Five-Year Follow-Up of Carpal Tunnel Release in Patients Over Age 65

2010 ◽  
Vol 35 (2) ◽  
pp. 207-211 ◽  
Author(s):  
Robert A. Weber ◽  
Daniel J. DeSalvo ◽  
Malcolm J. Rude
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release

scholarly journals Combined Cubital and Carpal Tunnel Release Results in Symptom Resolution Outside of the Median or Ulnar Nerve Distributions

2016 ◽  
Vol 10 (1) ◽  
pp. 111-119 ◽  
Author(s):  
Peter C. Chimenti ◽  
Allison W. McIntyre ◽  
Sean M. Childs ◽  
Warren C. Hammert ◽  
John C. Elfar
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Symptomatic Improvement ◽  
Patient Counseling ◽  
Symptom Resolution ◽  
Persistent Symptoms ◽  
Validated Questionnaires

Background: Resolution of symptoms including pain, numbness, and tingling outside of the median nerve distribution has been shown to occur following carpal tunnel release. We hypothesized that a similar effect would be found after combined release of the ulnar nerve at the elbow with simultaneous release of the median nerve at the carpal tunnel. Methods: 20 patients with combined cubital and carpal tunnel syndrome were prospectively enrolled. The upper extremity was divided into six zones and the location of pain, numbness, tingling, or strange sensations was recorded pre-operatively. Two-point discrimination, Semmes-Weinstein monofilament testing, and validated questionnaires were collected pre-operatively and at six-week follow-up. Results: Probability of resolution was greater in the median nerve distribution than the ulnar nerve for numbness (71% vs. 43%), tingling (86% vs. 75%). Seventy percent of the cohort reported at least one extra-anatomic symptom pre-operatively, and greater than 80% of these resolved at early follow-up. There was a decrease in pain as measured by validated questionnaires. Conclusion: This study documents resolution of symptoms in both extra-ulnar and extra-median distributions after combined cubital and carpal tunnel release. Pre-operative patient counseling may therefore include the likelihood of symptomatic improvement in a non-expected nerve distribution after this procedure, assuming no other concomitant pathology which may cause persistent symptoms. Future studies could be directed at correlating pre-operative disease severity with probability of symptom resolution using a larger population.

The Results of Carpal Tunnel Release: Open Versus Endoscopic Technique

1994 ◽  
Vol 19 (1) ◽  
pp. 14-17 ◽  
Author(s):  
S. BANDE ◽  
L. DE SMET ◽  
G. FABRY
Keyword(s):  
Patient Satisfaction ◽  
Return To Work ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Endoscopic Technique ◽  
Open Release ◽  
Significant Difference ◽  
Open Versus ◽  
Portal Technique

We retrospectively compared two similar groups of patients who underwent either endoscopic decompression of the carpal tunnel (single portal technique, 44 patients) or open decompression (58 patients) during 1 year in our department. To find out whether there was any subjective difference between the results of the two techniques, we sent each patient a questionnaire and received a 95% response. No major complications occurred. Three endoscopic decompressions had to be abandoned, and open release was performed. We could not demonstrate any significant difference in relief of symptoms and return to work between the two groups. Patient satisfaction at 6 to 18 months follow-up was high with both techniques.

An Assessment of Sleep Disturbance in Patients before and after Carpal Tunnel Release

2019 ◽  
Vol 24 (02) ◽  
pp. 144-146 ◽  
Author(s):  
John Erickson ◽  
Daniel Polatsch ◽  
Steven Beldner ◽  
Eitan Melamed
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbance ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Continuous Variables ◽  
Night Time ◽  
Before And After ◽  
Tunnel Syndrome ◽  
English Speaking

