ENDOSCOPIC CARPAL TUNNEL RELEASE: OUR EXPERIENCE WITH 12,702 CASES

Hand Surgery ◽  
2008 ◽  
Vol 13 (01) ◽  
pp. 21-26 ◽  
Author(s):  
Giorgio Pajardi ◽  
Loris Pegoli ◽  
Giorgio Pivato ◽  
Paolo Zerbinati
Keyword(s):  
Surgical Treatment ◽  
Carpal Tunnel Syndrome ◽  
Upper Extremity ◽  
Operative Treatment ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Nerve Entrapment ◽  
Entrapment Syndrome ◽  
Tunnel Syndrome ◽  
Nerve Entrapment Syndrome

Carpal tunnel syndrome (CTS) is still today the most common nerve entrapment syndrome at the level of the upper extremity. When surgery is indicated, the surgical treatment of choice is the opening of the retinaculum. The authors describe their experience on 12,702 carpal tunnel decompressions, by the endoscopic procedure in a period of 14 years, outlining the indications, post-operative treatment, complications and results.

Evaluation of female hormone-related symptoms in women undergoing carpal tunnel release

2013 ◽  
Vol 39 (2) ◽  
pp. 155-160 ◽  
Author(s):  
C. H. Song ◽  
H. S. Gong ◽  
K. J. Bae ◽  
J. H. Kim ◽  
K. P. Nam ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Upper Extremity ◽  
Carpal Tunnel ◽  
Rating Scale ◽  
Carpal Tunnel Release ◽  
Menopausal Status ◽  
Related Factors ◽  
Female Hormone ◽  
Scale Scores ◽  
Tunnel Syndrome

As carpal tunnel syndrome is more common in women, particularly around the menopause, female-related risk factors are suspected to play a role in its pathogenesis. We have assessed whether female hormone-related symptoms are associated with upper extremity disabilities in women undergoing carpal tunnel release. A total of 92 women with a mean age of 53 years scheduled for surgery for carpal tunnel syndrome were assessed preoperatively for female hormone-related symptoms using the menopausal rating scale and other female-related factors such as menopausal status, pregnancy number and serum female hormone levels. Upper extremity disability was evaluated using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. DASH scores had a moderate correlation with total menopausal rating scale scores, but not with other female-related factors assessed. This study suggests that female hormone-related symptoms are associated with subjective upper extremity disabilities in women with carpal tunnel syndrome. This information may be helpful in addressing patients’ complex symptoms or interpretation of outcomes in women with carpal tunnel syndrome.

scholarly journals Mini-open Carpal Tunnel Release

2018 ◽  
Vol 19 (4) ◽  
pp. 21-27
Author(s):  
Paulo Henrique Pires De Aguiar ◽  
Carlos Alexandre Martins Zicarelli ◽  
Fabio V. C. Sparapani ◽  
Pedro Augusto De Santana Jr ◽  
Alexandros Theodoros Panagoupolos ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Neurological Deficits ◽  
Motor Branch ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release ◽  
Nerve Entrapment Syndrome ◽  
Mini Open

Introduction: Median nerve compression is the most common nerve entrapment syndrome. After carpal tunnel release, patients often complain about the scar cosmetic appearance. Objective: The aim of our study was to evaluate the clinical outcome, surgical technique and complications of mini-open carpal release. Methods: We reviewed data from 48 surgical procedures for Carpal Tunnel Syndrome in 32 patients at the Pinheiros Neurologicaland Neurosurgical Clinic in the period of 2000 and 2008. The mean age was 49 years-old. We used a 2 cm incision and microscopic technique to obtain meticulous access of the palmar hand anatomy with special attention to both the recurrent motor branch and palmar cutaneous nerve. Results: Twenty-two patients had total resolution of symptoms. Two patients had no change of neurological symptoms. During the follow up no infection or neurological deficits were observed. Conclusion: Mini-open is a safe and effective approach for carpal tunnel syndrome release. However detailed palmar hand anatomy is mandatory to prevent lesion of branching palmar nerve. The use of microscope is desirable to help identify important structures and avoid complications.

scholarly journals ‘INSIGHT-PRECISION’: a new, mini-invasive technique for the surgical treatment of carpal tunnel syndrome

2019 ◽  
Vol 48 (1) ◽  
pp. 030006051987808
Author(s):  
José Dinis Carmo
Keyword(s):  
Surgical Treatment ◽  
Carpal Tunnel Syndrome ◽  
Surgical Technique ◽  
Minimally Invasive ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Invasive Technique ◽  
Electrodiagnostic Testing ◽  
Surgical Tool ◽  
Tunnel Syndrome

Objective To describe a new mini-invasive surgical technique for carpal tunnel release and to present clinical findings associated with using this technique. Methods Patients with idiopathic carpal tunnel syndrome without prior surgical treatment, who underwent a new minimally-invasive surgical technique using a specific surgical tool-kit developed by the author, were included. Prospective data were collected, including preoperative electrodiagnostic testing. The subjective condition of all patients was evaluated pre- and postoperatively with a five-level Likert-type scale (LS) and muscular strength was tested using a JAMAR dynamometer and pinch gauge. Results A total of 116 patients (157 hands/cases) underwent surgery performed by the author, and were followed for a mean of 40 months (range, 6 months–7 years). Of these, preoperative electrodiagnostic testing was performed in 112 patients (96.6%). No significant complications were reported. By three months, patients reported that they were satisfied or very satisfied in 147/149 cases (98.7%; LS grade I and II). Strength recovery at three months, based on the average of four measures, was 99.17% (range, 97.43–100.97%). Conclusions The described technique is minimally invasive, safe and simple to perform, and provides good results.

