scholarly journals Trigger Fingers After Open Carpal Tunnel Release

2020 ◽  
Vol 28 (4) ◽  
pp. 192-195
Author(s):  
Duffield Ashmead ◽  
Haruko Okada ◽  
Jonathan Macknin ◽  
Steven Vander Naalt ◽  
Ilene Staff ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Specific Treatment ◽  
Trigger Thumb ◽  
Carpal Tunnel Surgery ◽  
Tunnel Syndrome ◽  
Compensation Status ◽  
Open Carpal Tunnel Release

Trigger finger (TF) and carpal tunnel syndrome (CTS) are common conditions often occurring together with an unclear relationship. While some studies conclude that TFs occur as a result of carpal tunnel release (CTR), others have not established a causal relationship. Our purpose was to evaluate the prevalence and timing of TF development in the same hand after open CTR in our population. This was a retrospective review of 497 patients undergoing open CTR by a single surgeon. Two hundred twenty-nine charts were analysed for age, gender, handedness, BMI, workers’ compensation status, and background disease. We analysed the specific digit involved and timing to development of triggering after CTR. Thirty-one patients developed triggering after CTR (13.5%). Mean age was 52.5 (14.0) years. Follow-up ranged from 1 to 53 months with a median follow-up of 6 months (interquartile range = 2-13). The thumb was the most common to trigger (42.22%), followed by the ring 24.44%, middle 22.22%, little 8.89%, and index fingers 2.22%. Trigger thumb occurred at 3.5 months (3.6) post-operatively, while other digits triggered at 7.5 months (4-10.25) after surgery ( P = .022). No risk factors were associated with TF development. Our results suggest that a trigger thumb develops more frequently and earlier than other trigger digits after an open CTR. Further study is needed to clarify the mechanisms involved and may enable specific treatment such as local anti-inflammatory medication following CTR. We suggest educating prospective carpal tunnel surgery patients to high risk of triggering following CTR.

scholarly journals Mini-open Carpal Tunnel Release

2018 ◽  
Vol 19 (4) ◽  
pp. 21-27
Author(s):  
Paulo Henrique Pires De Aguiar ◽  
Carlos Alexandre Martins Zicarelli ◽  
Fabio V. C. Sparapani ◽  
Pedro Augusto De Santana Jr ◽  
Alexandros Theodoros Panagoupolos ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Neurological Deficits ◽  
Motor Branch ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release ◽  
Nerve Entrapment Syndrome ◽  
Mini Open

Introduction: Median nerve compression is the most common nerve entrapment syndrome. After carpal tunnel release, patients often complain about the scar cosmetic appearance. Objective: The aim of our study was to evaluate the clinical outcome, surgical technique and complications of mini-open carpal release. Methods: We reviewed data from 48 surgical procedures for Carpal Tunnel Syndrome in 32 patients at the Pinheiros Neurologicaland Neurosurgical Clinic in the period of 2000 and 2008. The mean age was 49 years-old. We used a 2 cm incision and microscopic technique to obtain meticulous access of the palmar hand anatomy with special attention to both the recurrent motor branch and palmar cutaneous nerve. Results: Twenty-two patients had total resolution of symptoms. Two patients had no change of neurological symptoms. During the follow up no infection or neurological deficits were observed. Conclusion: Mini-open is a safe and effective approach for carpal tunnel syndrome release. However detailed palmar hand anatomy is mandatory to prevent lesion of branching palmar nerve. The use of microscope is desirable to help identify important structures and avoid complications.

scholarly journals Early Postoperative Improvement in Sleep and Pain After Carpal Tunnel Release

Hand ◽  
2018 ◽  
Vol 15 (3) ◽  
pp. 311-314 ◽  
Author(s):  
Steven R. Niedermeier ◽  
Robert J. Pettit ◽  
Travis L. Frantz ◽  
Kara Colvell ◽  
Hisham M. Awan
Keyword(s):  
Sleep Quality ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Hand Surgery ◽  
Outpatient Setting ◽  
Compressive Neuropathy ◽  
Carpal Tunnel Surgery ◽  
Tunnel Syndrome ◽  
And Function