Background: Night time numbness is a key characteristic of CTS and relief of night time symptoms is one of the outcomes most important to patients. This study tested the null hypothesis that there is no difference between sleep quality and night symptoms before and after carpal tunnel release (CTR). Methods: Forty-four, English-speaking adult patients requesting open CTR for electrodiagnostically confirmed carpal tunnel syndrome completed questionnaires before and after surgery. Average age was 59, 24 patients were men and 20 were women. Patient with a primary or secondary sleep disorder were excluded. Before surgery, patients completed the Pittsburg Sleep Quality index (PSQI). At an average of 3 months after surgery, participants completed PSQI questionnaires. Onset of sleep quality improvement was specifically addressed. Differences between preoperative and postoperative sleep quality were evaluated using the paired t-test. Spearman correlations were used to assess the relationship between continuous variables. Results: Of the 44 patients, 32 (72%) were classified as poor sleepers (PSQI > 5.5) prior to surgery. At 3 months follow up, there was a significant improvement PSQI global scores (7.8 ± 5.1 vs 4 ± 3.5, p < 0.001) as well as subdivisions. Daytime dysfunction (0.2 ± 0.4, p < 0.001) and medication use (1.0 ± 1.2 vs 0.9 ± 1.2, p < 0.045) secondary to sleep disturbance and was improved as well. In all patients, onset of improvement was within 24 hours of surgery. Conclusions: CTR is associated with improvement in sleep quality at 3 months follow-up. CTR improves daytime dysfunction related to the sleep disturbance. The onset of sleep improvement is 24 hours after surgery in most cases.

scholarly journals Comparison of Local-Only Anesthesia Versus Sedation in Patients Undergoing Staged Bilateral Carpal Tunnel Release: A Randomized Trial

Hand ◽  
2019 ◽  
Vol 15 (6) ◽  
pp. 785-792 ◽  
Author(s):  
Garrhett G. Via ◽  
Andrew R. Esterle ◽  
Hisham M. Awan ◽  
Sonu A. Jain ◽  
Kanu S. Goyal
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Common Disease ◽  
Hand Laterality ◽  
Included Patient ◽  
High Satisfaction ◽  
Tunnel Syndrome ◽  
Second Procedure ◽  
Wide Awake

Purpose: Carpal tunnel syndrome is a common disease treated operatively. During the operation, the patient may be wide-awake or sedated. The current literature has only compared separate cohorts. We sought to compare patient experience with both local-only anesthesia and sedation. Methods: Staged bilateral carpal tunnel release utilizing open or endoscopic technique was scheduled and followed through to completion of per-protocol analysis in 31 patients. Patients chose initial hand laterality and were randomized regarding initial anesthesia method: local-only or sedation. Data collection via questionnaires began at consent and continued to 6 weeks postoperatively from second procedure. Primary outcome measures included patient satisfaction and patient anesthesia preference. Results: At final follow-up, 6 weeks postoperatively, high satisfaction (30 of 31 patients per method) was reported with both types of anesthesia. Among these patients, 17 (54%) preferred local-only anesthesia, 10 (34%) preferred sedation, 2 had no preference, and 2 opted out of response. Although anesthesia fees were approximately $390 lower with local-only anesthesia, total costs for carpal tunnel release were not significantly different with respect to the anesthesia cohorts. Total time in surgical facility was approximately 26 minutes quicker with local-only anesthesia, largely due to shorter time in the post-anesthesia care unit. Scaled comparison of worst postoperative pain following the 2 procedures revealed no difference between local-only anesthesia and sedation. Conclusions: Patients reported equal satisfaction scores with carpal tunnel release whether performed under local-only anesthesia or with sedation. In addition, local-only anesthesia was indicated as the preference of patients in 59% of cases.

Outcome of Carpal Tunnel Release in Diabetic Patients

1994 ◽  
Vol 19 (5) ◽  
pp. 626-629 ◽  
Author(s):  
M. M. AL-QATTAN ◽  
R. T. MANKTELOW ◽  
C. V. A. BOWEN
Keyword(s):  
Retrospective Study ◽  
Peripheral Neuropathy ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Complete Resolution ◽  
Carpal Tunnel Release ◽  
Nerve Conduction Studies ◽  
Diabetic Patients ◽  
Hand Symptoms

A retrospective study of 15 diabetic patients (20 hands), who underwent carpal tunnel release, was performed to determine the outcome. All patients had a minimum of 18 months of follow-up. Outcome was considered excellent if there was complete resolution of symptoms and this occurred in 35% of the treated hands. Eight hands (40%) had a good outcome with significant improvement of pre-operative symptoms. Outcome was considered poor when symptoms were minimally improved, unchanged, or worse after surgery and this occurred in 25% of treated hands. All hands with a poor final result had either no electrodiagnostic evidence of localized compression or only mild compression in pre-operative nerve conduction studies. It was postulated that the contribution of localized compression to pre-operative hand symptoms was less than the contribution of peripheral neuropathy in these hands.

