Patient-reported outcomes of carpal tunnel release surgery in patients with bilateral severe carpal tunnel syndrome

2017 ◽  
Vol 42 (9) ◽  
pp. 932-936 ◽  
Author(s):  
C. Q. Y. Tang ◽  
S. W. H. Lai ◽  
S. C. Tay
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Complete Resolution ◽  
Patient Reported Outcomes ◽  
Operative Time ◽  
Carpal Tunnel Release ◽  
Level Of Evidence ◽  
Patient Reported ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Release Surgery

This retrospective study examined whether the presenting complaint of numbness is relieved post-operatively in severe carpal tunnel syndrome and also assessed any correlation between outcomes of the first and second procedures in staged bilateral carpal tunnel releases. Carpal tunnel release (60 open and 38 endoscopic) was done in 49 patients with bilateral severe carpal tunnel syndrome. There was complete resolution of numbness post-operatively in 77% ( n = 75) of hands. The median post-operative time before complete resolution of numbness was 21 days (IQR 8 to 21; range 3 to 482). The likelihood of complete resolution of symptoms after the second carpal tunnel release in patients with complete resolution of symptoms after the first carpal tunnel release was 22 (95% CI: 4 to 131) times that of the likelihood of improvement in patients with incomplete resolution of symptoms after the first carpal tunnel release. Level of evidence: IV

The Effect of Hand Dominance on Patient-Reported Outcomes of Carpal Tunnel Release in Patients with Bilateral Carpal Tunnel Syndrome

2017 ◽  
Vol 22 (03) ◽  
pp. 303-308
Author(s):  
Qian Ying TANG ◽  
Wei Hong LAI ◽  
Shian Chao TAY
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Complete Resolution ◽  
Carpal Tunnel Release ◽  
Patient Reported Outcome ◽  
Dominant Hand ◽  
Hand Dominance ◽  
Significant Difference ◽  
Patient Reported ◽  
Tunnel Syndrome

Background: There is a paucity of studies in published literature that examines the effect of hand dominance on the resolution of symptoms following a carpal tunnel release. The objective of this study is to examine the effect of hand dominance on the resolution of symptoms following surgical decompression in patients with severe and moderate carpal tunnel syndrome. Methods: Bilateral carpal tunnel release (total 90 open and 84 endoscopic) was performed on 87 patients (11 males, 76 females) presenting with bilateral severe or moderate carpal tunnel syndrome of equal severity. Patient-reported outcome of resolution of symptoms were recorded, with patients followed up until complete resolution of symptoms or last recorded consultation (mean follow-up duration 11.4 months, range 3.1 to 32.4 months). Results: In patients with bilateral severe carpal tunnel syndrome, a larger proportion of non-dominant hand (75.4%) achieved complete resolution compared to dominant hand (72.1%), and did so at a statistically shorter time (mean: 52.3 days) than the dominant hand (mean: 81.0 days). However, there was no statistically significant difference between proportion of patients and time taken before complete resolution of symptoms between dominant and non-dominant hand in patients with bilateral moderate carpal tunnel syndrome. Conclusions: Symptoms in the non-dominant hand resolved faster after carpal tunnel release in patients with severe carpal tunnel syndrome. We postulate that greater daily activity by the dominant hand compared to the non-dominant hand may be a contributing factor to its slower rate of symptoms resolution post-surgically in patients with bilateral severe carpal tunnel syndrome. This effect of hand dominance is not evident in post-surgical patients with moderate carpal tunnel syndrome.

scholarly journals Use of conservative therapy before and after surgery for carpal tunnel syndrome

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Juhani Multanen ◽  
Mikko M. Uimonen ◽  
Jussi P. Repo ◽  
Arja Häkkinen ◽  
Jari Ylinen
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Level Of Evidence ◽  
Post Surgery ◽  
High Satisfaction ◽  
Before And After ◽  
Satisfaction With Treatment ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Release Surgery

Abstract Background Conservative therapies are typically offered to individuals who experience mild or intermittent symptoms of carpal tunnel syndrome (CTS) or postoperatively to subjects who have undergone carpal tunnel release. Although long-term studies report mostly positive results for carpal tunnel release, knowledge on the need for conservative treatments following surgery is scarce. The aim of this retrospective cohort study was to examine the use of conservative therapies before and after carpal tunnel releasing surgery. Methods Of 528 patients who underwent carpal tunnel release surgery in the study hospital during the study period, 259 provided sufficiently completed questionnaires (response rate 49 %). The patients completed a questionnaire battery including a sociodemographic, medical history and symptom questionnaire, the Boston Carpal Tunnel Syndrome Questionnaire, 6-item CTS symptoms scale and EuroQoL 5D. Frequencies of conservative therapies pre- and postoperatively were calculated. Association between Pain VAS and satisfaction with treatment were examined in patient groups according to the use of conservative therapies. Results Of all patients, 41 (16 %) reported receiving only preoperative, 18 (7 %) reported receiving only postoperative, 157 (60 %) reported receiving both pre- and postoperative conservative therapies and 43 (17 %) did not receive any therapies. Preoperative use of conservative therapies was more common in females than males (82 % vs. 64 %; p = 0.002), but postoperatively no significant gender difference was observed. The patients who received conservative therapies were younger than non-users in both the preoperative (median age 59 vs. 66; p < 0.001) and postoperative (59 vs. 66; p = 0.04) phases. The patients reported high satisfaction with their treatment and simultaneous improvement in Pain VAS scores. Those receiving conservative therapies only preoperatively reported the highest satisfaction. Conclusions While the use of conservative therapies decreased after surgery, a large proportion of the patients received these adjunct interventions. Patients reported high satisfaction with their treatment one year post surgery. Pain outcome seems to be closely related to satisfaction with treatment. Level of Evidence Level III.

