Combined Carpal Tunnel Release and Palmar Fasciectomy for Dupuytren’s Contracture Does Not Increase the Risk for Complex Regional Pain Syndrome

2018 ◽  
Vol 142 (5) ◽  
pp. 1251-1257 ◽  
Author(s):  
Scott N. Loewenstein ◽  
Stephen P. Duquette ◽  
Joshua M. Adkinson
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Pain Syndrome ◽  
Dupuytren’S Contracture ◽  
Dupuytren's Contracture

Co-existing carpal tunnel syndrome in complex regional pain syndrome after hand trauma

2009 ◽  
Vol 35 (3) ◽  
pp. 228-231 ◽  
Author(s):  
S. M. Koh ◽  
F. Moate ◽  
D. Grinsell
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Range Of Motion ◽  
Grip Strength ◽  
Complex Regional Pain Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Pain Syndrome ◽  
Hand Surgery ◽  
Pain Scores ◽  
Tunnel Syndrome

This study highlights the benefits of carpal tunnel release (CTR) in four patients presenting with complex regional pain syndrome (CRPS) after hand surgery who also had carpal tunnel syndrome (CTS) diagnosed clinically and by nerve conduction studies. Three of the patients underwent pre- and postoperative volumetric, circumference, grip strength and range of motion measurements. The Disabilities of the Arm, Shoulder and Hand (DASH) functional outcome measure and pain scores were also used. There was almost complete resolution of CRPS symptoms in all four patients, with notable reductions in oedema and improvements in grip strength and range of motion. There were also improvements in DASH outcome scores and pain scores after CTR.

scholarly journals The Incidence of Complex Regional Pain Syndrome in Simultaneous Surgical Treatment of Carpal Tunnel Syndrome and Dupuytren Contracture

Hand ◽  
2017 ◽  
Vol 13 (4) ◽  
pp. 391-394 ◽  
Author(s):  
Mitchell Buller ◽  
Steven Schulz ◽  
Morton Kasdan ◽  
Bradon J. Wilhelmi
Keyword(s):  
Surgical Treatment ◽  
Carpal Tunnel Syndrome ◽  
Complex Regional Pain Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Group Versus ◽  
Pain Syndrome ◽  
Increased Risk ◽  
Tunnel Syndrome ◽  
Dupuytren Contracture

Background: To determine the incidence of complex regional pain syndrome (CRPS) in the concurrent surgical treatment of Dupuytren contracture (DC) and carpal tunnel syndrome (CTS) through a thorough review of evidence available in the literature. Methods: The indices of 260 hand surgery books and PubMed were searched for concomitant references to DC and CTS. Studies were eligible for inclusion if they evaluated the outcome of patients treated with simultaneous fasciectomy or fasciotomy for DC and carpal tunnel release using CRPS as a complication of treatment. Of the literature reviewed, only 4 studies met the defined criteria for use in the study. Data from the 4 studies were pooled, and the incidence of recurrence and complications, specifically CRPS, was noted. Results: The rate of CRPS was found to be 10.4% in the simultaneous treatment group versus 4.1% in the fasciectomy-only group. This rate is nearly half the 8.3% rate of CRPS found in a randomized trial of patients undergoing carpal tunnel release. Conclusions: Our analysis demonstrates a marginal increase in the occurrence of CRPS by adding the carpal tunnel release to patients in need of fasciectomy, contradicting the original reports demonstrating a much higher rate of CRPS. This indicates that no clear clinical risk is associated with simultaneous surgical treatment of DC and CTS. In some patients, simultaneous surgical management of DC and CTS can be accomplished safely with minimal increased risk of CRPS type 1.

scholarly journals Abductor Digiti Minimi Flap for Vascularized Coverage in the Surgical Management of Complex Regional Pain Syndrome Following Carpal Tunnel Release

Hand ◽  
2016 ◽  
Vol 12 (6) ◽  
pp. 546-550 ◽  
Author(s):  
Kevin Cheung ◽  
Melissa A. Klausmeyer ◽  
Jesse B. Jupiter
Keyword(s):  
Median Nerve ◽  
Complex Regional Pain Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Donor Site ◽  
Retrospective Chart Review ◽  
Pain Syndrome ◽  
Outcome Instrument ◽  
Abductor Digiti Minimi

Background: The development of Complex Regional Pain Syndrome (CRPS) represents a potentially devastating complication following carpal tunnel release. In the presence of a suspected incomplete release of the transverse carpal ligament or direct injury to the median nerve, neurolysis as well as nerve coverage to prevent recurrent scar has been shown to be effective. Methods: Retrospective chart review and telephone interview was conducted for patients who underwent abductor digiti minimi flap coverage and neurolysis of the median nerve for CRPS following carpal tunnel release. Results: Fourteen wrists in 12 patients were reviewed. Mean patient age was 64 years (range, 49-83 years), and the mean follow-up was 44 months. Carpal tunnel outcome instrument scores were 47.4 ± 6.8 preoperatively and 27.1 ± 10.6 at follow-up ( P < .001). Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores at follow-up were 29.4 ± 26. No significant postoperative complications were identified. Conclusions: The abductor digiti minimi flap is a reliable option with minimal donor site morbidity. It provides predictable coverage when treating CRPS following carpal tunnel syndrome.

scholarly journals Incidence of Regional Pain Syndrome after Carpal Tunnel Release. Is there a Correlation with the Anesthetic Technique?

