Long-term Clinical Results of Carpal Tunnel Release Using Ultrasound Guidance

Hand ◽  
2021 ◽  
pp. 155894472098808
Author(s):  
Braeden M. Leiby ◽  
John P. Beckman ◽  
Anthony E. Joseph
Keyword(s):  
Carpal Tunnel ◽  
Ultrasound Guidance ◽  
Carpal Tunnel Release ◽  
Clinical Results ◽  
Satisfaction Score ◽  
Global Satisfaction ◽  
Us Guidance ◽  
Clinically Significant ◽  
Carpal Tunnel Questionnaire

Background: The purpose of this study was to determine the long-term safety and efficacy of carpal tunnel release (CTR) using ultrasound guidance in a group of patients treated by a single physician. Methods: The study group consisted of 76 consecutive CTRs performed on 47 patients between June 2017 and April 2019 for whom 1-year follow-up was available. All procedures were performed by the same operator using a single CTR technique. Outcomes included complications; Boston Carpal Tunnel Questionnaire symptom severity (BCTQ-SSS) and functional status (BCTQ-FSS) scores; Quick Disabilities of the Arm, Shoulder, and Hand (QDASH) scores; and a 5-point global satisfaction score (4 = satisfied, 5 = very satisfied). Results: The 47 patients included 27 females and 20 males (ages 31-91 years). Twenty-five patients (50 hands) had simultaneous bilateral CTRs, 4 patients (8 hands) had staged bilateral CTRs, and 18 patients had unilateral CTRs. No complications occurred. Statistically and clinically significant reductions in BCTQ-SSS, BCTQ-FSS, and QDASH scores occurred by 1 to 2 weeks post-CTR and persisted at 1-year (mean 1-year changes vs. pre-CTR -2.11, -1.70, and -44.99, respectively; P < .001 for all). The mean global satisfaction score at 1-year was 4.63. Conclusions: CTR using ultrasound (US) guidance is a safe and effective procedure that produces statistically and clinically significant improvements within 1 to 2 weeks postprocedure that persist to 1 year. Furthermore, simultaneous bilateral CTRs using US guidance are feasible and may be advantageous for patients who are candidates for bilateral CTR.

scholarly journals Analysis of the Long-Term Outcome in Open Carpal Tunnel Release Surgeries with and without External Neurolysis of Median Nerve, Using Boston Carpal Tunnel Questionnaire (BCTQ)–Hindi Version

2021 ◽  
Author(s):  
Sanjeev Pattankar ◽  
Rohan Roy ◽  
Anshu Warade ◽  
Ketan Desai
Keyword(s):  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Statistical Validity ◽  
Carpal Tunnel Questionnaire ◽  
External Neurolysis ◽  
Open Carpal Tunnel Release

Abstract Background The effectiveness of open carpal tunnel release (OCTR) in treating carpal tunnel syndrome (CTS) is well known. However, the role of ancillary external neurolysis of the median nerve is not well-documented. The Boston carpal tunnel questionnaire (BCTQ) is a commonly used disease-specific outcome instrument for CTS, which is validated across major languages of the world. No such validated Hindi version of BCTQ exists. Objectives To analyze and compare the long-term outcome in patients who underwent OCTR alone and OCTR with external neurolysis of the median nerve, using BCTQ–Hindi version, while checking its validity. Materials and Methods A retrospective, cross-sectional study was conducted at a tertiary care institute. The BCTQ was translated into Hindi language by a language expert. Eighty-four consecutive patients who underwent either unilateral/bilateral OCTR, with or without external neurolysis of the median nerve, between 2009 and 2019 were included in the study. Outcome analysis was done using BCTQ–Hindi version and patient satisfaction scoring. BCTQ–Hindi version was examined for statistical validity. Subgroup analysis of the outcome based on surgical technique (OCTR vs. OCTR with external neurolysis) used was carried out. Results Response rate was 80.9%. Total hands evaluated were 108. BCTQ–Hindi version showed statistical validity. Overall symptom severity score (SSS) and functional severity score (FSS) were 1.14 ± 0.4 and 1.12 ± 0.35, respectively. Subgroup analysis of outcome revealed statistically significant results in favor of OCTR with external neurolysis of the median nerve. Conclusions BCTQ–Hindi version is statistically validated. OCTR with external neurolysis of the median nerve is a promising avenue in surgical management of CTS. Further prospective studies are warranted.

