Pulmonary artery re-thrombosis following interruption of anti-thrombotic therapy for bilateral carpal tunnel release surgery: An update of current protocols

The surgical outcomes in 149 patients with diabetes and carpal tunnel syndrome who underwent transverse carpal ligament release surgery are reported. Associated factors such as insulin dependence, length of time with diabetes, electrodiagnostic studies, severity of neurological deficit, presence of polyneuropathy, and cervical disc disease were considered. Analysis of preoperative and postoperative symptoms, clinical findings, diagnostic studies, and patient self-assessment indicated that the majority of patients with diabetes experienced a favorable surgical outcome, regardless of any associated factors. Eighty-four percent of the patients reported good to excellent postoperative results in their hands. Further analysis of the subpopulation of insulin-dependent diabetics showed that 81% experienced good to excellent postoperative results. These results compare favorably with those of the control group: 200 nondiabetic patients, of whom 90% rated their results from carpal tunnel release surgery as good to excellent. There were no major complications in any group.

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Endoscopic carpal tunnel release surgery: retrospective study of 390 consecutive cases

Advanced Peripheral Nerve Surgery and Minimal Invasive Spinal Surgery - Acta Neurochirurgica ◽

10.1007/3-211-27458-8_10 ◽

2005 ◽

pp. 41-45 ◽

Cited By ~ 8

Author(s):

Paolo Quaglietta ◽

G. Corriero

Keyword(s):

Retrospective Study ◽

Carpal Tunnel ◽

Carpal Tunnel Release ◽

Endoscopic Carpal Tunnel Release ◽

Carpal Tunnel Release Surgery

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Endoscopic Carpal Tunnel Release

Operative Plastic Surgery ◽

10.1093/med/9780190499075.003.0098 ◽

2019 ◽

pp. 989-994

Author(s):

Antony Hazel ◽

Neil F. Jones

Keyword(s):

Carpal Tunnel ◽

Carpal Tunnel Release ◽

Hand Surgery ◽

Anatomical Landmarks ◽

Transverse Carpal Ligament ◽

Palmar Arch ◽

Endoscopic Carpal Tunnel Release ◽

Tunnel Syndrome ◽

Carpal Tunnel Release Surgery ◽

Open Carpal Tunnel Release

Conventional open carpal tunnel release surgery is one of most successful procedures in hand surgery and has been demonstrated to be an effective treatment for carpal tunnel syndrome. However, a known sequelae in some individuals who undergo the procedure is “pillar” pain. In an effort to avoid this condition and help people return to work more quickly, the endoscopic technique was developed. Endoscopic carpal tunnel release offers a minimally invasive alternative to other traditional techniques with similar outcomes. By placing the incision proximal to the transverse carpal ligament there is potential for decreased scar sensitivity and pillar pain. The technique is technically demanding. The superficial palmar arch and common digital nerve to the ring and middle fingers are at risk for injury during the procedure. With adherence to anatomical landmarks and the proper visualization, the surgery may be safely performed.

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Validation of an Online Assessment of Orthopedic Surgery Residents' Cognitive Skills and Preparedness for Carpal Tunnel Release Surgery

Journal of Graduate Medical Education ◽

10.4300/jgme-d-09-00103.1 ◽

2010 ◽

Vol 2 (3) ◽

pp. 435-441 ◽

Cited By ~ 5

Author(s):

Janet Shanedling ◽

Ann Van Heest ◽

Michael Rodriguez ◽

Matthew Putnam ◽

Julie Agel

Keyword(s):

