Opponensplasty using the extensor indicis proprius tendon for severe carpal tunnel syndrome in 40 patients

2021 ◽  
pp. 175319342110459
Author(s):  
Hiroyuki Matsuki ◽  
Yukio Nakatsuchi ◽  
Toshimitsu Momose
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Clinical Results ◽  
Pinch Strength ◽  
Level Of Evidence ◽  
Thenar Muscle ◽  
Extensor Indicis Proprius ◽  
Tunnel Syndrome ◽  
The Mean

The aim of this study was to assess the clinical results after extensor indicis proprius opponensplasty in patients with carpal tunnel syndrome and severe thenar muscle atrophy. Forty patients who underwent this procedure during open carpal tunnel releases. The mean follow-up period was 17 months (range 10 to 36). Kapandji scores significantly improved from 5.5 before surgery to 9.6 at final follow-up. Thumb pronation angle also significantly improved from 111° before surgery to 149°. Side and pulp pinch strength significantly improved postoperatively, as well as DASH scores at final follow-up. In conclusion, the extensor indicis proprius tendon transfer technique represents a reliable opponensplasty procedure to achieve consistent results in patients with severe carpal tunnel syndrome. Level of evidence: IV

Carpal tunnel syndrome and finger deformities in children with mucopolysaccharidoses and mucolipidoses: a retrospective review of 52 patients

2021 ◽  
pp. 175319342110619
Author(s):  
Clément Thirache ◽  
Mathilde Gaume ◽  
Cyril Gitiaux ◽  
Arielle Salon ◽  
Caroline Dana ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Clinical Signs ◽  
Single Centre ◽  
Level Of Evidence ◽  
Age At Surgery ◽  
Tunnel Syndrome ◽  
The Mean

This single-centre retrospective study reports our management of carpal tunnel syndrome in 52 children (103 hands) with mucopolysaccharidoses and mucolipidoses. All except one were bilateral. The median age at surgery was 4 years (range 1.5 to 12). The diagnosis of carpal tunnel syndrome was confirmed by an electromyogram (EMG) in all patients; 38% of these presented without any clinical signs. Surgical neurolysis was performed in all hands, combined with epineurotomy in 52 hands (50%) and flexor tenosynovectomy in 75 hands (73%). Surgery was bilateral in 98% of children (102 hands). The mean follow-up was 12 years (range 1 to 19) and the EMG was normalized in 78% of hands. Ten patients suffered recurrence, eight of whom required further surgery. Screening for carpal tunnel syndrome is essential for the management of children mucopolysaccharidoses and mucolipidoses. Surgical treatment should be carried out early with follow-up by EMG to detect recurrence. Level of evidence: IV

Prevalence of decompression surgery in patients with carpal tunnel syndrome 8 years after initial treatment with a local corticosteroid injection

2016 ◽  
Vol 42 (3) ◽  
pp. 275-280 ◽  
Author(s):  
A. Hameso ◽  
J. D. P. Bland
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Corticosteroid Injection ◽  
Decompression Surgery ◽  
Level Of Evidence ◽  
Clinically Important Difference ◽  
Group A ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Questionnaire

Repeated local corticosteroid injections have become a common mode of treatment for carpal tunnel syndrome, despite an existing recommendation that no more than three injections should be given. We studied the clinical outcomes in 254 patients who initially opted for a corticosteroid injection into their carpal canal during 2007. Follow-up records of treatment were obtained for 157 patients of whom 41% had proceeded to surgery by 2015. A mean of 1.9 injections had been given before surgery. In the unoperated group, a mean of two (range 0–12) further injections had been given. The final subjective severity and functional status scores measured using the Boston carpal tunnel questionnaire were significantly lower in the operated than in the unoperated group, but both groups improved significantly from baseline. The differences between the final scores are less than the estimated minimal clinically important difference for these measures. We conclude that repeated steroid injection may be a valid treatment option for some patients with carpal tunnel syndrome. Level of evidence: III

NEW TECHNIQUE FOR REDUCING FIBROSIS IN RECURRENT CASES OF CARPAL TUNNEL SYNDROME

Hand Surgery ◽  
2014 ◽  
Vol 19 (03) ◽  
pp. 381-387 ◽  
Author(s):  
Wael A. M. Nassar ◽  
Ahmed Naeem Atiyya
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Rating Scale ◽  
Functional Results ◽  
Verbal Rating Scale ◽  
Functional Score ◽  
Symptom Severity Score ◽  
Tunnel Syndrome ◽  
The Mean

Purpose: Synthetic bio-degradable materials have been used as an artificial barrier in prophylaxis of adhesions. We report on the use of lactid caprolacton film (Mesofol®) in recurrent carpal tunnel syndrome. We hypothesise that its use will give favourable results regarding the functional outcome and the recurrence rate. Patients and methods: Fourteen patients were prospectively reviewed following neurolysis and application of Mesofol® film. Average age was 48 years. Outcome assessment measures included; two-point discrimination, verbal rating scale, and Boston Questionnaire. Results: Follow-up period averaged 25.5 months. Post-operative two-point discrimination improved to an average of 4.57 mm. The post-operative average verbal rating scale was 1.5. The mean symptom severity score improved to 1.88 and the mean functional score improved to 1.69 post-operatively. Conclusion: In cases of recurrent carpal tunnel syndrome, the use of mesofol barrier yields good functional results at the short term follow-up. The technique is simple. No patients needed further surgeries.

