Trigger Digit Incidence After Carpal Tunnel Release: Reconstruction in Elongated Position Versus Traditional Carpal Tunnel Release

Hand ◽  
2019 ◽  
pp. 155894471989305
Author(s):  
Ignacio Esteban-Feliu ◽  
Irene Gallardo-Calero ◽  
Sergi Barrera-Ochoa ◽  
Núria Vidal-Tarrason ◽  
Jorge Nuñez-Camarena ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Retrospective Review ◽  
Carpal Tunnel Release ◽  
Flexor Retinaculum ◽  
Tunnel Syndrome ◽  
Mean Time ◽  
Reconstruction Group ◽  
Long Term Studies

Background: The development of trigger digit after carpal tunnel syndrome release surgery has been widely reported. Lluch described reconstruction of the flexor retinaculum in elongated position to prevent such complication. Methods: We conducted a retrospective review to determine whether patients who undergo reconstruction in elongated position of the flexor retinaculum have a lower incidence of trigger digit postoperatively. In total, 1050 patients were included, 865 of whom had undergone traditional carpal tunnel release and 185 flexor retinaculum reconstruction. Results: No differences were found in the incidence of trigger digit after surgery (8.7% of the patients who underwent traditional release vs 11.9% in the reconstruction group). Neither difference was found when comparing mean time with the development of trigger digit. Conclusions: In the absence of randomized long-term studies comparing traditional release and reconstruction in elongated position after carpal tunnel release, given our results, we see no reason to favor reconstruction over standard carpal tunnel release as a means to prevent postoperative triggering of digits.

Complete Endoscopic Carpal Tunnel Release in Long-Term Haemodialysis Patients

1996 ◽  
Vol 21 (5) ◽  
pp. 668-671 ◽  
Author(s):  
I. OKUTSU ◽  
I. HAMANAKA ◽  
T. TANABE ◽  
Y. TAKATORI ◽  
S. NINOMIYA
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Distal Portion ◽  
Proximal Portion ◽  
Flexor Retinaculum ◽  
Endoscopic Release ◽  
Before And After ◽  
Tunnel Syndrome ◽  
Infusion Technique

The roof of the carpal tunnel (or canal) consists of the distal portion of the flexor retinaculum, the flexor retinaculum (or the transverse carpal ligament) and the proximal portion of the flexor retinaculum. We tried to determine which anatomical structures were relevant to complete endoscopic carpal tunnel decompression in long-term haemodialysis patients with carpal tunnel syndrome. Carpal tunnel pressure was measured using the continuous infusion technique before and after endoscopic release of the flexor retinaculum, distal portion of the flexor retinaculum and the proximal portion of the flexor retinaculum respectively in 257 hands. We concluded that release of the distal portion of the flexor retinaculum, in addition to the flexor retinaculum, is essential for complete carpal tunnel decompression in long-term haemodialysis patients.

INVESTIGATION OF SEGMENTAL CARPAL TUNNEL PRESSURE IN PATIENTS WITH IDIOPATHIC CARPAL TUNNEL SYNDROME — IS IT NECESSARY TO RELEASE THE DISTAL APONEUROTIC PORTION OF THE FLEXOR RETINACULUM IN ENDOSCOPIC CARPAL TUNNEL RELEASE SURGERY?

Hand Surgery ◽  
2007 ◽  
Vol 12 (03) ◽  
pp. 205-209 ◽  
Author(s):  
Keiichi Murata ◽  
Hiroshi Yajima ◽  
Naoki Maegawa ◽  
Koji Hattori ◽  
Yoshinori Takakura
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Guide Wire ◽  
Carpal Tunnel Release ◽  
Endoscopic Carpal Tunnel Release ◽  
Flexor Retinaculum ◽  
Before And After ◽  
Idiopathic Carpal Tunnel Syndrome ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Release Surgery

