Long-Term Results of Carpal Tunnel Release

1995 ◽  
Vol 20 (4) ◽  
pp. 470-474 ◽  
Author(s):  
M. P. NANCOLLAS ◽  
C. A. PEIMER ◽  
D. R. WHEELER ◽  
F. S. SHERWIN
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Long Term Results ◽  
Significant Morbidity ◽  
Surgical Scar ◽  
Internal Neurolysis ◽  
Maximum Improvement ◽  
Tunnel Syndrome

To determine the long-term results of carpal tunnel release, we retrospectively reviewed 60 cases, an average of 5.5 years after surgery. 87% reported a good or excellent overall outcome; the average time to maximum improvement of symptoms was 9.8 months. However, 30% reported poor to fair strength and long-term scar discomfort, and 57% noted a return of some pre-operative symptoms, most commonly pain, beginning an average of 2 years after surgery. We found no correlation between pre-operative symptoms or extent of surgical dissection (internal neurolysis) and outcome. Carpal tunnel syndrome was job related in 42%; of these, 26% changed from heavy to lighter work following surgery. Although occupational cases were slower to improve and remained off work longer, the long-term subjective results were the same for both groups. We found significant morbidity from the surgical scar and decreased strength, and often considerable delay until ultimate improvement, especially in patients with job-related carpal tunnel syndrome.

scholarly journals The Effect Of Tenosynovectomy On Patient Outcome In Carpal Tunnel Syndrome Surgery

2021 ◽  
Author(s):  
Ahmet Levent Aydın ◽  
Melih Üçer
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Large Scale ◽  
Long Term Results ◽  
Vascular Elements ◽  
Tunnel Syndrome ◽  
Subsynovial Connective Tissue

INTRODUCTION: Carpal tunnel syndrome (CTS) is estimated to be the most frequently seen mononeuropathy, needing surgical intervention. Its prevalence is known to range between 1, and 3 percent. The components contained in this tunnel are the median nerve, four deep digital flexor tendons, as well as four superficial flexors and the tendon of flexor pollicis longus. Between the tendons and bursae an anatomical structure is present called subsynovial connective tissue (SSCT). SSCT absorbs and transmits stress between tendons and the median nerve and it functions as a scaffold for vascular elements. To find out the role of compression or pathologic proliferation of SSCT in the pathogenesis of CTS, we aimed to conduct a study about the surgical technique of this pathology and compared the long- term results of patients operated with or without SSCT excision in our neurosurgery clinic. METHODS: Between 2003 and 2019 we operated 1279 patients at our neurosurgery clinic. Among them 250 patients who had SSCT excision (syn+) were chosen and they were compared with other 250 patients operated without SSCT excision (Syn-). RESULTS: All patients were evaluated preoperatively and 12 months postoperatively based on the results of Boston Carpal Tunnel Syndrome Questionnaire. When pre-, and post-operative results were compared, we didn’t observe a statistically significant intergroup difference. DISCUSSION AND CONCLUSION: Although our primary goal in patients in whom we performed excision of tenosynovium is to relieve the median nerve by increasing decompression, we observed that there was no difference between the two groups in this large-scale study. We think that only liberation of the transverse carpal ligament during surgery will be sufficient.

scholarly journals Does Recurrence of Carpal Tunnel Syndrome (CTS) after Complete Division of the Transverse Ligament Really Exist?

