Bilateral simultaneous endoscopic carpal tunnel release: Mean time to resume activities of daily living and return to work

2018 ◽  
Vol 37 (3) ◽  
pp. 175-179
Author(s):  
B. Degeorge ◽  
R. Coulomb ◽  
P. Kouyoumdjian ◽  
O. Mares
Keyword(s):  
Return To Work ◽  
Activities Of Daily Living ◽  
Carpal Tunnel ◽  
Daily Living ◽  
Carpal Tunnel Release ◽  
Endoscopic Carpal Tunnel Release ◽  
Mean Time

Return to Activities After Simultaneous Bilateral Endoscopic Carpal Tunnel Release

Hand ◽  
2020 ◽  
pp. 155894472094006
Author(s):  
Rachel E. Hein ◽  
Andrew W. Hollins ◽  
Amanda N. Fletcher ◽  
David S. Ruch ◽  
Marc J. Richard ◽  
...  
Keyword(s):  
Return To Work ◽  
Activities Of Daily Living ◽  
Carpal Tunnel ◽  
Daily Living ◽  
Older Patients ◽  
Telephone Interview ◽  
Carpal Tunnel Release ◽  
Pain Medication ◽  
Recreational Activities ◽  
Female Patients

Background Approximately 56% of patients diagnosed with carpal tunnel syndrome present with bilateral symptoms; however, few studies have investigated bilateral simultaneous endoscopic carpal tunnel release (ECTR) and postoperative effect on return to activity. The purpose of this study was to evaluate the length of recovery in patients who received bilateral simultaneous ECTR, including pain medication requirements, return to activities of daily living, return to work, and return to recreational activities. Methods A retrospective analysis was performed on patients who underwent bilateral ECTR by a single hand fellowship–trained surgeon from 2013 to 2019. Demographic, operative, and clinical outcomes were collected via chart review and a telephone interview. Student t tests and χ2 tests were conducted for analysis. Results Eighty patients were included in the study; 40 were successfully contacted for telephone interview follow-up. Patients reported an average of 2 days of use of postoperative narcotic pain medication and an average of 5, 7, and 19 days of return to activities of daily living, work, and recreational activities, respectively. Female patients reported more days of narcotic pain medications (1 day vs 3 days, P = .0483) and an average of longer return to work than men (9 days vs 5 days, P = .0477). Manual laborers reported longer return to work (9 days vs 5 days, P = .0500). Older patients (aged >65 years) reported longer return to recreational activities (39 days vs 11 days, P = .0189). Conclusions Simultaneous bilateral ECTR is a successful procedure with shorter recovery times than reported previously. Female patients, manual laborers, and older patients experience a longer recovery and should be counseled appropriately.

Early Mobilization Following Carpal Tunnel Release

1995 ◽  
Vol 20 (2) ◽  
pp. 228-230 ◽  
Author(s):  
A. C. COOK ◽  
R. M. SZABO ◽  
S. W. BIRKHOLZ ◽  
E. F. KING
Keyword(s):  
Return To Work ◽  
Activities Of Daily Living ◽  
Carpal Tunnel ◽  
Daily Living ◽  
Carpal Tunnel Release ◽  
Randomized Study ◽  
Early Mobilization ◽  
Scar Tissue ◽  
Pinch Strength ◽  
Wrist Flexion

A prospective randomized study was undertaken of 50 consecutive patients undergoing surgery for idiopathic carpal tunnel syndrome to determine the value of splintage of the wrist following open carpal tunnel release. Patients were randomized to either be splinted for 2 weeks following surgery or to begin range-of-motion exercises on the first post-operative day. Subjects were evaluated at 2 weeks, 1 month, 3 months, and 6 months after surgery by motor and sensory testing, physical examination, and a questionnaire. Variables assessed included date of return to activities of daily living, dates of return to work at light duty and at full duty, pain level, grip strength, key pinch strength, and occurrence of complications. Patients who were splinted had significant delays in return to activities of daily living, return to work at light and full duty, and in recovery of grip and key pinch strength. Patients with splinted wrists experienced increased pain and scar tenderness in the first month after surgery; otherwise there was no difference between the groups in the incidence of complications. We conclude that splinting the wrist following open release of the flexor retinaculum is largely detrimental, although it may have a role in preventing the rare but significant complications of bowstringing of the tendons or entrapment of the median nerve in scar tissue. We recommend a home physiotherapy programme in which the wrist and fingers are exercised separately to avoid simultaneous finger and wrist flexion, which is the position most prone to cause bowstringing.