Carpal tunnel release: a randomized comparison of three surgical methods

2013 ◽  
Vol 38 (6) ◽  
pp. 646-650 ◽  
Author(s):  
M. B. Larsen ◽  
A. I. Sørensen ◽  
K. L. Crone ◽  
T. Weis ◽  
M. E. H. Boeckstyns
Keyword(s):  
Grip Strength ◽  
Carpal Tunnel ◽  
Controlled Trial ◽  
Carpal Tunnel Release ◽  
Endoscopic Technique ◽  
Randomized Controlled ◽  
Surgical Methods ◽  
Single Blind ◽  
Endoscopic Group

A single-blind, randomized, controlled trial was done to compare the results of carpal tunnel release using classic incision, short incision, or endoscopic technique. In total, 90 consecutive cases were included. Follow-up was 24 weeks. We found a significantly shorter sick leave in the endoscopic group. No significant differences in pain, paraesthesiae, range of motion, pillar pain, and grip strength could be found at 24 weeks of follow-up, although intermediate significant differences were seen, especially in grip strength, in favour of endoscopic technique. No major advantage to using a short incision could be found. There were no serious complications in either group. The results indicate that the endoscopic procedure is safe and has the benefit of faster rehabilitation and return to work.

Endoscopic Carpal Tunnel Release

1997 ◽  
Vol 22 (4) ◽  
pp. 505-507 ◽  
Author(s):  
A. P. ARMSTONG ◽  
J. R. FLYNN ◽  
D. M. DAVIES
Keyword(s):  
Retrospective Study ◽  
Carpal Tunnel ◽  
Complication Rate ◽  
Carpal Tunnel Release ◽  
Endoscopic Release ◽  
Iatrogenic Nerve Injury ◽  
Portal Technique ◽  
Results Of Surgery

We report our experience over a 30 month period of endoscopic release of the carpal tunnel by the Chow two-portal technique. The objective of this retrospective study was to evaluate the long-term subjective results of surgery and to assess if any iatrogenic nerve injury had been caused by the endoscopic procedure. The follow-up period was from 3 to 34 months. Our permanent, iatrogenic, postoperative nerve complication rate was 0.9% (2/208). No other serious complications occurred.

Mini-Open Blind Procedure Versus Limited Open Technique for Carpal Tunnel Release: A 30-Month Follow-Up Study

2005 ◽  
Vol 30 (3) ◽  
pp. 493-499 ◽  
Author(s):  
Paolo Cellocco ◽  
Constantino Rossi ◽  
Francesco Bizzarri ◽  
Luigi Patrizio ◽  
Giuseppe Costanzo
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Open Technique ◽  
Follow Up Study ◽  
Mini Open

Carpal Tunnel Release Using a Short Palmar Incision and a New Knife

2000 ◽  
Vol 25 (4) ◽  
pp. 357-360 ◽  
Author(s):  
S. AVCI ◽  
U. SAYLI
Keyword(s):  
Light Source ◽  
Carpal Tunnel ◽  
Local Anaesthesia ◽  
Carpal Tunnel Release ◽  
Self Care ◽  
Operation Time ◽  
Major Complications ◽  
Flexor Retinaculum ◽  
The Mean

A new knife with its own battery powered light source (Knifelight®, Stryker Instruments, Kalamazoo, Michigan, USA) was used for carpal tunnel release in 31 wrists of 25 patients. Under local anaesthesia, a short palmar incision was used and the carpal tunnel contents were visualized during division of the flexor retinaculum. The mean operation time was 11 minutes and no major complications were seen. The patients could use their hands for self-care after 3 days and returned to work at a mean of 23 days. At a minimum follow-up of 6 months, all but one of the patients were satisfied with the final result. Mild scar tenderness was seen in two patients and pillar pain in one patient.

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