scholarly journals Patient Comprehension of Carpal Tunnel Surgery

Hand ◽  
2016 ◽  
Vol 12 (2) ◽  
pp. 175-180 ◽  
Author(s):  
Gregory R. Waryasz ◽  
Joseph A. Gil ◽  
Daniel Chiou ◽  
Paul Ramos ◽  
Jonathan R. Schiller ◽  
...  
Keyword(s):  
Health Literacy ◽  
Carpal Tunnel ◽  
Postoperative Care ◽  
Medical Condition ◽  
Carpal Tunnel Release ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Average Percentage ◽  
Patient Comprehension ◽  
Carpal Tunnel Surgery

Background: Health literacy is the ability of a patient to understand their medical condition. The purpose of this investigation is to determine whether patients are able to obtain an elementary understanding of the fundamental principles of carpal tunnel release and the postoperative instructions after going through the process of informed consent and being provided an additional standardized postoperative instruction document. Our hypothesis is that patients will lack an understanding of these principles and, therefore, will be at risk for being noncompliant in their postoperative care. Methods: Fifty patients with a diagnosis of carpal tunnel surgery who elected to undergo carpal tunnel release alone were enrolled. A standardized education process was performed. Patients completed the questionnaire at their postoperative visit. Results: The average percentage of correct answers was 75.8% (8.34 out of 11 correct). Fisher exact test analysis demonstrated that patients with a lower education level were less likely to know how long it takes for their preoperative symptoms to resolve ( P = .0071), and they were less likely to correctly choose all of the important elements of postoperative care during the first week after surgery ( P = .022). Conclusions: Although we made efforts to help patients achieve health literacy in carpal tunnel surgery, we found that patients continued to lack comprehension of pertinent components of carpal tunnel surgery, particularly understanding the involved anatomy.

Variations in incisions and postoperative management in carpal tunnel surgery

2002 ◽  
Vol 10 (2) ◽  
pp. 63-67 ◽  
Author(s):  
Carolyn M Levis ◽  
Thomas H Tung ◽  
Susan E Mackinnon
Keyword(s):  
Carpal Tunnel ◽  
Postoperative Care ◽  
Carpal Tunnel Release ◽  
Vertical Axis ◽  
Postoperative Management ◽  
Anatomical Landmarks ◽  
The Third ◽  
Carpal Tunnel Surgery ◽  
Web Space ◽  
Open Carpal Tunnel Release

This study examines the variations in incisions and postoperative protocol of open carpal tunnel release. A questionnaire was distributed to 65 hand surgeons. Respondents were asked to draw their preferred incision on original photocopies of the same palm. The results were measured against standard anatomical landmarks (thenar crease, vertical axis of the third web space, proximal palmar crease and the distal wrist crease). The participants were also asked to answer questions concerning their postoperative protocols. Demographics of the cohort, as well as the variations in incisions and postoperative management, were analyzed. Significant variations existed in the length and location of the incision in the palm. The differences in postoperative care in this cohort of surgeons were less significant.

scholarly journals Patient’s Perceptions of Carpal Tunnel Surgery

2019 ◽  
Vol 30 (3) ◽  
pp. 197-206
Author(s):  
Raíssa Mansilla ◽  
Marcus André Acioly ◽  
Tayla Taynan Romão ◽  
Alison Mangolin ◽  
Jonadab Dos Santos Silva ◽  
...  
Keyword(s):  
Carpal Tunnel ◽  
Medical Condition ◽  
Carpal Tunnel Release ◽  
Public Institution ◽  
Structured Interviews ◽  
Carpal Tunnel Surgery ◽  
Returning To Work ◽  
Tunnel Syndrome ◽  
Severity Of The Disease ◽  
Patient’S Perception