Primary Palmaris Longus Transfer as an Opponensplasty in Carpal Tunnel Release

1991 ◽  
Vol 16 (1) ◽  
pp. 56-60 ◽  
Author(s):  
G. FOUCHER ◽  
C. MALIZOS ◽  
D. SAMMUT ◽  
F. MARIN BRAUN ◽  
J. MICHON
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Long Term Results ◽  
Technical Modification ◽  
Palmaris Longus

Seventy three Camitz-Littler operations combining carpal tunnel release and palmaris longus oppenens transfer provided 90.7% good long term results. A technical modification can provide pronation.

A COMPARISON OF FUNCTIONAL ASSESSMENT OF PRE- AND POSTSURGICAL CARPAL TUNNEL SYNDROME USING BOSTON CARPAL TUNNEL QUESTIONNAIRE AND NERVE CONDUCTION STUDY: A PROSPECTIVE STUDY FROM A TERTIARY CENTER OF SOUTH INDIA

2021 ◽  
pp. 117-120
Author(s):  
Padmapriyadarsini V ◽  
Navin K ◽  
Abdul Gafoor S ◽  
Chitra G
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Functional Outcome ◽  
Conduction Velocity ◽  
Carpal Tunnel ◽  
Nerve Conduction Study ◽  
Electrophysiological Study ◽  
Carpal Tunnel Release ◽  
Boston Carpal Tunnel Questionnaire ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Questionnaire

INTRODUCTION: Carpal tunnel syndrome (CTS) is the most common entrapment syndrome of median nerve causing frequent disability especially among working populations. Boston Carpal Tunnel Questionnaire and Electrophysiological study helps in detecting and aiding in the diagnosis of CTS and helps in determining level of improvement after surgical release of carpal tunnel. OBJECTIVES: To assess functional outcome of patients with Carpal Tunnel Syndrome after surgery as assessed by Boston Carpel Tunnel Questionnaire and Electrophysiological study. METHODS: A prospective observational study conducted over a period of one year (January 2017 to January 2018). The study was conducted among consecutive 31 electrophysiological conrmed carpal tunnel syndrome attending the outpatient department of Physical Medicine and Rehabilitation, Government Medical College, Thiruvananthapuram. All patients underwent open carpal tunnel release. Functional outcome was assessed using Boston Carpal Tunnel Questionnaire (BCTQ) both preoperatively and at interval of 3 weeks, 6weeks and 3 months postoperatively. Electrophysiological study assessed using nerve conduction study both preoperatively and 3 weeks post operatively. Data was entered in Microsoft excel and analyzed using SPSS statistical software. RESULTS: The study involves 31 conrmed cases of Carpal tunnel syndrome patients. Mean Boston Carpal Tunnel Questionnaire (BCTQ) score preoperatively was 58.52 ± 12.73 which was markedly improved postoperatively at 3weeks with mean score of 29.77±6.68. At 6 weeks and 3 month follow up period it was reduced respectively to mean score of 23.94±4.23 and 22.94±4.62. Preoperative NCS shows decreased conduction velocity with mean nerve sensory velocity (NSV) score 21.51±8.19 and mean nerve motor velocity (NMV) score of 20.72±8.81 which statistically improved following surgery with mean NSV score of 32.04±9.01 and mean NML score of 33.78±8.1. Correlation between pre- and post-operative BCTQ and NCS parameters shows positive correlation with latency and negative correlation with amplitude and conduction velocity. Increased latency and decreased conduction velocity associated with higher BCTQ score with signicant 'p' value (p<0.05). CONCLUSION: There is statistically signicant improvement of functional outcome following carpal tunnel release surgery assessed through Boston Carpal Tunnel Questionnaire and Electrophysiological ndings