Evaluation of PROMIS Outcomes for Surgical Treatment of Cubital Tunnel Syndrome With and Without Carpal Tunnel Syndrome

Hand ◽  
2021 ◽  
pp. 155894472110289
Author(s):  
Amy Phan ◽  
Warren Hammert
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Postoperative Period ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Measurement Information ◽  
Level Of Evidence ◽  
Patient Reported ◽  
Tunnel Syndrome ◽  
Measurement Information System

Background: Assessment of outcomes for cubital tunnel syndrome (CuTS) surgeries has been difficult due to heterogeneity in outcome reporting. Our objective was to evaluate the outcomes for 2 cohorts treated surgically for isolated CuTS and for combined CuTS and carpal tunnel syndrome (CTS) using Patient Reported Outcomes Measurement Information System (PROMIS). Methods: There were 29 patients in the isolated CuTS cohort and 30 patients in the combined CuTS and CTS cohort. PROMIS Physical Function (PF), Pain Interference (PI), Depression, and Upper Extremity (UE) were completed preoperatively and 1-week, 6-weeks, and 3-months postoperatively. Responsiveness was evaluated by standardized response means (SRM). Results: Significant improvements from the 1-week to 6-week postoperative period are shown in the isolated CuTS cohort for PROMIS PF ( P = .002), PI ( P = .0002), and UE ( P = .02), but scores plateau after 6-weeks postoperatively. A similar pattern for the same time points was seen for the combined CuTS and CTS group for PROMIS PF ( P = .001), PI ( P = .02), and UE ( P = .04), with a plateau of scores beyond 6 weeks postoperatively. PROMIS UE was more responsive (SRM range: 0.11-1.03) than the PF (SRM range: 0.02-0.52) and PI (SRM range: 0.11-0.40), which were both mildly responsive for both cohorts. Conclusions: PROMIS lacks the sensitivity to show improvement beyond 6-weeks postoperatively for both isolated CuTS and combined CuTS and CTS. Patients with combined nerve compressions follow similar trajectories in the postoperative period as those with isolated CuTS. Level of Evidence: Level IV.

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.

Prospective evaluation of preoperative and postoperative sleep quality in carpal tunnel release

2018 ◽  
Vol 44 (3) ◽  
pp. 278-282 ◽  
Author(s):  
Cüneyt Emre Okkesim ◽  
Sancar Serbest ◽  
Uğur Tiftikçi ◽  
Meriç Çirpar
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Sleep Quality ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Level Of Evidence ◽  
Nerve Decompression ◽  
Tunnel Syndrome ◽  
Median Nerve Decompression

Sleep disturbance is a frequent symptom of carpal tunnel syndrome. The aim of this study was to investigate the effect of median nerve decompression on sleep quality of patients with this condition. The study sample consisted of 41 patients with severe carpal tunnel syndrome who were admitted to our clinic and treated with open median nerve decompression. Sensation and functional recovery of the patients were followed using the Boston Function Questionnaire, the Semmes–Weinstein monofilament test and the two-point discrimination test. Symptomatic recovery of the patients was followed by the Boston Symptom Questionnaire. The tests were used before surgery and at three and six months afterwards. Sensory, functional and symptomatic recovery from the third month to the sixth month following surgery also affected sleep parameters and improved the sleep quality of patients with carpal tunnel syndrome. Level of evidence: IV

Endoscopic treatment of carpal tunnel syndrome: a critical review

1998 ◽  
Vol 88 (5) ◽  
pp. 817-826 ◽  
Author(s):  
David F. Jimenez ◽  
Scott R. Gibbs ◽  
Adam T. Clapper
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Critical Review ◽  
Carpal Tunnel Release ◽  
Content Type ◽  
Endoscopic Techniques ◽  
Endoscopic Carpal Tunnel Release ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Release Surgery ◽  
Fine Print

Object. The goal of this paper is to present a critical review of the endoscopic procedures currently in use for the treatment of carpal tunnel syndrome. Endoscopic techniques and outcomes are discussed. Methods. 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. In many studies in which open and endoscopic techniques were compared, it was reported that patients in the the latter group experienced significantly less pain and returned to work and activities of daily living earlier. Conclusions. Success and complication rates of endoscopic carpal tunnel release surgery are similar to those for standard open procedures.

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.

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