Introduction: Carpal tunnel syndrome is a debilitating medical condition to many patients, and in cases refractory to conservative treatment, carpal tunnel decompressive surgery is indicated. In Latin America, however, little is known about the patient’s perception of the surgical procedure and their experience. Objective: In this study, we analyzed patient’s perception and the overall experience about carpal tunnel decompression in a Brazilian public institution and compared the results with literature from other countries. Methods: We conducted a prospective qualitative study with semi-structured interviews with 20 patients who underwent carpal tunnel release. Interviews were audio recorded and transcribed for thematic analysis. Results: Six topics emerged from the analysis: (1) functional restriction and pain are the main reason for seeking surgery; (2) our patients considered CTS as a serious illness, contrarily to previous reports of other countries. (3) patients were satisfied with the overall surgical experience; (4) many patients did not return to work after surgery, despite reporting significant improvement; (5) patients recommend surgical treatment as soon as possible; (6) most patients considered physical therapy important in rehabilitation. Conclusion: perception of CTS surgery is influenced by various socioeconomic and psychocultural variables, and further strategies to improve patient’s outcomes and expectations are still needed. In our community, we need to improve the perception of the severity of the disease and the recovering time before returning to work.

scholarly journals E-health and health literacy of young adult Ukrainian female immigrants and Polish counterparts

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
Y Krasko ◽  
J Marianowska ◽  
M Duplaga
Keyword(s):  
Health Status ◽  
Health Literacy ◽  
Young Adult ◽  
Online Survey ◽  
Health Behaviours ◽  
Study Groups ◽  
University Education ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Ehealth Literacy

Abstract Background According to recent projections, even 10% of Polish gross domestic product is contributed by Ukrainian immigrants. There is also a considerable number of Ukrainians continuing university education in Poland. The level of health literacy in Ukrainian society has not been studied so far. The aim of the study was the comparison of health literacy (HL) and e-health literacy (eHL) of young adult Ukrainian (UA) women with their Polish (PL) counterparts Methods A snowball technique was used to recruit a sample of UA women working or studying in Poland to the Internet-based survey. The questionnaire used in the study consisted of the 16-item European HL Survey questionnaire (HLS-EU-16), eHealth Literacy Scale (eHEALS), the set of the questions asking about health behaviours (HB), self-assessment of health status (HS) and items exploring sociodemographic variables. For comparison, the data of an age-matched sample of 100 respondents was extracted from the online survey performed in a representative sample of PL women. Results The mean age (standard deviation, SD) of 57 UA respondents was 20.23 (1.78) years and in Polish sample 20.25 (1.79). HL did not differ between both groups (11.06 (4.22) vs 11.44 (4.34), respectively, p = 0.53), but eHL was significantly lower in UA group (25.91 (5.36) vs 28.17 (5.37), U Mann-Whitney test, p = 0.01). Only 58.5% of UA respondents vs 80.5% of PL ones assessed their HS as at least good (Fisher exact test, p < 0.001). The rates of active smoking (34.6% vs. 35.0%, p = 0.55), using e-cigarettes (35.3% vs 34.0%, p = 0.99), frequent alcohol consumption (26.9% vs. 20%, p = 0.41), and intensive physical activity (49.0% vs. 38.0%, p = 0.22) did not differ between study groups. Conclusions Young UA women show lower eHL than PL counterparts. Although HL and HB in both groups did not differ significantly, UA respondents have assessed their HS much lower than PL participants. Key messages E-health literacy and self-assessed health status were significantly lower among young Ukrainian than among Polish women. Both groups did not differ for health literacy and health behaviours.

scholarly journals Supraretinacular endoscopic carpal tunnel release: A safe alternative method for treatment of carpal tunnel syndrome

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199340
Author(s):  
Kotaro Sato ◽  
Kenya Murakami ◽  
Yoshikuni Mimata ◽  
Gaku Takahashi ◽  
Minoru Doita
Keyword(s):  
Learning Curve ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Open Surgery ◽  
Carpal Tunnel Release ◽  
Safe Alternative ◽  
Endoscopic Carpal Tunnel Release ◽  
Flexor Retinaculum ◽  
Carpal Tunnel Surgery ◽  
Conversion Rates