2021 ◽  
Vol 10 (18) ◽  
pp. 4208
Author(s):  
Fatma Kilinc ◽  
Bedjan Behmanesh ◽  
Volker Seifert ◽  
Gerhard Marquardt
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Surgical Intervention ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Long Term Results ◽  
Transverse Ligament ◽  
Tunnel Syndrome ◽  
Clinical Signs And Symptoms

The aim of this study was to evaluate whether recurrent carpal tunnel syndrome (CTS) after complete and sufficient division of the transverse ligament really exists. Another goal was to analyze the underlying reasons for recurrent CTS operated on in our department. Over an observation period of eleven years, 156 patients underwent surgical intervention due to CTS. The records of each patient were analyzed with respect to baseline data (age, gender, affected hand), as were clinical signs and symptoms pre- and postoperatively. To assess long-term results, standardized telephone interviews were performed using a structured questionnaire in which the patients were questioned about persisting symptoms, if any. Of the 156 patients, 128 underwent first surgical intervention due to CTS in our department. In long-term follow-up, two-thirds of these patients had no symptoms at all; one-third of the patients described mild persisting numbness. None of the patients experienced a recurrence of CTS. The 28 patients who received their first operation outside of our department were operated on for recurrent CTS. The cause of recurrence was incomplete division of the distal part of the transverse carpal ligament in all cases. The results suggest that recurrent CTS after complete and sufficient division of the transverse ligament is very unlikely.

scholarly journals Does Carpal Tunnel Release Provide Long-Term Relief in Patients with Hemodialysis-Associated Carpal Tunnel Syndrome?

2012 ◽  
Vol 470 (9) ◽  
pp. 2561-2565 ◽  
Author(s):  
Ho Jung Kang ◽  
Il Hyun Koh ◽  
Won Yong Lee ◽  
Yun Rak Choi ◽  
Soo Bong Hahn
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Tunnel Syndrome

Trigger Digit Incidence After Carpal Tunnel Release: Reconstruction in Elongated Position Versus Traditional Carpal Tunnel Release

Hand ◽  
2019 ◽  
pp. 155894471989305
Author(s):  
Ignacio Esteban-Feliu ◽  
Irene Gallardo-Calero ◽  
Sergi Barrera-Ochoa ◽  
Núria Vidal-Tarrason ◽  
Jorge Nuñez-Camarena ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Retrospective Review ◽  
Carpal Tunnel Release ◽  
Flexor Retinaculum ◽  
Tunnel Syndrome ◽  
Mean Time ◽  
Reconstruction Group ◽  
Long Term Studies

Background: The development of trigger digit after carpal tunnel syndrome release surgery has been widely reported. Lluch described reconstruction of the flexor retinaculum in elongated position to prevent such complication. Methods: We conducted a retrospective review to determine whether patients who undergo reconstruction in elongated position of the flexor retinaculum have a lower incidence of trigger digit postoperatively. In total, 1050 patients were included, 865 of whom had undergone traditional carpal tunnel release and 185 flexor retinaculum reconstruction. Results: No differences were found in the incidence of trigger digit after surgery (8.7% of the patients who underwent traditional release vs 11.9% in the reconstruction group). Neither difference was found when comparing mean time with the development of trigger digit. Conclusions: In the absence of randomized long-term studies comparing traditional release and reconstruction in elongated position after carpal tunnel release, given our results, we see no reason to favor reconstruction over standard carpal tunnel release as a means to prevent postoperative triggering of digits.

Open Surgical Therapy for Carpal Tunnel Decompression in Long-Term Haemodialysis Patients

2001 ◽  
Vol 26 (6) ◽  
pp. 529-532 ◽  
Author(s):  
E. SHIOTA ◽  
K. TSUCHIYA ◽  
K. YAMAOKA ◽  
O. KAWANO
Keyword(s):  
Retrospective Study ◽  
Carpal Tunnel Syndrome ◽  
Functional Recovery ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
The Other ◽  
Lower Recurrence Rate ◽  
Open Surgical Therapy ◽  
Tunnel Syndrome

This retrospective study assessed the treatment of 91 cases of carpal tunnel syndrome in long-term haemodialysis patients. One group of patients underwent an enlargement reconstruction of the flexor retinaculum with synovectomy and the other group was treated with a conventional carpal tunnel release. There were no major changes or differences between the outcomes of the two groups. However, there was an earlier functional recovery of grip strength and a lower recurrence rate in the enlargement plasty with synovectomy group.