2011 ◽  
Vol 61 (4) ◽  
pp. 425-433 ◽  
Author(s):  
Veronica Vieira da Costa ◽  
Sandro Barbosa de Oliveira ◽  
Maria do Carmo Barreto Fernandes ◽  
Renato Ângelo Saraiva
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Pain Syndrome ◽  
Anesthetic Technique

Piso-triquetral pain syndrome after carpal tunnel release

1989 ◽  
Vol 14 (5) ◽  
pp. 858-862 ◽  
Author(s):  
Houshang Seradge ◽  
Espanta Seradge
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Pain Syndrome

Acute and Nonacute Complications Associated with Interscalene Block and Shoulder Surgery

2001 ◽  
Vol 95 (4) ◽  
pp. 875-880 ◽  
Author(s):  
Alain Borgeat ◽  
Georgios Ekatodramis ◽  
Fabian Kalberer ◽  
Cedric Benz
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Complex Regional Pain Syndrome ◽  
Carpal Tunnel ◽  
Brachial Plexus Block ◽  
Pain Syndrome ◽  
Muscular Weakness ◽  
Interscalene Brachial Plexus Block ◽  
Tunnel Syndrome ◽  
Sulcus Ulnaris ◽  
Plexus Block

Background The incidence, etiology, and evolution of complications after interscalene brachial plexus block (ISB) are not well-known. The authors prospectively monitored 521 patients for complications during the first 9 months after ISB. Methods A total of 521 adults scheduled for elective shoulder surgery performed with an ISB were included in this prospective study. The ISB procedure was standardized for all patients Acute complications were recorded. Patients were observed daily (for 10 days) for paresthesias, dysesthesias, pain not related to surgery, and muscular weakness and were evaluated at 1, 3, 6, and 9 months after surgery. Persistence of paresthesias dysesthesias, pain not related to surgery, or muscular weakness was investigated at 1 or 3 months by means of electroneuromyography. Final evaluation was performed at 9 months. Results A total of 520 patients completed the study; one was excluded after surgical axillary nerve damage. Two hundred thirty-four patients had an interscalene catheter. Acute complications consisted of one pneumothorax (0.2%) and one episode of central nervous system toxicity (incoherent speech; 0.2%). A 10 days, 74 patients (14%) were symptomatic, and none had muscular weakness. At 1 month, 41 patients (7.9%) had symptoms, and none had muscular weakness. Thirty patients under went electroneuromyography; sulcus ulnaris syndrome (n = 8) carpal tunnel syndrome (n = 2), and complex regional pain syndrome (n = 1) were diagnosed. At 3 months 20 patient (3.9%) were symptomatic, and none had muscular weakness All underwent electroneuromyography; carpal tunnel syndrome (n = 2), complex regional pain syndrome (n = 4), plexus neuropathy (n = 1), and plexus damage (n = 1) were diagnosed. At 6 months, 5 patients (0.9%) were symptomatic. At 9 months 1 patient (0.2%) had persistence of dysesthesia. Conclusions Interscalene brachial plexus block performed with a standardized technical approach, material, and drugs is associated with an incidence of short- and severe long-term complications of 0.4%. In case of persistent paresthesia, dysesthesia, or pain not related to surgery after ISB, sulcus ulnaris syndrome, carpal tunnel syndrome, or complex regional pain syndrome should be excluded since specific treatment may be required.

scholarly journals Selective Fasciectomy in Dupuytren’s Contracture: An Experience of A Specialized Tertiary Hospital in Bangladesh

2022 ◽  
Vol 6 (1) ◽  
pp. 41
Author(s):  
Md Ashraful Islam ◽  
Ismat Ara Begum ◽  
Khandker Md Nurul Arifeen ◽  
Manoshi Datta ◽  
Sk Mohammad Ali ◽  
...  
Keyword(s):  
Pain Syndrome ◽  
Tertiary Hospital ◽  
Dupuytren’S Contracture ◽  
Dupuytren's Contracture ◽  
Superficial Wound ◽  
Skin Loss ◽  
Protective Sensation ◽  
Plexus Block ◽  
Medical University ◽  
Loupe Magnification

Background: Dupuytren’s disease is a benign yet disabling, irreversible, progressive fibroproliferative condition affecting the palm and fingers, leading to flection contracture of metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints.Objective: To evaluate results of selective fasciectomy to correct the deformity of MCP and PIP joints and observe the complications.Methods: This crosssectional study was done on 30 patients of Dupuytren’s contracture treated by selective fasciectomy, between January 2015 and December 2018, in Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Selective fasciectomy was done under brachial plexus block, tourniquet control and loupe magnification. Brunner zigzag incision was used. Indications for surgery was MCP flection contracture more than 30⁰ and any degree of PIP flection contracture. Postoperatively hand was immobilised in extension of MCP and PIP joints for 2 weeks and then active and passive movements were encouraged and intermittent splinting for 10 weeks (only at night in last 6 weeks).Results: Among 30 patients, 24 (80%) patients were male, 6 (20%) were female; mean age was 62 years (56-74 years). 12 (40%) cases were bilateral, ring and little fingers involvement were seen in most cases (92%). Mean MCP correction was 53⁰ and mean PIP correction was 34⁰ (p<0.001). There were 3 digital nerve injuries peroperatively which were repaired/reconstructed and protective sensation regained in repaired nerve area at 1 year and 3 (10%) marginal skin loss postoperatively which healed secondarily. Superficial wound infection developed in 3 (10%) patients which healed on dressing and antibiotics. Complex regional pain syndrome developed in 2 (6.66%) patients which were mild and resolved on conservative management. 3 (10%) patients developed scar sequilae which were mild and resolved on conservative treatment. Radial digital artery injury was observed in 1 (3.33%); however, no ischaemic insult was observed postoperatively. 2 (6.66%) patients developed recurrence of the disease who were more than 70 years old; however, they declined further intervention.Conclusion: Selective fasciectomy is an easy and effective procedure with less complication to correct the deformities and improve the gripstrength significantly in Dupuytren’s contracture patients.International Journal of Human and Health Sciences Vol. 06 No. 01 January’22 Page: 41-46

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