scholarly journals Sickness absence after carpal tunnel release: a multicentre prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041656
Author(s):  
Lisa Newington ◽  
Georgia Ntani ◽  
David Warwick ◽  
Jo Adams ◽  
Karen Walker-Bone
Keyword(s):  
Cohort Study ◽  
Return To Work ◽  
Sickness Absence ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Work Absence ◽  
Actual Duration ◽  
Different Types ◽  
Observational Cohort ◽  
Preoperative Expectations

ObjectivesTo describe when patients return to different types of work after elective carpal tunnel release (CTR) surgery and identify the factors associated with the duration of sickness absence.DesignMulticentre prospective observational cohort study.Setting and participantsParticipants were recruited preoperatively from 16 UK centres and clinical, occupational and demographic information were collected. Participants completed a weekly diary and questionnaires at four and 12 weeks postoperatively.OutcomesThe main outcome was duration of work absence from date of surgery to date of first return to work.Results254 participants were enrolled in the study and 201 provided the follow-up data. Median duration of sickness absence was 20 days (range 1–99). Earlier return to work was associated with having surgery in primary care and a self-reported work role involving more than 4 hours of daily computer use. Being female and entitlement to more than a month of paid sick leave were both associated with longer work absences. The duration of work absence was strongly associated with the expected duration of leave, as reported by participants before surgery. Earlier return to work was not associated with poorer clinical outcomes reported 12 weeks after CTR.ConclusionsThere was wide variation in the duration of work absence after CTR across all occupational categories. A combination of occupational, demographic and clinical factors was associated with the duration of work absence, illustrating the complexity of return to work decision making. However, preoperative expectations were strongly associated with the actual duration of leave. We found no evidence that earlier return to work was harmful. Clear, consistent advice from clinicians preoperatively setting expectations of a prompt return to work could reduce unnecessary sickness absence after CTR. To enable this, clinicians need evidence-informed guidance about appropriate timescales for the safe return to different types of work.

scholarly journals Return to work recommendations after carpal tunnel release: a survey of UK hand surgeons and hand therapists

2018 ◽  
Vol 43 (8) ◽  
pp. 875-878 ◽  
Author(s):  
Lisa Newington ◽  
Kristin Francis ◽  
Georgia Ntani ◽  
David Warwick ◽  
Jo Adams ◽  
...  
Keyword(s):  
Return To Work ◽  
Carpal Tunnel ◽  
Current Practice ◽  
Carpal Tunnel Release ◽  
Evidence Base ◽  
British Society ◽  
Level Of Evidence ◽  
Functional Activities ◽  
Different Types ◽  
Carpal Tunnel Release Surgery

There is a limited evidence base from which to derive recommendations for safe and effective return to different types of occupation after carpal tunnel release surgery. The current practice of members of the British Society for Surgery of the Hand and the British Association of Hand Therapists was investigated with a questionnaire. In total, 173 surgeons and 137 therapists responded from an estimated sample of 1959. Median recommended return-to-work times were 7 days for desk-based duties, 15 days for repetitive light manual duties and 30 days for heavy manual duties. However, the responses were wide-ranging: 0–30 days for desk-based; 1–56 days for repetitive light manual; and 1–90 days for heavy manual. Variation in the recommended timescales for return to work and other functional activities after carpal tunnel release suggests that patients are receiving different and possibly even conflicting advice. Level of evidence: V

The Influence of Illness Perception and Mental Health on Return to Work After Carpal Tunnel Release Surgery

2021 ◽  
Vol 46 (9) ◽  
pp. 748-757
Author(s):  
Miguel C. Jansen ◽  
Mark J.W. van der Oest ◽  
Nicoline P. de Haas ◽  
Ruud W. Selles, PhD ◽  
J. Michiel Zuidam, MD, PhD ◽  
...  
Keyword(s):  
Mental Health ◽  
Return To Work ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Illness Perception ◽  
Carpal Tunnel Release Surgery

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.