scholarly journals Anomalous Radial Artery as an Incidental Finding During a Routine Carpal Tunnel Release

Hand ◽  
2017 ◽  
Vol 12 (5) ◽  
pp. NP101-NP103 ◽  
Author(s):  
Charles A. Gober ◽  
Tarik Mujadzic ◽  
John E. Hershman ◽  
Mirsad M. Mujadzic
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Radial Artery ◽  
Carpal Tunnel ◽  
Incidental Finding ◽  
Carpal Tunnel Release ◽  
Anatomical Structure ◽  
Large Vessel ◽  
Tunnel Syndrome ◽  
Nerve Entrapment Syndrome

Background: Compression of the median nerve at the wrist, or carpal tunnel syndrome, is the most commonly recognized nerve entrapment syndrome. Carpal tunnel syndrome is usually caused by compression of the median nerve due to synovial swelling, tumor, or anomalous anatomical structure within the carpal tunnel. Methods: During a routine carpal tunnel decompression, a large vessel was identified within the carpal tunnel. Results: The large vessel was the radial artery. It ran along the radial aspect of the carpal tunnel just adjacent to the median nerve. Conclusions: The unusual presence of the radial artery within the carpal tunnel could be a contributing factor to the development of carpal tunnel syndrome. In this case, after surgical carpal tunnel release, all symptoms of carpal tunnel syndrome resolved.

HIGH DEFINITION ULTRASOUND AS DIAGNOSTIC ADJUNCT FOR INCOMPLETE CARPAL TUNNEL RELEASE

Hand Surgery ◽  
2011 ◽  
Vol 16 (03) ◽  
pp. 289-294 ◽  
Author(s):  
Ter Chyan Tan ◽  
Chong Jin Yeo ◽  
Einar Wilder Smith
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Upper Limb ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Nerve Entrapment ◽  
High Definition ◽  
Tunnel Syndrome

Carpal tunnel syndrome is the most common nerve entrapment in the upper limb and carpal tunnel release (CTR) provides the most predictable outcome and relief of symptoms. Incomplete carpal tunnel releases are uncommon, however, in the event of incomplete surgical releases, symptoms following such incomplete releases tend to be more severe than the symptoms presented at the initial complaint. We present our experience in utilizing high definition ultrasound to reliably and accurately localize the anatomical cause to aid focused revision CTR.

scholarly journals Surgical anatomy of the carpal tunnel

1997 ◽  
Vol 3 (1) ◽  
pp. E3 ◽  
Author(s):  
Allan H. Friedman
Keyword(s):  
Surgical Treatment ◽  
Carpal Tunnel Syndrome ◽  
Patient Outcomes ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Surgical Anatomy ◽  
Poor Patient ◽  
Endoscopic Carpal Tunnel Release ◽  
Tunnel Syndrome

The author describes and details the anatomy of the carpal tunnel and surrounding structures pertinent to the surgical treatment of carpal tunnel syndrome. Potential complications of both open and endoscopic carpal tunnel release are discussed as well as techniques to avoid or minimize poor patient outcomes.

scholarly journals Carpal Tunnel Syndrome Secondary to Acute Thrombosis of Persistent Median Artery and Review of the Literature

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Antoine Lessard
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Upper Extremity ◽  
Carpal Tunnel ◽  
Anatomic Variation ◽  
Carpal Tunnel Release ◽  
Review Of The Literature ◽  
Acute Thrombosis ◽  
Tunnel Syndrome ◽  
Median Artery

Carpal tunnel syndrome (CTS) is the most common neuropathy of the upper extremity.1 We report a case in which a twenty-eight-year-old manual labourer presented with acute thrombosis in a persistent median artery which triggered acute carpal tunnel symptoms. A bifid median nerve was found upon carpal tunnel release. The knowledge of the existence of this anatomic variation is important in order to prevent inadvertent injury. We further discuss the possible aetiologies for CTS as well as neurovascular anomalies which may lead to median nerve compression at the wrist.

scholarly journals Surgical Treatment of Carpal Tunnel Syndrome and Lymphedema in Advanced-Stage Upper Extremity Lymphedema

2021 ◽  
Author(s):  
Soo-Byn Kim ◽  
Kyung-Chul Moon
Keyword(s):  
Breast Cancer ◽  
Carpal Tunnel Syndrome ◽  
Upper Extremity ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Adjuvant Chemoradiotherapy ◽  
Axillary Lymph ◽  
Advanced Stage ◽  
Transverse Carpal Ligament ◽  
Tunnel Syndrome

Abstract Background Recent advances in supermicrosurgery have evolved to treat lymphedema surgically. For patients with carpal tunnel syndrome (CTS) and advanced-stage lymphedema, lymphovenous anastomosis (LVA) may effectively improve lymphedema after carpal tunnel release in patients with CTS and advanced stage lymphedema. However, no studies have reported simultaneous carpal tunnel release and LVA surgeries for patients with CTS and advanced-stage lymphedema.Case Presentation A 60-year-old female with carpal tunnel syndrome and International Society of Lymphology late stage 2 right upper extremity lymphedema following right mastectomy and axillary lymph node dissection and adjuvant chemoradiotherapy for treating breast cancer was admitted to our lymphedema clinic. She developed carpal tunnel syndrome four years after breast cancer surgery. She underwent release of the transverse carpal ligament, followed by four lymphovenous anastomoses at the wrist, forearm, and antecubital area. After two simultaneous surgeries, she had less neuropathic pain and volume reduction in her hand.Conclusion The authors recommend simultaneous LVA and release of the transverse carpal ligament as the first treatment option for patients with advanced-stage lymphedema and concurrent CTS.

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.

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