CARPAL TUNNEL SYNDROME IN PATIENT WITH HEMIHYPERTROPHY: CASE REPORT

Hand Surgery ◽  
2013 ◽  
Vol 18 (03) ◽  
pp. 411-412
Author(s):  
Takashi Shimoe ◽  
Yasunori Taniguchi ◽  
Munehito Yoshida
Keyword(s):  
Magnetic Resonance Imaging ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Transverse Carpal Ligament ◽  
Common Condition ◽  
Resonance Imaging ◽  
Thenar Muscle ◽  
Left Hand ◽  
Tunnel Syndrome

Carpal tunnel syndrome is a common condition; however, it has not been previously reported in patients with hemihypertrophy. A 67-year-old woman with left-sided hemihypertrophy presented with carpal tunnel syndrome of the left hand. Magnetic resonance imaging showed enlargement of the median nerve proximal to the transverse carpal ligament. Carpal tunnel decompression was performed, and pain was immediately relieved by decompression of the carpal tunnel. At the six-month follow-up examination, the patient experienced relief from numbness and improvement in thenar muscle atrophy was noted.

The effect of the involvement of the dominant or non-dominant hand on grip/pinch strengths and the Levine score in patients with carpal tunnel syndrome

2011 ◽  
Vol 37 (5) ◽  
pp. 427-431 ◽  
Author(s):  
A. Żyluk ◽  
I. Walaszek
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Grip Strength ◽  
Carpal Tunnel ◽  
Outcome Measurement ◽  
Carpal Tunnel Release ◽  
Pinch Strength ◽  
Dominant Hand ◽  
Before And After ◽  
Tunnel Syndrome

The Levine questionnaire is a disease-oriented instrument developed for outcome measurement of carpal tunnel syndrome (CTS) management. The objective of this study was to compare Levine scores in patients with unilateral CTS, involving the dominant or non-dominant hand, before and after carpal tunnel release. Records of 144 patients, 126 women (87%) and 18 men (13%) aged a mean of 58 years with unilateral CTS, treated operatively, were analysed. The dominant hand was involved in 100 patients (69%), the non-dominant in 44 (31%). The parameters were analysed pre-operatively, and at 1 and 6 months post-operatively. A comparison of Levine scores in patients with the involvement of the dominant or non-dominant hand showed no statistically significant differences at baseline and any of the follow-up measurements. Statistically significant differences were noted in total grip strength at baseline and at 6 month assessments and in key-pinch strength at 1 and 6 months.

scholarly journals Carpal tunnel syndrome: issues of diagnosis and treatment

2019 ◽  
Vol 11 (2S) ◽  
pp. 46-51 ◽  
Author(s):  
A. S. Gilveg ◽  
V. A. Parfenov ◽  
G. Yu. Evzikov
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Diagnosis And Treatment ◽  
Decompression Surgery ◽  
Thenar Muscle ◽  
Highly Effective ◽  
Tunnel Syndrome ◽  
The Mean

Objective: to analyze the typical medical practice management of patients with carpal tunnel syndrome (CTS), to evaluate the efficiency of surgical treatment, and to identify factors influencing the successful outcomes of surgical treatment.Patients and methods. The investigation enrolled 85 patients (14 men and 71 women; mean age, 62±10.8 years). Previous diagnosis and treatment of patients were assessed in other healthcare facilities. All patients underwent median nerve decompression. The efficiency of surgical treatment was assessed according to the Boston Carpal Tunnel Questionnaire (BCTQ) and a visual analogue scale for pain before and 1, 3, 6, and 12 months after surgery.Results and discussion. Informative diagnostic tests are rarely performed in patients with CTS, but cervical spine neurovisualization is often unreasonably prescribed. Erroneous diagnoses (predominantly those of cervical spine osteochondrosis (46%), and diabetic neuropathy (6%)) are made frequently (60%) in patients with CTS; the latter receive ineffective treatment for a long time. Surgical treatment in reducing pain and improving hand functionality is noted to be highly effective. The mean BCTQ score decreased from 2.81±0.68 to 1.62±0.55 and 1.24±0.41 at 1 and 12 months, respectively (p<0.05), the mean functional state score dropped from 2.92±0.78 to 2.4±0.72 and 1.46±0.57, respectively (p<0.05). Permanent numbness, subjective weakness, thenar muscle atrophy, Stage III CTS, and diabetes mellitus are predictors for less pronounced improvement in BCTQ scores after surgery (p<0.05).Conclusion. Physicians are noted to be unaware of the manifestations of CTS and effective methods for its diagnosis and treatment. Decompression surgery is shown to be a highly effective procedure in patients with CTS following 1 and 12 months. 