Background: Carpal tunnel syndrome (CTS) is the most common compressive neuropathy of the upper extremity. We sought to assess the subjective improvement in preoperative symptoms related to CTS, particularly those affecting sleep, and describe opioid consumption postoperatively. Methods: All patients undergoing primary carpal tunnel release (CTR) for electromyographically proven CTS were studied prospectively. All procedures were performed by hand surgery fellowship–trained adult orthopedic and plastic surgeons in the outpatient setting. Patients underwent either endoscopic or open CTR from June 2017 to December 2017. Outcomes assessed were pre- and postoperative Quick Disabilities of Arm, Shoulder and Hand (QuickDASH), visual analog scale (VAS), and Pittsburgh Sleep Quality Index (PSQI) scores as well as postoperative pain control. Results: Sixty-one patients were enrolled. At 2 weeks, all showed significant ( P < .05) improvement in QuickDASH scores. At 6 weeks, 40 patients were available for follow-up. When compared with preoperative scores, QuickDASH (51 vs 24.5; P < .05), VAS (6.7 vs 2.9; P < .05), and PSQI (10.4 vs 6.4; P < .05) scores continued to improve when compared with preoperative scores. At 2-week follow-up, 39 patients responded to the question, “How soon after your carpal tunnel surgery did you notice an improvement in your sleep?” Seventeen patients (43.6%) reported they had improvement in sleep within 24 hours, 12 patients (30.8%) reported improvement between 2 and 3 days postoperatively, 8 patients (20.5%) reported improvement between 4 and 5 days postoperatively, and 2 patients (5.1%) reported improvement between 6 and 7 days postoperatively. Conclusions: The present study demonstrates rapid and sustained improvement in sleep quality and function following CTR.

Neurophysiology not Required Before Surgery for Typical Carpal Tunnel Syndrome

2001 ◽  
Vol 26 (1) ◽  
pp. 61-64 ◽  
Author(s):  
V. FINSEN ◽  
H. RUSSWURM
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Clinical Diagnosis ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Neurophysiological Tests ◽  
Carpal Tunnel Surgery ◽  
Neurophysiological Studies ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release

Sixty-eight patients with typical carpal tunnel syndrome underwent neurophysiological investigations preoperatively, but these were not assessed until the end of the study. Open carpal tunnel release was performed and the clinical diagnosis of carpal tunnel syndrome was considered as confirmed when there was a prompt resolution of the preoperative symptoms. Sixty-three of the 68 patients responded well to surgery, three had equivocal outcomes and two did not improve, and thus were considered not to have carpal tunnel syndrome. The neurophysiological tests were normal in these two patients, but were also normal in 14 of the 63 patients who improved with carpal tunnel surgery. Preoperative neurophysiology might therefore have led to up to 14 of the 63 cases of carpal tunnel syndrome being turned down for surgery. We conclude that neurophysiological studies contribute little to the diagnosis in typical cases of carpal tunnel syndrome, and are more often confounding than of assistance.

scholarly journals Angiolipoma: A Unique Cause of Carpal Tunnel Syndrome

2021 ◽  
pp. 24-28
Author(s):  
Yi Deng ◽  
Sindy Vrancic ◽  
Adrienne Morey
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Signs And Symptoms ◽  
Surgical Excision ◽  
Unique Case ◽  
Palmar Surface ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release

Carpal tunnel syndrome is one of the most common conditions affecting the hand. The majority of cases are idiopathic, with tumours causing less than 3% of cases. We present a unique case of an angiolipoma overlying the carpal tunnel as a cause of median nerve compression. A 54-year-old female presented with signs and symptoms consistent with carpal tunnel syndrome associated with an enlarging lump overlying the carpal tunnel on the palmar surface of her hand. Nerve conduction studies confirmed median neuropathy. The case was successfully treated by surgical excision of the tumour and open carpal tunnel release. Histopathology confirmed the presence of an angiolipoma. The patient had complete resolution of symptoms at the final 6-week follow-up. This case highlights the importance of considering tumours in the differential diagnosis of carpal tunnel syndrome.