LONG-TERM FOLLOW-UP OF DUAL-PORTAL ENDOSCOPIC RELEASE OF THE TRANSVERSE LIGAMENT IN CARPAL TUNNEL SYNDROME

Neurosurgery ◽  
2009 ◽  
Vol 64 (1) ◽  
pp. 131-138 ◽  
Author(s):  
Doerthe Keiner ◽  
Michael R. Gaab ◽  
Henry W.S. Schroeder ◽  
Joachim Oertel
Keyword(s):  
Patient Satisfaction ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Long Term Results ◽  
Transverse Ligament ◽  
Endoscopic Release ◽  
Long Term Follow Up ◽  
Tunnel Syndrome

Abstract OBJECTIVE The long-term efficacy of dual-portal endoscopic release of the transverse ligament in carpal tunnel syndrome is still being debated. In this study, the authors present 94 endoscopic carpal tunnel surgery cases with long-term follow-up data. METHODS The study includes 72 patients aged 17 to 86 years (mean age, 53.4 years); bilateral surgery was performed in 22 of these patients. Seventy-two hands of female patients and 22 hands of male patients were included. All procedures were performed with a dual-portal set according to the Chow technique. All patients were examined 2 to 3 months after surgery. The long-term follow-up evaluation was based on telephone interviews 5 to 12 years (mean, 8.2 years) after surgery. RESULTS From a cohort of 214 cases that were treated surgically between 1995 and 2002, 94 cases (44%) could be evaluated for long-term follow-up. Four of these patients had to be excluded from long-term follow-up because of a switch to an open technique and early open revision (3–6 months after the first surgery), owing to persistent symptoms. A good to optimal postoperative outcome with improvement of neurological signs and subjective patient satisfaction was observed in 84 (93.3%) of the remaining 90 cases. There were no recurrences. CONCLUSION The study shows that dual-portal endoscopic release of the transverse ligament in carpal tunnel syndrome is a valuable technique that produces very good long-term results and high patient satisfaction and does not result in a significant recurrence rate.

scholarly journals Management of Carpal Tunnel Syndrome – Surgical Vs Medical?

2020 ◽  
Vol 10 (1) ◽  
pp. 75-81
Author(s):  
Md Ruhul Kuddus ◽  
Md Omar Faruk ◽  
Samiul Alam ◽  
KM Atiqul Islam ◽  
Shamsul Alam ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Surgical Approach ◽  
Carpal Tunnel Release ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Surgical Methods ◽  
Tunnel Syndrome ◽  
Surgical Group

Background: Carpal Tunnel Syndrome (CTS) is the most common form of entrapment neuropathy. Both the Medical and surgical treatments are popular in the management of CTS. The effectiveness of the surgical treatment of carpal tunnel syndrome (CTS) is well known on short term. Surgical approach has proved to be more efficient relative to the conservative methods of steroid injections and splinting. On the other hand, many studies have demonstrated both advantages and adverse effects of the surgical methods. However, limited data is available about long-term outcome after carpal tunnel release (CTR). So debate is still persists regarding Conservative vs. Surgical approach to treatment of CTS. Methods: A retrospective analysis of 15 consecutive cases performed during 1.5 year was conducted. 8 patients were treated surgically with transpalmar approach. 7 patient were treated conservatively. The criteria for treatment efficacy were improvements in symptoms, such as pain, paresthesia and recurrences after surgery. Results: Female were predominant 80% than male 20%. Right hand was more frequently affected 80% than left 20%. most paitents were diabetic except 2. outcome in the surgical group was excellent. Patient of non-surgical group was not satisfied as surgical group. Conclusions: CTR is a robust treatment for CTS and its effect persists after a period of years. CTR is the choice of treatment in case of moderate to severe form of CTS. Long term follow up and inclusion of more cases is needed for a definite conclusion. Bang. J Neurosurgery 2020; 10(1): 75-81

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