Return to work following ultrasound guided thread carpal tunnel release versus open carpal tunnel release: a comparative study

2021 ◽  
pp. 175319342110512
Author(s):  
Derek B. Asserson ◽  
Taylor J. North ◽  
Peter C. Rhee ◽  
Allen T. Bishop ◽  
Jeffrey S. Brault ◽  
...  

A retrospective review of hospital employees at a single employer institution who underwent ultrasound guided thread carpal tunnel release (TCTR) or open carpal tunnel release (OCTR) between January 2018 and August 2020 was performed to ascertain differences in return-to-work status. Patient age, sex, occupation, handedness, severity of carpal tunnel syndrome, prior treatments and surgical outcomes were reviewed. A total of 18 patients underwent TCTR and 17 patients underwent OCTR. The TCTR group averaged 12 days to return to work without restrictions, as opposed to 33 days for the OCTR group. Resolution of symptoms was afforded in all patients without any complications regardless of surgical technique. While both TCTR and OCTR were effective, our data indicates that TCTR resulted in a shorter return to work. Level of evidence: III

2020 ◽  
Vol 1 (2) ◽  
pp. 113-117
Author(s):  
Ali Niyaf ◽  
Kiran Niraula ◽  
Aishath Sofia Shareef ◽  
Mohamed Sajuan Mushrif

Objectives: To compare the efficacy between endoscopic and open carpal tunnel release procedures for carpal tunnel syndrome patients. Design and setting: Randomised control study in a single neurosurgery department   Participants: 30 patients aged 35-69 years with clinically diagnosed carpal tunnel syndrome   Main outcome measures: Primarily - operative duration, bleeding, pain score on day one, requirement of non-steroidal anti-inflammatory drugs (NSAIDs), time spent in hospital and days taken to return to work. Other outcomes include infection, wound status/cosmesis, injury to median nerve, chronic regional pain syndrome and patient satisfaction.   Results: 15 patients were allocated to open surgery, and the other 15 for endoscopic. The average operative duration for open surgery was 9.9 minutes compared to 52 minutes spent for the endoscopic procedure. Cauterization had to be performed 4:1 times in endoscopic compared to open. Pain scores rated 3x higher after open surgery and resulted in increased NSAIDs use. Time spent in hospital after open surgery was 0.7 hours compared to 2.2 in endoscopic, however patients were able to return to work an average of 10.6 days earlier after endoscopic surgery.   Conclusions: In carpal tunnel syndrome, endoscopic surgery allowed patients to experience less post-operative pain and return to work several days sooner than in open surgery.


2015 ◽  
Vol 41 (2) ◽  
pp. 137-142 ◽  
Author(s):  
J. R. Fowler ◽  
M. Munsch ◽  
Y. Huang ◽  
W. C. Hagberg ◽  
J. E. Imbriglia

The purpose of this study was to determine if nerve conduction studies predict time to resolution of symptoms after carpal tunnel release. A total of 56 patients undergoing open carpal tunnel release were prospectively enrolled. Pre-operative presence of nocturnal symptoms and daytime numbness/tingling were documented. Pre-operative nerve conduction studies were reviewed and classified as mild, moderate, or severe. After open carpal tunnel release, patients were contacted by phone within 48 hours, at 1 week, and then at 2-week intervals for up to 9 months or until both nocturnal and daytime symptoms had resolved. This study found that patients with mild or moderate carpal tunnel syndrome experience a faster time to resolution of daytime numbness and tingling when compared with patients with severe carpal tunnel syndrome. Nocturnal symptoms resolved quickly in both groups. The results of this study are in contrast to previous studies that found little to no value of nerve conduction studies in predicting post-operative functional and subjective outcomes. Level of Evidence: IV


2018 ◽  
Vol 35 (04) ◽  
pp. 248-254 ◽  
Author(s):  
Antoine Hakime ◽  
Jonathan Silvera ◽  
Pascal Richette ◽  
Rémy Nizard ◽  
David Petrover

AbstractCarpal tunnel syndrome (CTS) may be treated surgically if medical treatment fails. The classical approach involves release of the flexor retinaculum by endoscopic or open surgery. Meta-analyses have shown that the risk of nerve injury may be higher with endoscopic treatment. The recent contribution of ultrasound to the diagnosis and therapeutic management of CTS opens new perspectives. Ultrasound-guided carpal tunnel release via a minimally invasive approach enables the whole operation to be performed as a percutaneous radiological procedure. The advantages are a smaller incision compared with classical techniques; great safety during the procedure by visualization of anatomic structures, particularly variations in the median nerve; and realization of the procedure under local anesthesia. These advantages lead to a reduction in postsurgical sequelae and more rapid resumption of daily activities and work. Dressings are removed by the third day postsurgery. Recent studies seem to confirm the medical, economic, and aesthetic benefits of this new approach.


2006 ◽  
Vol 31 (6) ◽  
pp. 608-610 ◽  
Author(s):  
M. M AL-QATTAN

During open carpal tunnel release in patients with severe idiopathic carpal tunnel syndrome, an area of constriction in the substance of the median nerve is frequently noted. In a prospective study of 30 patients, the central point of the constricted part of the nerve was determined intraoperatively and found to be, on average, 2.5 (range 2.2–2.8) cm from the distal wrist crease. This point always corresponded to the location of the hook of the hamate bone. These intraoperative findings were compared with the “narrowest” point of the carpal canal as determined by anatomical and radiological studies in the literature.


2017 ◽  
Vol 42 (9) ◽  
pp. 932-936 ◽  
Author(s):  
C. Q. Y. Tang ◽  
S. W. H. Lai ◽  
S. C. Tay

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


Hand Surgery ◽  
2004 ◽  
Vol 09 (02) ◽  
pp. 235-239 ◽  
Author(s):  
Lam Chuan Teoh ◽  
Puay Ling Tan

Recurrent carpal tunnel syndrome from various causes has been shown to occur in up to 19% of patients. Endoscopic carpal tunnel release has been used to decompress the median nerve in carpal tunnel syndrome for many years. However, endoscopic release for recurrent carpal tunnel syndrome after previous surgical release has not been reported. Nine hands in six patients had recurrent carpal tunnel syndrome five to 20 years after previous open carpal tunnel release. All the cases were successfully treated with endoscopic release.


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