scholarly journals Sonographic short-term follow-up after surgical decompression of the median nerve at the carpal tunnel: a single-center prospective observational study

2015 ◽  
Vol 39 (3) ◽  
pp. E6 ◽  
Author(s):  
Sueleyman Tas ◽  
Frank Staub ◽  
Thomas Dombert ◽  
Gerhard Marquardt ◽  
Christian Senft ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Surgical Decompression ◽  
High Definition ◽  
Distal Motor Latency ◽  
Motor Latency ◽  
Tunnel Syndrome ◽  
The Mean

OBJECT Carpal tunnel syndrome causes increased cross-sectional area (CSA) of the median nerve, which can be assessed by high-definition ultrasonography. It is unclear today, however, whether high-definition ultrasonography may play a role in the postoperative period. This prospective study aimed to determine the natural history of the morphology of the median nerve at the carpal tunnel after surgical decompression assessed by high-definition ultrasonography. METHODS Between October and December 2014, patients with suspected carpal tunnel syndrome who were referred to the authors’ center for peripheral neurosurgery were prospectively enrolled and underwent pre- and postoperative (3 months) high-definition ultrasonography, electrophysiology, and clinical testing. RESULTS Eighty-one patients were enrolled in the study, and 100% were clinically better at the 3-month follow-up. The mean CSA decreased from 14.7 ± 4.9 mm2 to 12.4 ± 3.4 mm2 (mean ± SD, p < 0.0001). The mean distal motor latency decreased from 6.6 ± 2.4 msec to 4.8 ± 1.0 msec (mean ± SD, p < 0.0001). Ninety-eight percent of patients who were available for electrodiagnostic follow-up showed an improvement of the distal motor latency; only 80% had a reduction in the CSA. CONCLUSIONS The authors present the second-largest series of patients with sonographic follow-up after surgical decompression of the carpal tunnel reported in the literature so far. This study, which showed a decrease in size of the median nerve after surgical decompression, suggests that the preoperative increase in median nerve CSA at the carpal tunnel may be due to compression and that enlargement of the median nerve is (partially) reversible.

Evaluation of the Reliability and Quality of Information in Carpal Tunnel Syndrome Shared on YouTube

2021 ◽  
Author(s):  
Emre Anıl Özbek ◽  
Mehmet Armangil ◽  
Mustafa Onur Karaca ◽  
Abdullah Merter ◽  
Merve Dursun ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Total Duration ◽  
Video Content ◽  
Level Of Evidence ◽  
Internet Users ◽  
Global Quality ◽  
Tunnel Syndrome ◽  
The Mean

Abstract Purpose Most of the internet users search online on YouTube for their health problems and the treatments. The purpose of this study is to evaluate the quality and the reliability of the videos on YouTube for Carpal tunnel syndrome (CTS). Methods The search was made by typing the keywords “Carpal tunnel syndrome” and/or “CTS” into the YouTube search engine, the first 50 videos on the first three pages of YouTube were evaluated. Of these videos, title, duration, number of views, days since uploaded, view ratio (view per day), number of likes, number of dislikes, video power index (VPI), video source, and video content data were recorded. The Journal of the American Medical Association (JAMA) benchmark criteria were used to evaluate the reliability of videos, where the Global Quality Score (GQS) and Carpal tunnel syndrome-specific score (CTS-SS) were used to evaluate the quality of the videos. Results The mean duration of the videos was 364.12 seconds (min 57, max 1,638) and the total duration of videos was 18,206 seconds. The mean number of views was 140,916.1 (min 10,543, max 1,271,040) and total number of views was 7,045,804. The mean JAMA score was 1.8 (min 1, max 4), the mean GQS was 2.72 (min 1, max 5), and the mean CTS-SS was 4.74 (min 1, max 14). There was no significant effect of video content on VPI, JAMA, GQS, or CTS-SS (p >0.05). The JAMA, GQS, CT-SS scores of the videos from physicians and academic sources were significantly higher compared with other sources (p <0.05). Conclusion YouTube is one of the most frequently used resource for patients to get information about their diagnosis and treatment methods and it consists of videos with low reliability and quality for CTS. We believe that the creation of an internet-based information resource, which the patients can refer to is one of the current social responsibilities of the physicians and the academicians. Level of Evidence This is a Level V study.

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.

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