Construct Validity ◽

Carpal Tunnel ◽

Cognitive Skills ◽

Carpal Tunnel Release ◽

Technical Skills ◽

Skills Assessment ◽

Validity And Reliability ◽

School Students ◽

Internal Reliability ◽

Carpal Tunnel Release Surgery

Abstract Background Surgical competence requires both cognitive and technical skills. Relatively little is found in the literature regarding the value of Web-based assessments to measure surgery residents' mastery of the competencies. Objective To determine the validity and reliability of 2 online instruments for predicting the cognitive preparedness of residents for performing carpal tunnel release surgery. Method Twenty-eight orthopedic residents and 2 medical school students responded to an online measure of their perception of preparedness and to an online cognitive skills assessment prior to an objective structured assessment of technical skills, in which they performed carpal tunnel release surgery on cadaveric specimens and received a pass/fail assessment. The 2 online assessments were analyzed for their internal reliability, external correlation with the pass/fail decision, and construct validity. Results The internal consistency of the perception of preparedness measure was high (α = .92) while the cognitive assessment was less strong (α = .65). Both instruments demonstrated moderately strong correlations with the pass/fail decision, with Spearman correlation of .606 (P = .000) and .617 (P = .000), respectively. Using logistic regression to analyze the predictive strength of each instrument, the perception of preparedness measure demonstrated a 76% probability (η2 = .354) and the cognitive skills assessment a 73% probability (η2 = .381) of correctly predicting the pass/fail decision. Analysis of variance modeling resulted in significant differences between levels at P < .005, supporting good construct validity. Conclusions The online perception of preparedness measure and the cognitive skills assessment both are valid and reliable predictors of readiness to successfully pass a cadaveric motor skills test of carpal tunnel release surgery.

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Return to work recommendations after carpal tunnel release: a survey of UK hand surgeons and hand therapists

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193418786375 ◽

2018 ◽

Vol 43 (8) ◽

pp. 875-878 ◽

Cited By ~ 4

Author(s):

Lisa Newington ◽

Kristin Francis ◽

Georgia Ntani ◽

David Warwick ◽

Jo Adams ◽

...

Keyword(s):

Return To Work ◽

Carpal Tunnel ◽

Current Practice ◽

Carpal Tunnel Release ◽

Evidence Base ◽

British Society ◽

Level Of Evidence ◽

Functional Activities ◽

Different Types ◽

Carpal Tunnel Release Surgery

There is a limited evidence base from which to derive recommendations for safe and effective return to different types of occupation after carpal tunnel release surgery. The current practice of members of the British Society for Surgery of the Hand and the British Association of Hand Therapists was investigated with a questionnaire. In total, 173 surgeons and 137 therapists responded from an estimated sample of 1959. Median recommended return-to-work times were 7 days for desk-based duties, 15 days for repetitive light manual duties and 30 days for heavy manual duties. However, the responses were wide-ranging: 0–30 days for desk-based; 1–56 days for repetitive light manual; and 1–90 days for heavy manual. Variation in the recommended timescales for return to work and other functional activities after carpal tunnel release suggests that patients are receiving different and possibly even conflicting advice. Level of evidence: V

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Two-portal endoscopic carpal tunnel release surgery: report of early experience

Neurosurgical FOCUS ◽

10.3171/foc.1997.3.1.8 ◽

1997 ◽

Vol 3 (1) ◽

pp. E7 ◽

Cited By ~ 3

Author(s):

Cynthia B. Piccirilli ◽

Christopher I. Shaffrey ◽

Jacob N. Young ◽

LaVerne R. Lovell

Keyword(s):

Learning Curve ◽

Carpal Tunnel ◽

Carpal Tunnel Release ◽

Early Experience ◽

Prospective Analysis ◽

Transverse Carpal Ligament ◽

Steep Learning Curve ◽

Endoscopic Carpal Tunnel Release ◽

Carpal Tunnel Release Surgery ◽

Very High

Endoscopic carpal tunnel release is increasingly performed to treat median nerve entrapment neuropathy at the transverse carpal ligament. Proponents of these procedures claim that there are early postoperative advantages to be gained by the patient in the form of decreased pain and weakness, thus facilitating an earlier return to function. However, serious complications associated with the use of these techniques have been reported, especially during the surgeon's purported initial steep learning curve. A prospective analysis of the authors' first 51 cases using a two-portal endoscopic technique was conducted to determine whether these learning curve complications occurred. The authors did experience a learning curve; however, it was not significant. They encountered no serious complications and patient satisfaction was very high. It is concluded that the procedure is relatively easy to learn and safe to perform.

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