scholarly journals Open versus endoscopic carpal tunnel release: A systematic review and meta-analysis of randomized controlled trials

2020 ◽  
Author(s):  
Yueying Li ◽  
Wenqi Luo ◽  
Guangzhi Wu ◽  
Shusen Cui ◽  
Xiaossong Gu ◽  
...  
Keyword(s):  
Return To Work ◽  
Randomized Controlled Trials ◽  
Nerve Injury ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Endoscopic Carpal Tunnel Release ◽  
Satisfaction Rates

Abstract Background Endoscopic carpal tunnel release (ECTR) and open carpal tunnel release (OCTR) both have advantages and disadvantages for the treatment of carpal tunnel syndrome (CTS). We compared the effectiveness and safety of ECTR and OCTR based on evidence from a high-level randomized controlled trial. MethodsWe comprehensively searched PubMed, EMBASE, Cochrane Library, Web of Science, and Medline to identify relevant articles published until August 2019. Data regarding operative time, grip strength, Boston Carpal Tunnel Questionnaire scores, digital sensation, patient satisfaction, key pinch strength, return to work time, and complications were extracted and compared. All mean differences (MD) and odds ratios (OR) were expressed as ECTR relative to OCTR. Results Twenty-eight studies were included in our meta-analysis. ECTR was associated with significantly higher satisfaction rates (MD, 3.13; 95% confidence interval [CI], 1.43 to 4.82; P = 0.0003), greater key pinch strengths (MD, 0.79 kg; 95% CI, 0.27 to 1.32; P = 0.003), earlier return to work times (MD, -7.25 days; 95% CI, -14.31 to -0.19; P = 0.04), higher transient nerve injury rates (OR, 4.87; 95% CI, 1.37 to 17.25; P = 0.01), and a lower incidence of scar-related complications (OR, 0.20; 95% CI, 0.07 to 0.59; P = 0.004). There were no significant differences between the two methods in terms of permanent nerve injury (OR, 1.93; 95% CI, 0.58 to 6.40; P = 0.28). Conclusions Overall, evidence from randomized controlled trials indicates that ECTR results in better recovery of daily life functions than OCTR, as revealed by higher satisfaction rates, greater key pinch strengths, earlier return to work times, and fewer scar-related complications. Our findings suggest that patients with CTS can be effectively managed with ECTR.

scholarly journals Endoscopic treatment of carpal tunnel syndrome: a critical review

1997 ◽  
Vol 3 (1) ◽  
pp. E8 ◽  
Author(s):  
David F. Jimenez ◽  
Scott R. Gibbs ◽  
Adam T. Clapper
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Complication Rates ◽  
Palmar Arch ◽  
Endoscopic Techniques ◽  
Endoscopic Carpal Tunnel Release ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Release Surgery ◽  
Mean Time

An extensive review of published articles on the subject of endoscopic carpal tunnel release surgery is presented, encompassing six endoscopic techniques used to treat carpal tunnel syndrome. Since the first report in 1987, 7091 patients have undergone 8068 operations. The overall success rate has been 96.52%, with a complication rate of 2.67% and a failure rate of 2.61%. The mean time to return to work in patients not receiving Workers' Compensation was 17.8 days, ranging between 10.8 and 22.3 days. The most common complications were transient paresthesias of the ulnar and median nerves. Other complications included superficial palmar arch injuries, reflex sympathetic dystrophy, flexor tendon lacerations, and incomplete transverse carpal ligament division. All studies in which open and endoscopic techniques were compared reported that patients in the latter group experienced significantly less pain and returned to work and activities of daily living earlier. The reported success and complication rates of endoscopic carpal tunnel release surgery are similar to those for standard open procedures. Endoscopic techniques and outcomes are discussed.

