scholarly journals Analysis of the Long-Term Outcome in Open Carpal Tunnel Release Surgeries with and without External Neurolysis of Median Nerve, Using Boston Carpal Tunnel Questionnaire (BCTQ)–Hindi Version

2021 ◽  
Author(s):  
Sanjeev Pattankar ◽  
Rohan Roy ◽  
Anshu Warade ◽  
Ketan Desai
Keyword(s):  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Statistical Validity ◽  
Carpal Tunnel Questionnaire ◽  
External Neurolysis ◽  
Open Carpal Tunnel Release

Abstract Background The effectiveness of open carpal tunnel release (OCTR) in treating carpal tunnel syndrome (CTS) is well known. However, the role of ancillary external neurolysis of the median nerve is not well-documented. The Boston carpal tunnel questionnaire (BCTQ) is a commonly used disease-specific outcome instrument for CTS, which is validated across major languages of the world. No such validated Hindi version of BCTQ exists. Objectives To analyze and compare the long-term outcome in patients who underwent OCTR alone and OCTR with external neurolysis of the median nerve, using BCTQ–Hindi version, while checking its validity. Materials and Methods A retrospective, cross-sectional study was conducted at a tertiary care institute. The BCTQ was translated into Hindi language by a language expert. Eighty-four consecutive patients who underwent either unilateral/bilateral OCTR, with or without external neurolysis of the median nerve, between 2009 and 2019 were included in the study. Outcome analysis was done using BCTQ–Hindi version and patient satisfaction scoring. BCTQ–Hindi version was examined for statistical validity. Subgroup analysis of the outcome based on surgical technique (OCTR vs. OCTR with external neurolysis) used was carried out. Results Response rate was 80.9%. Total hands evaluated were 108. BCTQ–Hindi version showed statistical validity. Overall symptom severity score (SSS) and functional severity score (FSS) were 1.14 ± 0.4 and 1.12 ± 0.35, respectively. Subgroup analysis of outcome revealed statistically significant results in favor of OCTR with external neurolysis of the median nerve. Conclusions BCTQ–Hindi version is statistically validated. OCTR with external neurolysis of the median nerve is a promising avenue in surgical management of CTS. Further prospective studies are warranted.

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

Long-term outcome after carpal tunnel release and identification of prognostic factors

2019 ◽  
Vol 161 (4) ◽  
pp. 663-671 ◽  
Author(s):  
Floriaan G. C. M. De Kleermaeker ◽  
Jan Meulstee ◽  
Ronald H. M. A. Bartels ◽  
Wim I. M. Verhagen
Keyword(s):  
Prognostic Factors ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Term Outcome ◽  
Long Term Outcome

Long-term Clinical Results of Carpal Tunnel Release Using Ultrasound Guidance

Hand ◽  
2021 ◽  
pp. 155894472098808
Author(s):  
Braeden M. Leiby ◽  
John P. Beckman ◽  
Anthony E. Joseph
Keyword(s):  
Carpal Tunnel ◽  
Ultrasound Guidance ◽  
Carpal Tunnel Release ◽  
Clinical Results ◽  
Satisfaction Score ◽  
Global Satisfaction ◽  
Us Guidance ◽  
Clinically Significant ◽  
Carpal Tunnel Questionnaire

Background: The purpose of this study was to determine the long-term safety and efficacy of carpal tunnel release (CTR) using ultrasound guidance in a group of patients treated by a single physician. Methods: The study group consisted of 76 consecutive CTRs performed on 47 patients between June 2017 and April 2019 for whom 1-year follow-up was available. All procedures were performed by the same operator using a single CTR technique. Outcomes included complications; Boston Carpal Tunnel Questionnaire symptom severity (BCTQ-SSS) and functional status (BCTQ-FSS) scores; Quick Disabilities of the Arm, Shoulder, and Hand (QDASH) scores; and a 5-point global satisfaction score (4 = satisfied, 5 = very satisfied). Results: The 47 patients included 27 females and 20 males (ages 31-91 years). Twenty-five patients (50 hands) had simultaneous bilateral CTRs, 4 patients (8 hands) had staged bilateral CTRs, and 18 patients had unilateral CTRs. No complications occurred. Statistically and clinically significant reductions in BCTQ-SSS, BCTQ-FSS, and QDASH scores occurred by 1 to 2 weeks post-CTR and persisted at 1-year (mean 1-year changes vs. pre-CTR -2.11, -1.70, and -44.99, respectively; P < .001 for all). The mean global satisfaction score at 1-year was 4.63. Conclusions: CTR using ultrasound (US) guidance is a safe and effective procedure that produces statistically and clinically significant improvements within 1 to 2 weeks postprocedure that persist to 1 year. Furthermore, simultaneous bilateral CTRs using US guidance are feasible and may be advantageous for patients who are candidates for bilateral CTR.

