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.

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.

ULNAR NERVE ENTRAPMENT BY ANCONEUS EPITROCHLEARIS LIGAMENT

Hand Surgery ◽  
2012 ◽  
Vol 17 (01) ◽  
pp. 83-84 ◽  
Author(s):  
William H. C. Tiong ◽  
Jason Kelly
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Ulnar Nerve ◽  
Upper Limb ◽  
Carpal Tunnel ◽  
Nerve Entrapment ◽  
Entrapment Neuropathy ◽  
Review Of The Literature ◽  
Inflammatory Conditions ◽  
Ulnar Nerve Entrapment ◽  
Tunnel Syndrome

Ulnar nerve entrapment at the elbow is the second most common upper limb entrapment neuropathy other than carpal tunnel syndrome. There have been many causes identified ranging from chronic aging joint changes to inflammatory conditions or systemic disorders. Among them, uncommon anatomical variants accounts for a small number of cases. Here, we report our experience in managing ulnar nerve entrapment caused by a rare vestigial structure, anconeus epitrochlearis ligament, and provide a brief review of the literature of its management.

Clinical Update: Assessing Maximum Medical Improvement in Carpal Tunnel Syndrome

2003 ◽  
Vol 8 (4) ◽  
pp. 4-5
Author(s):  
Christopher R. Brigham ◽  
James B. Talmage
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Proper Time ◽  
Carpal Tunnel Release ◽  
Hand Function ◽  
Factors Affecting ◽  
Early Results ◽  
Medical Evaluation ◽  
Nerve Recovery ◽  
Tunnel Syndrome

Abstract Permanent impairment cannot be assessed until the patient is at maximum medical improvement (MMI), but the proper time to test following carpal tunnel release often is not clear. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) states: “Factors affecting nerve recovery in compression lesions include nerve fiber pathology, level of injury, duration of injury, and status of end organs,” but age is not prognostic. The AMA Guides clarifies: “High axonotmesis lesions may take 1 to 2 years for maximum recovery, whereas even lesions at the wrist may take 6 to 9 months for maximal recovery of nerve function.” The authors review 3 studies that followed patients’ long-term recovery of hand function after open carpal tunnel release surgery and found that estimates of MMI ranged from 25 weeks to 24 months (for “significant improvement”) to 18 to 24 months. The authors suggest that if the early results of surgery suggest a patient's improvement in the activities of daily living (ADL) and an examination shows few or no symptoms, the result can be assessed early. If major symptoms and ADL problems persist, the examiner should wait at least 6 to 12 months, until symptoms appear to stop improving. A patient with carpal tunnel syndrome who declines a release can be rated for impairment, and, as appropriate, the physician may wish to make a written note of this in the medical evaluation report.

Systematic review and meta-analysis of surgical options for recurrent or persistent carpal tunnel syndrome: simple decompression versus coverage of the median nerve

2021 ◽  
pp. 175319342110017
Author(s):  
Saskia F. de Roo ◽  
Philippe N. Sprangers ◽  
Erik T. Walbeehm ◽  
Brigitte van der Heijden
Keyword(s):  
Systematic Review ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Meta Analysis ◽  
Surgical Techniques ◽  
Open Release ◽  
Flap Coverage ◽  
Tunnel Syndrome

We performed a systematic review on the success of different surgical techniques for the management of recurrent and persistent carpal tunnel syndrome. Twenty studies met the inclusion criteria and were grouped by the type of revision carpal tunnel release, which were simple open release, open release with flap coverage or open release with implant coverage. Meta-analysis showed no difference, and pooled success proportions were 0.89, 0.89 and 0.85 for simple open carpal tunnel release, additional flap coverage and implant groups, respectively. No added value for coverage of the nerve was seen. Our review indicates that simple carpal tunnel release without additional coverage of the median nerve seems preferable as it is less invasive and without additional donor site morbidity. We found that the included studies were of low quality with moderate risk of bias and did not differentiate between persistent and recurrent carpal tunnel syndrome.

