had a united fracture. Mean MWS was 75.0 ± 8.8 in all the subjects, ranging from 54 to 90 six months after surgery. Three subjects (10%) were grouped as excellent, 9 (30%) good, 16 (53.3%) satisfactory, and 3 (6.7%) poor., Conclusion: A fracture or nonunion of the scaphoid bone can be a complex and troubling injury, but the modified Matti-Russe method showed satisfactory results six months after surgery.

Background: 1,2 ICSRA, introduced by Aidembery et al., is a well-established technique, with up to 100% union rate among different studies. The purpose of our study was to evaluate the outcome of scaphoid nonunion undergoing 1,2 ICSRA bone graft in Iran., Materials and Methods: All participants who presented sequentially over a period of 24 months between 2010 and 2013 with nonunion scaphoid fracture with AVN in proximal pole were included in the study. Anteroposterior and lateral view plain radiographs of carpal bones were obtained for diagnosis of nonunion, and a diagnosis of avascular necrosis was made by MRI of the scaphoid. Subjects underwent 1,2 ICSRA bone graft surgery. Patients were assessed based on radiographs and the Mayo Wrist Score (MWS) questionnaire on before and after surgery. Data were analyzed using SPSS ver. 18 by paired t test., Results: Overall, 16 patients (100% male) were included in the study. Mean age of subjects was 27.50 ± 5.86 (18 to 38). Mean Mayo score was 36.63 ± 8.92 and 83.75 ± 9.22 before and 6 month after surgery, respectively, and the difference was statistically significant (P < 0.001). after 8 weeks, 10 (62.5%) had union, and after 12 weeks, all subjects had union. Nine (56.25%) of our patients had excellent functional outcome, 5 (31.25%) had good and 2 (12.5%) had satisfactory functional outcome., Conclusion: 1,2 ICSRA is a proper pedicle of vascularized bone graft due to the ease of visibility and dissection. The functional results and union rates were satisfactory in our study.

Background: Floating knee, referred to as ipsilateral fractures of the femur and tibia, is usually associated with several complications and mortality. This study was designed to present our experience with treatment of this injury throughout; age, sex, mechanism of injury, associated injuries, method and results of treatment, and complications of floating knee are discussed., Materials and Methods: This retrospective study was performed between January 2006 and December 2011. All patients with floating knee injuries who were admitted to the referral educational hospitals were included. The information about the 238 cases of floating knee injuries were gathered through the 254,620 trauma files and after excluding 18 patients who died within 6 months, the remaining files were studied and the target information was recorded., Results: The most frequent age group was 20-29 years (44.5%). The floating knee injuries were more common in males (85.5%). Type (D) according to "the classification of Letts and Vincent" was observed in 38.9% cases. The most frequent mechanism of injury was car to motorcycles accidents (48.2%). The most common associated injury was pelvic fractures (86.8%). Open reduction and internal fixation was the common type of treatment (70%). The most common early and late complications were knee hemarthrosis in 31 cases (14%) and knee osteoarthritis in 30 cases (13.6%), respectively. Death during the 5 years follow up was due to circulatory disruption, followed by deep vein thrombosis (61%). There was a significant relation between the age and outcomes as it worsens with age (P-value < 0.05)., Conclusion: This study revealed that the complication rate associated with floating knee injuries remained high, regardless of the used treatment regimen and surgeons should focus on reducing complications while treating it.

Aim: To assess possible relationships of knowledge and related factors with educational level and osteoporosis-related life habits., Methods: This was a cross sectional study conducted on 268 women (≥ 35 years old) from June 2011 to August 2011. The sample collection was done in outpatient clinics in three university hospitals in Isfahan, Iran. We used a demographic questionnaire containing questions that evaluated osteoporosis-related life habits, including exercise, smoking, intake of calcium and vitamin D supplements and so on. We also used the Osteoporosis Knowledge Assessment Tool to measure osteoporosis knowledge of women., Results: The mean level of knowledge about awareness of osteoporosis, its risk factors and preventive factors were 56, 55 and 22, respectively. The relationship of education level and awareness of osteoporosis, its risk factors and preventive factors was significant, with R = 0.76, R = 0.73 and R = 0.83, respectively (P < 0.001). The relationship of education level and osteoporosis-related life habits was not significant (R = 0.03 and P = 0.56). The relationship of osteoporosis-related life habits and awareness of osteoporosis and its risk factors was significant, with R = 16%, P = 0.006 and R = 16%, P = 0.008, respectively, but the relationship of osteoporosis-related life habits and preventive factors was not significant (R = 0, P = 0.99)., Conclusion: Iranian women with a higher education level have significantly better knowledge about osteoporosis than women with a lower educational level but they do not use this knowledge in their life.

Background: Patients with carpal tunnel syndrome (CTS) often complain of prominent pain in shoulder and arm, also there are patients that have pain in their shoulder and arm which is due to myofascial trigger point (MTP) located in their upper trapezius muscle. Despite the frequency of this observation, few studies have previously sought to establish possible relationship between the CTS and MTP in shoulder area., Methods: Samples were 160 patients (221 hands) consist of 130 females and 30 males, with suspected diagnosis of CTS, from March 2008 to October 2008. In this study after performing electrodiagnosis searches, another evaluation was performed to find out if there was any sign of myofascial trigger point. The correlation between these two was sought., Results: It was found that all of 36 hands with normal electrodiagnostic findings had myofascial trigger points in their upper trapezius muscle. Out of 185 hands, 130 hands (70%) with electrophysiological evidences of CTS showed myofascial trigger points in their trapezius muscles. Statistical analysis revealed significant (p < 0.001) reverse correlation between the severity of CTS and the presence of MTP., Conclusions: The findings of this study imply the significant correlation between occurrence of CTS and MTP. It is suggested that clinicians consider the probability of existence of MTP in patients referred for diagnosis of CTS.