Purpose: Supraretinacular endoscopic carpal tunnel release (SRECTR) is a technique in which an endoscope is inserted superficial to the flexor retinaculum through a subcutaneous tunnel. The benefits of this method include a clear view for the surgeon and absence of median nerve compression. Surgeons can operate with a familiar view of the flexor retinaculum and median nerve downward, similar to open surgery. This study aimed to investigate the learning curve for SRECTR, an alternate method for carpal tunnel release, and evaluate its complications and the functional outcomes using a disposable commercial kit. Methods: We examined the open conversion rates and complications associated with SRECTR in 200 consecutive patients performed by two surgeons. We compared the operative time operated by a single surgeon. We evaluated outcomes in 191 patients according to Kelly’s grading system. Patients’ mean follow-up period was 12.7 months. Results: Nine patients required conversion to open surgery. There were no injuries to the nerves and tendons and no hematoma or incomplete dissection of the flexor retinaculum. The operative times varied between 11 and 34 minutes. We obtained the following results based on Kelly’s grading of outcomes: excellent in 116, good in 59, fair in 13, and poor in 3 patients. Conclusions: We found no patients with neurapraxia, major nerve injury, flexor tendon injury, superficial palmar arch injury, and hematoma. Although there was a learning curve associated with SRECTR, we performed 200 consecutive cases without neurovascular complications. This method may be a safe alternative to minimally invasive carpal tunnel surgery.

Topical Anaesthesia to Reduce Pain Associated with Carpal Tunnel Surgery

2002 ◽  
Vol 27 (5) ◽  
pp. 462-464 ◽  
Author(s):  
T. M. LAWRENCE ◽  
V. V. DESAI
Keyword(s):  
Carpal Tunnel ◽  
Local Anaesthetic ◽  
Carpal Tunnel Release ◽  
Statistical Significance ◽  
Eutectic Mixture ◽  
Local Anaesthetics ◽  
Needle Insertion ◽  
Visual Analogue Pain ◽  
Pain Scores ◽  
Carpal Tunnel Surgery

This randomized, double-blinded study assessed the effectiveness of a topical anaesthetic, eutectic mixture of local anaesthetics (EMLA), in reducing pain associated with carpal tunnel release performed under local anaesthetic. Fifty-six patients undergoing carpal tunnel release under local anaesthetic were randomized into either EMLA ( n=29) or placebo ( n=27) groups. Visual analogue pain scores were obtained for needle insertion, injection of anaesthetic and surgery itself. Pain scores were significantly less for needle insertion ( P=0.001) and injection of anaesthetic ( P=0.0005). Scores related to surgery were also lower in the EMLA group, but this did not reach statistical significance.

scholarly journals Minimally Invasive Carpal Tunnel Release (CTR) Using the Wongsiri Technique with MiniSURE

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Sunton Wongsiri ◽  
Wongthawat Liawrungrueang
Keyword(s):  
Minimally Invasive ◽  
Return To Work ◽  
Carpal Tunnel ◽  
Endoscopic Surgery ◽  
Operative Time ◽  
Carpal Tunnel Release ◽  
Line Of Sight ◽  
Open Technique ◽  
Working Space ◽  
Carpal Tunnel Surgery