scholarly journals Ultrasound-Guided Surgery for Carpal Tunnel Syndrome: A New Interventional Procedure

2018 ◽  
Vol 35 (04) ◽  
pp. 248-254 ◽  
Author(s):  
Antoine Hakime ◽  
Jonathan Silvera ◽  
Pascal Richette ◽  
Rémy Nizard ◽  
David Petrover
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Interventional Procedure ◽  
Carpal Tunnel Release ◽  
Ultrasound Guided ◽  
Recent Contribution ◽  
Invasive Approach ◽  
Guided Surgery ◽  
Tunnel Syndrome ◽  
Meta Analyses

AbstractCarpal tunnel syndrome (CTS) may be treated surgically if medical treatment fails. The classical approach involves release of the flexor retinaculum by endoscopic or open surgery. Meta-analyses have shown that the risk of nerve injury may be higher with endoscopic treatment. The recent contribution of ultrasound to the diagnosis and therapeutic management of CTS opens new perspectives. Ultrasound-guided carpal tunnel release via a minimally invasive approach enables the whole operation to be performed as a percutaneous radiological procedure. The advantages are a smaller incision compared with classical techniques; great safety during the procedure by visualization of anatomic structures, particularly variations in the median nerve; and realization of the procedure under local anesthesia. These advantages lead to a reduction in postsurgical sequelae and more rapid resumption of daily activities and work. Dressings are removed by the third day postsurgery. Recent studies seem to confirm the medical, economic, and aesthetic benefits of this new approach.

Carpal Tunnel Syndrome in Madelung’s Deformity

1988 ◽  
Vol 13 (1) ◽  
pp. 19-22
Author(s):  
R. LUCHETTI ◽  
A. MINGIONE ◽  
M. MONTELEONE ◽  
G. CRISTIANI
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Surgical Approach ◽  
Nerve Entrapment ◽  
Clinical Implications ◽  
Tunnel Syndrome ◽  
Madelung’S Deformity

The authors describe a case of carpal tunnel syndrome due to Madelung’s deformity. They discuss the pathophysiological causes of median nerve entrapment to explain the compression which occurs in this disease and its clinical implications. They take also into consideration the surgical approach to the carpal tunnel in this particular condition.

Is carpal tunnel syndrome a slow, chronic, progressive nerve entrapment?

2014 ◽  
Vol 125 (3) ◽  
pp. 642-646 ◽  
Author(s):  
Jefferson Becker ◽  
Renata Siciliani Scalco ◽  
Franciane Pietroski ◽  
Luiz Felippe S. Celli ◽  
Irenio Gomes
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Entrapment ◽  
Tunnel Syndrome

scholarly journals Non-Surgical Management and Post-Surgical Rehabilitation of Carpal Tunnel Syndrome: An Algorithmic Approach and Practical Guideline

2020 ◽  
Vol 11 (3) ◽  
Author(s):  
Mahshid Nazarieh ◽  
Azadeh Hakakzadeh ◽  
Shima Ghannadi ◽  
Faezeh Maleklou ◽  
Zahra Tavakol ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Surgical Management ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Treatment Options ◽  
Operative Management ◽  
Functional Improvement ◽  
Therapeutic Effects ◽  
Multiple Treatment ◽  
Tunnel Syndrome

: One of the most common forms of entrapment neuropathy is Carpal Tunnel Syndrome (CTS). There are various treatment options for CTS. However, there are no clear and structured guidelines. This review classified the existing treatments and developed an algorithm to help physicians to choose the best option for their patients. Treatment options were summarized in three sections: non-surgical management of CTS, post-operative management of CTS, and practical open carpal tunnel release post-op protocol. The physicians can prescribe multiple treatment options to CTS patients. Corticosteroid in oral or injectable form has strong evidence in pain control and functional improvement in the short term. Shockwave therapy and nocturnal wrist splints display moderate therapeutic effects. Post carpal tunnel release rehabilitation can be started a few days after the operation.

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