Long-term outcome of carpal tunnel syndrome after conservative treatment

2004 ◽  
Vol 58 (4) ◽  
pp. 337-339 ◽  
Author(s):  
A.C.F. Hui ◽  
S.M. Wong ◽  
A. Tang ◽  
V. Mok ◽  
L.K. Hung ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Conservative Treatment ◽  
Carpal Tunnel ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Tunnel Syndrome

Long-term Outcome after Carpal Tunnel Decompression – A Prospective Randomised Study of the Indiana Tome and a Standard Limited Palmar Incision

2008 ◽  
Vol 33 (3) ◽  
pp. 332-336 ◽  
Author(s):  
T. R. CRESSWELL ◽  
C. HERAS-PALOU ◽  
M. J. BRADLEY ◽  
S. T. CHAMBERLAIN ◽  
R. H. HARTLEY ◽  
...  
Keyword(s):  
Carpal Tunnel ◽  
Randomised Trial ◽  
Open Group ◽  
Self Assessment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Randomised Study ◽  
Functional Scores ◽  
Median Nerve Injury

This randomised trial compared the results of carpal tunnel decompression using the TM Indiana Tome (Biomet, Warsaw, Indiana, USA) and a standard limited palmar open incision. Two hundred patients were randomly selected to have a carpal tunnel decompression with either the Indiana Tome or a limited palmar technique. They were assessed clinically for 3 months and using the Levine–Katz self-assessment evaluation for 7 years. After 7 years, there were 62 returned questionnaires from the open group and 53 from the Tome group. There were no significant differences in functional scores, pain, scar tenderness, pinch and grip strength at 3 months. There were two complications in the open group and nine in the Tome group, including one median nerve injury. There was both a higher rate of immediate complications, and more recurrences and persisting symptoms at 7 years in the Indiana Tome group.

scholarly journals Postoperative diagnostic potentials of median nerve strain and applied pressure measurement after carpal tunnel release

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuichi Yoshii ◽  
Wen-lin Tung ◽  
Hiroshi Yuine ◽  
Tomoo Ishii
Keyword(s):  
Median Nerve ◽  
Carpal Tunnel ◽  
Operating Characteristic ◽  
Carpal Tunnel Release ◽  
Applied Pressure ◽  
Strain Ratio ◽  
Cross Sectional ◽  
Receiver Operating Characteristic Curves ◽  
Clinical Recovery ◽  
Open Carpal Tunnel Release

Abstract Bakground The objective of this study is to investigate the prognostic values of median nerve strain and applied pressure measurement for the assessment of clinical recovery after carpal tunnel release. Methods Forty-five wrists, from 45 idiopathic carpal tunnel syndrome patients who treated with open carpal tunnel release, were evaluated by ultrasound. Median nerve strain, pressure applied to the skin, and ratio of pressure-strain were measured at the proximal part of the carpal tunnel. In addition, distal latencies in the motor and sensory nerve conductions studies and cross-sectional area of median nerve were measured. The parameters were compared before and after the open carpal tunnel release. According to patient recovery, the receiver operating characteristic curves were generated to evaluate the prognostic values of the parameters. The areas under the receiver operating characteristic curves were compared among parameters. Results There was a significant increase in the median nerve strain, and significant decreases in the pressure applied to the skin and ratio of pressure-strain after carpal tunnel release (P < 0.01). There were significant decreases in the distal latencies and the cross-sectional area after carpal tunnel release (P < 0.01). The areas under the curves were 0.689, 0.773, 0.811, 0.668, 0.637, and 0.562 for the pressure, strain, pressure-strain ratio, motor latency, sensory latency, and area, respectively. Conclusions The results suggest that elasticity of the median nerve and pressure around the nerve recover quickly after carpal tunnel release. Pressure-strain ratio was the most reliable parameter to reflect clinical recovery. The measurement of strain and applied pressure can be useful indicators to evaluate effectiveness of the carpal tunnel release. Trial registration Registered as NCT04027998 at ClinicalTrials.gov. Retrospectively registered on July 22, 2019.

The Anatomical Site of Constriction of the Median Nerve in Patients with Severe Idiopathic Carpal Tunnel Syndrome

2006 ◽  
Vol 31 (6) ◽  
pp. 608-610 ◽  
Author(s):  
M. M AL-QATTAN
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Anatomical Site ◽  
Idiopathic Carpal Tunnel Syndrome ◽  
Tunnel Syndrome ◽  
A Prospective Study ◽  
Open Carpal Tunnel Release ◽  
Radiological Studies

During open carpal tunnel release in patients with severe idiopathic carpal tunnel syndrome, an area of constriction in the substance of the median nerve is frequently noted. In a prospective study of 30 patients, the central point of the constricted part of the nerve was determined intraoperatively and found to be, on average, 2.5 (range 2.2–2.8) cm from the distal wrist crease. This point always corresponded to the location of the hook of the hamate bone. These intraoperative findings were compared with the “narrowest” point of the carpal canal as determined by anatomical and radiological studies in the literature.

Sign in / Sign up

Export Citation Format

Share Document