Introduction. The standard open technique for carpal tunnel surgery has wound problems and complications significantly more than minimally invasive surgery using the Wongsiri technique with MiniSURE Kit® (Surgical Innovation Healthcare Co., Ltd, Bangkok, Thailand) and in particular, the open technique surgery requires a longer time for return to work. CTR surgery with endoscopic devices improves the results with fewer wound problems when compared with the commonly used open technique; however, nerve complications and injury are more prevalent with endoscopic surgery than with the open technique. The Wongsiri technique produces good results with new medical devices such as the MiniSURE View, for improved vision and line-of-sight, and the MiniSURE Cut for improved and complete cutting via the supraretinacular technique that may reduce the nerve problems associated with endoscopic tooling in the carpal tunnel. Purpose. To evaluate the results of the operation and postoperative outcomes of the Wongsiri technique with a MiniSURE Kit®. Methods. 20 patients underwent carpal tunnel release using the Wongsiri technique and a MiniSURE Kit® with a five-step surgery: MIS starts when the surgeon makes a 1.5–1.8 cm incision, creates a working space, inserts the visual tube of MiniSURE View, inserts the freer, and then cuts the transverse carpal ligament by using the MiniSURE Cut. Results. All 20 successes of the Wongsiri technique and MiniSURE Kit® surgery occurred within 6.8 minutes operative time and a 12 mm wound size. A single outlier, in one case (6.7%), the patient experienced pillar pain which abated within one month. Patients can return to work in 7.3 days. Conclusions. The Wongsiri technique with the MiniSURE Kit® demonstrated good outcomes similar to the endoscope. By contrast with the endoscopic surgery, the Wongsiri technique with the MiniSURE Kit® reduced preop, operating, and postop time, many resources, and significant costs and resulted in no nerve problems or complications.

scholarly journals Does the Duration and Severity of Symptoms Have an Impact on Relief of Symptoms after Carpal Tunnel Release?

2019 ◽  
Vol 14 (01) ◽  
pp. e1-e8
Author(s):  
Mehreen Masud ◽  
Mamoon Rashid ◽  
Saleem Malik ◽  
Muhommad Ibrahim Khan ◽  
Saad-ur-Rehman Sarwar
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Hand Function ◽  
Normal Function ◽  
Duration Of Symptoms ◽  
Compressive Neuropathy ◽  
Carpal Tunnel Surgery ◽  
Short Period ◽  
Group 2 ◽  
Open Carpal Tunnel Release

Rationale Carpal tunnel syndrome (CTS) is the most frequently encountered compressive neuropathy of the upper limb. The treatment of CTS ranges from conservative management to carpal tunnel release. Many patients with misconception about the potential morbidity and with the hope of successful conservative treatment delay the surgical release of carpal tunnel. This delay results in reduced recovery of sensory and motor median nerve function. Objective The aim of this study was to evaluate the influence of preoperative duration and severity of symptom on the outcome of carpal tunnel surgery. Method It included 45 cases of CTS, all treated with limited access open carpal tunnel release. The duration of symptoms (i.e., pain, numbness, tingling, waking up at night because of pain/numbness, difficulty in grasping small objects, and their preoperative severity) was noted using Boston CTS questionnaire. To investigate the outcome, patients were divided into three groups based on their duration of symptoms. Result Group1: The severity of symptoms was reduced to normal in a short period of time in patients who presented with duration of symptoms less than 6 months. Group 2: Patients in whom symptoms lasted for 6 to 12 months had reduced or delayed recovery of hand function as compared with first group. Group 3: Patients who had symptoms for more than 12 months had incomplete recovery of grip strength. Return to normal function took the longest time (median: 16 weeks) in this group. Conclusion This study suggests that patients who present late have delayed/incomplete relief of symptoms after carpal tunnel release.

scholarly journals Minimally invasive carpal tunnel surgery in leprosy

2014 ◽  
Vol 33 (01) ◽  
pp. 42-44
Author(s):  
José Marcos Pondé ◽  
Clarissa Ramos ◽  
Lazaro Santos ◽  
João Pedro Magalhaes ◽  
Ana Flavia Cavalcanti
Keyword(s):  
Developing Countries ◽  
Cost Effectiveness ◽  
Minimally Invasive ◽  
Median Nerve ◽  
Local Anesthesia ◽  
Carpal Tunnel ◽  
Surgical Approach ◽  
Carpal Tunnel Release ◽  
Nerve Involvement ◽  
Carpal Tunnel Surgery

Abstract Objective: Evaluate carpal tunnel release in leprosy. Methods: The authors operated upon 60 patients with median nerve involvement by leprosy between February 2008 and February 2012. The outpatients were under local anesthesia submitted to carpal tunnel release. Results: All the patients showed post-operative improvement in pain and sensation. Conclusion: The surgical approach is a cost effectiveness procedure adequate to developing countries.

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