scholarly journals Open versus endoscopic carpal tunnel release: A systematic review and meta-analysis of randomized controlled trials

2020 ◽  
Author(s):  
Yueying Li ◽  
Wenqi Luo ◽  
Guangzhi Wu ◽  
Shusen Cui ◽  
Zhan Zhang ◽  
...  
Keyword(s):  
Return To Work ◽  
Randomized Controlled Trials ◽  
Nerve Injury ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Endoscopic Carpal Tunnel Release ◽  
Satisfaction Rates

Abstract Background: Endoscopic carpal tunnel release (ECTR) and open carpal tunnel release (OCTR) both have advantages and disadvantages for the treatment of carpal tunnel syndrome (CTS). We compared the effectiveness and safety of ECTR and OCTR based on evidence from a high-level randomized controlled trial. Methods: We comprehensively searched PubMed, EMBASE, Cochrane Library, Web of Science, and Medline to identify relevant articles published until August 2019. Data regarding operative time, grip strength, Boston Carpal Tunnel Questionnaire scores, digital sensation, patient satisfaction, key pinch strength, return to work time, and complications were extracted and compared. All mean differences (MD) and odds ratios (OR) were expressed as ECTR relative to OCTR. Results: Twenty-eight studies were included in our meta-analysis. ECTR was associated with significantly higher satisfaction rates (MD, 3.13; 95% confidence interval [CI], 1.43 to 4.82; P = 0.0003), greater key pinch strengths (MD, 0.79 kg; 95% CI, 0.27 to 1.32; P = 0.003), earlier return to work times (MD, -7.25 days; 95% CI, -14.31 to -0.19; P = 0.04), higher transient nerve injury rates (OR, 4.87; 95% CI, 1.37 to 17.25; P = 0.01), and a lower incidence of scar-related complications (OR, 0.20; 95% CI, 0.07 to 0.59; P = 0.004). There were no significant differences between the two methods in terms of permanent nerve injury (OR, 1.93; 95% CI, 0.58 to 6.40; P = 0.28). Conclusions: Overall, evidence from randomized controlled trials indicates that ECTR results in better recovery of daily life functions than OCTR, as revealed by higher satisfaction rates, greater key pinch strengths, earlier return to work times, and fewer scar-related complications. Our findings suggest that patients with CTS can be effectively managed with ECTR.

Endoscopic Carpal Tunnel Release: Prospective Assessment of 255 Consecutive Cases

1997 ◽  
Vol 22 (1) ◽  
pp. 42-47 ◽  
Author(s):  
I. ATROSHI ◽  
R. JOHNSSON ◽  
E. ORNSTEIN
Keyword(s):  
Return To Work ◽  
Carpal Tunnel ◽  
Local Anaesthesia ◽  
Regional Anaesthesia ◽  
Carpal Tunnel Release ◽  
Neurological Complications ◽  
Complete Relief ◽  
Persistent Symptoms ◽  
Endoscopic Carpal Tunnel Release ◽  
A Prospective Study

A prospective study was conducted to evaluate the efficacy and safety of two-portal endoscopic carpal tunnel release. Two hundred and fifty-five consecutive hands (204 patients) were operated on by one surgeon using general or regional anaesthesia in the first 48 hands and local anaesthesia in the following 207 hands. The patients were evaluated preoperatively and 3 and 6 months postoperatively by an independent examiner. At the 6-month follow-up, 83% reported complete relief of symptoms and 89% were satisfied with the results of surgery. The median time until return to work was 17 days. Complications included five postoperative digital neurapraxias, all occurring under general or regional anaesthesia, and four open reoperations due to persistent symptoms. Two-portal endoscopic carpal tunnel release can be effective and safe and appears to shorten the time until return to work. The use of local anaesthesia might be important in avoiding neurological complications.

Sign in / Sign up

Export Citation Format

Share Document