Segmental carpal tunnel pressure was measured in 12 hands of 11 idiopathic carpal tunnel syndrome patients before and after two-portal endoscopic carpal tunnel release. We aimed to determine at which part of the carpal tunnel the median nerve could be compressed, and to evaluate whether carpal tunnel pressure could be reduced sufficiently at all segments of the carpal tunnel after the surgery. Pressure measurements were performed using a pressure guide wire. The site with the highest pressure corresponded to the area around the hamate hook; the pressure in the area distal to the flexor retinaculum could be pathogenically high (more than 30 mmHg) before the surgery. The two-portal endoscopic carpal tunnel release achieved sufficient pressure reduction in all segments of the carpal tunnel when the flexor retinaculum and the fibrous structure between the flexor retinaculum and the palmar aponeurosis were completely released.

Simultaneous modified Camitz opponensplasty using a pulley at the radial side of the flexor retinaculum in severe carpal tunnel syndrome

2013 ◽  
Vol 39 (6) ◽  
pp. 632-636 ◽  
Author(s):  
N. Kato ◽  
T. Yoshizawa ◽  
H. Sakai
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Radial Side ◽  
Palmaris Longus ◽  
Flexor Retinaculum ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release

Camitz opponensplasty using the palmaris longus has been used in patients undergoing open carpal tunnel release. It is considered to have several advantages over other opponensplasty techniques, but it provides weak flexion and pronation, which are prerequisites for opposition. To address this shortcoming, we have used a modified Camitz procedure with a pulley at the radial side of the dissected flexor retinaculum and have assessed the results in comparison with the conventional Camitz procedure. Both procedures provided significant improvements in palmar abduction and Disabilities of the Arm, Shoulder, and Hand and Kapandji scores at 3 months post-operatively, but patients who underwent the modified Camitz procedure showed better improvement in pulp pinch, palmar abduction, and thumb pronation.

scholarly journals Endoscopic treatment of carpal tunnel syndrome: a critical review

1997 ◽  
Vol 3 (1) ◽  
pp. E8 ◽  
Author(s):  
David F. Jimenez ◽  
Scott R. Gibbs ◽  
Adam T. Clapper
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Complication Rates ◽  
Palmar Arch ◽  
Endoscopic Techniques ◽  
Endoscopic Carpal Tunnel Release ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Release Surgery ◽  
Mean Time

An extensive review of published articles on the subject of endoscopic carpal tunnel release surgery is presented, encompassing six endoscopic techniques used to treat carpal tunnel syndrome. Since the first report in 1987, 7091 patients have undergone 8068 operations. The overall success rate has been 96.52%, with a complication rate of 2.67% and a failure rate of 2.61%. The mean time to return to work in patients not receiving Workers' Compensation was 17.8 days, ranging between 10.8 and 22.3 days. The most common complications were transient paresthesias of the ulnar and median nerves. Other complications included superficial palmar arch injuries, reflex sympathetic dystrophy, flexor tendon lacerations, and incomplete transverse carpal ligament division. All studies in which open and endoscopic techniques were compared reported that patients in the latter group experienced significantly less pain and returned to work and activities of daily living earlier. The reported success and complication rates of endoscopic carpal tunnel release surgery are similar to those for standard open procedures. Endoscopic techniques and outcomes are discussed.

scholarly journals Does Carpal Tunnel Release Provide Long-Term Relief in Patients with Hemodialysis-Associated Carpal Tunnel Syndrome?