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.

Determinants of Return to Work After Carpal Tunnel Release

2012 ◽  
Vol 37 (1) ◽  
pp. 18-27 ◽  
Author(s):  
James Cowan ◽  
Heeren Makanji ◽  
Chaitanya Mudgal ◽  
Jesse Jupiter ◽  
David Ring
Keyword(s):  
Return To Work ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release

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.

scholarly journals Prognostic Variables for Patient Return-to-Work Interval Following Carpal Tunnel Release in a Workers’ Compensation Population

Hand ◽  
2016 ◽  
Vol 12 (3) ◽  
pp. 246-251 ◽  
Author(s):  
Jenniefer Y. Kho ◽  
Michael P. Gaspar ◽  
Patrick M. Kane ◽  
Sidney M. Jacoby ◽  
Eon K. Shin
Keyword(s):  
Chronic Pain ◽  
Return To Work ◽  
Carpal Tunnel ◽  
Multivariate Analyses ◽  
Carpal Tunnel Release ◽  
Recovery Period ◽  
Time Interval ◽  
Workers Compensation ◽  
Care Providers ◽  
Surgical Data

Background: We hypothesize that depressive and anxiety disorders, chronic pain conditions, and work-related factors are significant determinants of the time interval for return to work (RTW) in the workers’ compensation (WC) population following carpal tunnel release (CTR) surgery. Methods: We retrospectively reviewed records of all WC patients who underwent open CTR surgery over a 5-year period by 1 of 3 fellowship-trained hand surgeons. One hundred fifty-two wrists in 108 patients (64 unilateral, 44 bilateral) met the inclusion criteria. Demographic, medical, and surgical data were obtained from patient records. Bivariate and multivariate analyses were performed to assess predictors of RTW. Results: Eighty-nine percent of all patients returned to work full-duty. Average RTW duration in all wrists was 12.5 ± 11.3 weeks. Predictors of delayed RTW in bivariate and multivariate analyses were depression with or without anxiety, chronic pain disorders including fibromyalgia, preoperative opioid use, and modified preoperative work status. Job type, motor nerve conduction velocity, and bilateral surgery were not predictive of delayed RTW interval. Conclusions: WC patients with depression, anxiety, or fibromyalgia and other chronic pain disorders were significantly more likely to have delayed RTW following CTR than were WC patients without these conditions. In addition, those who use opioid medications preoperatively and those with preoperative work restrictions were also found to have a significantly delayed RTW after CTR. Knowledge of these risk factors may help care providers and employers identify those WC patients who are most likely to have a protracted postoperative recovery period.

ENDOSCOPIC CARPAL TUNNEL RELEASE: SINGLE OR DOUBLE PORTAL?

Hand Surgery ◽  
1996 ◽  
Vol 01 (02) ◽  
pp. 89-94
Author(s):  
Malcolm H. Wicks
Keyword(s):  
Return To Work ◽  
Carpal Tunnel ◽  
Local Anaesthesia ◽  
Carpal Tunnel Release ◽  
The Other ◽  
Pinch Strength ◽  
Accelerated Rehabilitation ◽  
Light Sedation ◽  
Portal Technique ◽  
No Tourniquet

This report outlines my experience with 20 patients who underwent bilateral endoscopic carpal tunnel releases: one side by a uni-portal (Unit-Cut) release, the other by a two portal (modified Chow) technique at the same time. All patients were treated as out-patients, the operations being performed under local anaesthesia with light sedation, no tourniquet inflated, and with pressure bandage applied for twelve hours only. The patients underwent an accelerated rehabilitation programme beginning the same day, and were encouraged to use their hands as soon as possible. Grip and pinch strength return was similar for both techniques, the single portal being slightly quicker. Return to work averaged 8.5 days (range 3–25 days) and full activities returned by 14.3 days (range 1–40 days). When asked, the patient strongly preferred the single portal technique, i.e., 18 out of 20 patients.

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