scholarly journals Tourniquet Use in Wide-Awake Carpal Tunnel Release

Hand ◽  
2018 ◽  
Vol 15 (1) ◽  
pp. 59-63 ◽  
Author(s):  
Sarah E. Sasor ◽  
Julia A. Cook ◽  
Stephen P. Duquette ◽  
Elizabeth A. Lucich ◽  
Adam C. Cohen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Carpal Tunnel ◽  
Local Anesthetic ◽  
Operative Time ◽  
Carpal Tunnel Release ◽  
Estimated Blood Loss ◽  
Tunnel Syndrome ◽  
Clinically Significant ◽  
Without Tourniquet ◽  
Wide Awake

Background: Carpal tunnel syndrome is a common cause of upper extremity discomfort. Surgical release of the median nerve can be performed under general or local anesthetic, with or without a tourniquet. Wide-awake carpal tunnel release (CTR) (local anesthesia, no sedation) is gaining popularity. Tourniquet discomfort is a reported downside. This study reviews outcomes in wide-awake CTR and compares tourniquet versus no tourniquet use. Methods: Wide-awake, open CTRs performed from February 2013 to April 2016 were retrospectively reviewed. Patients were divided into 2 cohorts: with and without tourniquet. Demographics, comorbidities, tobacco use, operative time, estimated blood loss, complications and outcomes were compared. Results: A total of 304 CTRs were performed on 246 patients. The majority of patients were male (88.5%), and the mean age was 59.9 years. One hundred patients (32.9%) were diabetic, and 92 patients (30.2%) were taking antithrombotics. Seventy-five patients (24.7%) were smokers. A forearm tourniquet was used for 90 CTRs (29.6%). Mean operative time was 24.97 minutes with a tourniquet and 21.69 minutes without. Estimated blood loss was 3.16 mL with a tourniquet and 4.25 mL without. All other analyzed outcomes were not statistically significant. Conclusion: Operative time was statistically longer and estimated blood loss was statistically less with tourniquet use, but these findings are not clinically significant. This suggests that local anesthetic with epinephrine is a safe and effective alternative to tourniquet use in CTR. The overall rate of complications was low, and there were no major differences in postoperative outcomes between groups.

scholarly journals Long-Term Outcomes following Single-Portal Endoscopic Carpal Tunnel Release

Hand ◽  
2014 ◽  
Vol 9 (3) ◽  
pp. 384-388 ◽  
Author(s):  
K. R. Means ◽  
N. H. Dubin ◽  
K. M. Patel ◽  
J. D. Pletka
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Long Term Outcomes ◽  
Endoscopic Carpal Tunnel Release

scholarly journals Minimally Invasive Ultrasound-Guided Carpal Tunnel Release: Preliminary Clinical Results

2018 ◽  
Vol 37 (11) ◽  
pp. 2699-2706 ◽  
Author(s):  
P. Troy Henning ◽  
Lynda Yang ◽  
Tariq Awan ◽  
Daniel Lueders ◽  
Adam M. Pourcho
Keyword(s):  
Minimally Invasive ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Clinical Results ◽  
Ultrasound Guided

Endoscopic Carpal Tunnel Release

1997 ◽  
Vol 22 (4) ◽  
pp. 505-507 ◽  
Author(s):  
A. P. ARMSTONG ◽  
J. R. FLYNN ◽  
D. M. DAVIES
Keyword(s):  
Retrospective Study ◽  
Carpal Tunnel ◽  
Complication Rate ◽  
Carpal Tunnel Release ◽  
Endoscopic Release ◽  
Iatrogenic Nerve Injury ◽  
Portal Technique ◽  
Results Of Surgery

We report our experience over a 30 month period of endoscopic release of the carpal tunnel by the Chow two-portal technique. The objective of this retrospective study was to evaluate the long-term subjective results of surgery and to assess if any iatrogenic nerve injury had been caused by the endoscopic procedure. The follow-up period was from 3 to 34 months. Our permanent, iatrogenic, postoperative nerve complication rate was 0.9% (2/208). No other serious complications occurred.

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.

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