2012 ◽  
Vol 470 (9) ◽  
pp. 2561-2565 ◽  
Author(s):  
Ho Jung Kang ◽  
Il Hyun Koh ◽  
Won Yong Lee ◽  
Yun Rak Choi ◽  
Soo Bong Hahn
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Tunnel Syndrome

Long-Term Results of Carpal Tunnel Release

1995 ◽  
Vol 20 (4) ◽  
pp. 470-474 ◽  
Author(s):  
M. P. NANCOLLAS ◽  
C. A. PEIMER ◽  
D. R. WHEELER ◽  
F. S. SHERWIN
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Long Term Results ◽  
Significant Morbidity ◽  
Surgical Scar ◽  
Internal Neurolysis ◽  
Maximum Improvement ◽  
Tunnel Syndrome

To determine the long-term results of carpal tunnel release, we retrospectively reviewed 60 cases, an average of 5.5 years after surgery. 87% reported a good or excellent overall outcome; the average time to maximum improvement of symptoms was 9.8 months. However, 30% reported poor to fair strength and long-term scar discomfort, and 57% noted a return of some pre-operative symptoms, most commonly pain, beginning an average of 2 years after surgery. We found no correlation between pre-operative symptoms or extent of surgical dissection (internal neurolysis) and outcome. Carpal tunnel syndrome was job related in 42%; of these, 26% changed from heavy to lighter work following surgery. Although occupational cases were slower to improve and remained off work longer, the long-term subjective results were the same for both groups. We found significant morbidity from the surgical scar and decreased strength, and often considerable delay until ultimate improvement, especially in patients with job-related carpal tunnel syndrome.

Open Surgical Therapy for Carpal Tunnel Decompression in Long-Term Haemodialysis Patients

2001 ◽  
Vol 26 (6) ◽  
pp. 529-532 ◽  
Author(s):  
E. SHIOTA ◽  
K. TSUCHIYA ◽  
K. YAMAOKA ◽  
O. KAWANO
Keyword(s):  
Retrospective Study ◽  
Carpal Tunnel Syndrome ◽  
Functional Recovery ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
The Other ◽  
Lower Recurrence Rate ◽  
Open Surgical Therapy ◽  
Tunnel Syndrome

This retrospective study assessed the treatment of 91 cases of carpal tunnel syndrome in long-term haemodialysis patients. One group of patients underwent an enlargement reconstruction of the flexor retinaculum with synovectomy and the other group was treated with a conventional carpal tunnel release. There were no major changes or differences between the outcomes of the two groups. However, there was an earlier functional recovery of grip strength and a lower recurrence rate in the enlargement plasty with synovectomy group.

scholarly journals Management of Carpal Tunnel Syndrome – Surgical Vs Medical?

2020 ◽  
Vol 10 (1) ◽  
pp. 75-81
Author(s):  
Md Ruhul Kuddus ◽  
Md Omar Faruk ◽  
Samiul Alam ◽  
KM Atiqul Islam ◽  
Shamsul Alam ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Surgical Approach ◽  
Carpal Tunnel Release ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Surgical Methods ◽  
Tunnel Syndrome ◽  
Surgical Group

Background: Carpal Tunnel Syndrome (CTS) is the most common form of entrapment neuropathy. Both the Medical and surgical treatments are popular in the management of CTS. The effectiveness of the surgical treatment of carpal tunnel syndrome (CTS) is well known on short term. Surgical approach has proved to be more efficient relative to the conservative methods of steroid injections and splinting. On the other hand, many studies have demonstrated both advantages and adverse effects of the surgical methods. However, limited data is available about long-term outcome after carpal tunnel release (CTR). So debate is still persists regarding Conservative vs. Surgical approach to treatment of CTS. Methods: A retrospective analysis of 15 consecutive cases performed during 1.5 year was conducted. 8 patients were treated surgically with transpalmar approach. 7 patient were treated conservatively. The criteria for treatment efficacy were improvements in symptoms, such as pain, paresthesia and recurrences after surgery. Results: Female were predominant 80% than male 20%. Right hand was more frequently affected 80% than left 20%. most paitents were diabetic except 2. outcome in the surgical group was excellent. Patient of non-surgical group was not satisfied as surgical group. Conclusions: CTR is a robust treatment for CTS and its effect persists after a period of years. CTR is the choice of treatment in case of moderate to severe form of CTS. Long term follow up and inclusion of more cases is needed for a definite conclusion. Bang. J Neurosurgery 2020; 10(1): 75-81

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