scholarly journals Carpal Tunnel Release Surgery- A Systematic Review of Open and Endoscopic Approaches

2020 ◽  
Vol 10 (6) ◽  
Author(s):  
Vwaire Orhurhu ◽  
Sebastian Orman ◽  
Jacquelin Peck ◽  
Ivan Urits ◽  
Mariam Salisu Orhurhu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pain Relief ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Inclusion Criteria ◽  
Short Term ◽  
Pain Outcomes ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release

Context: Carpal tunnel syndrome (CTS) is the most frequent peripheral compression-induced neuropathy observed in patients worldwide. Surgery is necessary when conservative treatments fail and severe symptoms persist. Traditional Open carpal tunnel release (OCTR) with visualization of carpal tunnel is considered the gold standard for decompression. However, Endoscopic carpal tunnel release (ECTR), a less invasive technique than OCTR is emerging as a standard of care in recent years. Evidence Acquisition: Criteria for this systematic review were derived from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two review authors searched PubMed, MEDLINE, and the Cochrane Database in May 2018 using the following MeSH terms from 1993-2016: ‘carpal tunnel syndrome,’ ‘median nerve neuropathy,’ ‘endoscopic carpal tunnel release,’ ‘endoscopic surgery,’ ‘open carpal tunnel release,’ ‘open surgery,’ and ‘carpal tunnel surgery.’ Additional sources, including Google Scholar, were added. Also, based on bibliographies and consultation with experts, appropriate publications were identified. The primary outcome measure was pain relief. Results: For this analysis, 27 studies met inclusion criteria. Results indicate that ECTR produced superior post-operative pain outcomes during short-term follow-up. Of the studies meeting inclusion criteria for this analysis, 17 studies evaluated pain as a primary or secondary outcome, and 15 studies evaluated pain, pillar tenderness, or incision tenderness at short-term follow-up. Most studies employed a VAS for assessment, and the majority reported superior short-term pain outcomes following ECTR at intervals ranging from one hour up to 12 weeks. Several additional studies reported equivalent pain outcomes at short-term follow-up as early as one week. No study reported inferior short-term pain outcomes following ECTR. Conclusions: ECTR and OCTR produce satisfactory results in pain relief, symptom resolution, patient satisfaction, time to return to work, and adverse events. There is a growing body of evidence favoring the endoscopic technique for pain relief, functional outcomes, and satisfaction, at least in the early post-operative period, even if this difference disappears over time. Several studies have demonstrated a quicker return to work and activities of daily living with the endoscopic technique.

scholarly journals Carpal tunnel release by mini palmar incision

2011 ◽  
Vol 5 (1) ◽  
pp. 139-142 ◽  
Author(s):  
Kawee Pataradool ◽  
Pravit Kitidumrongsook ◽  
Adisorn Patradul
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Gold Standard ◽  
Standard Treatment ◽  
Carpal Tunnel Release ◽  
Small Series ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release ◽  
Mini Incision

Abstract Background: Open carpal tunnel release is the gold standard treatment for carpal tunnel syndrome. However, there are complications related to the long incision. Method: We report the results from a mini-incision open carpal tunnel release with simple instruments. Results: There were no complications in our small series, improvement of scores was shown at four-week follow-up, and cosmetic results were satisfactory. Conclusions: Mini-incision carpal tunnel release is one option to treat carpal tunnel syndrome.

Endoscopic Carpal Tunnel Release

2019 ◽  
pp. 989-994
Author(s):  
Antony Hazel ◽  
Neil F. Jones
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Hand Surgery ◽  
Anatomical Landmarks ◽  
Transverse Carpal Ligament ◽  
Palmar Arch ◽  
Endoscopic Carpal Tunnel Release ◽  
Tunnel Syndrome ◽  
Carpal Tunnel Release Surgery ◽  
Open Carpal Tunnel Release

Conventional open carpal tunnel release surgery is one of most successful procedures in hand surgery and has been demonstrated to be an effective treatment for carpal tunnel syndrome. However, a known sequelae in some individuals who undergo the procedure is “pillar” pain. In an effort to avoid this condition and help people return to work more quickly, the endoscopic technique was developed. Endoscopic carpal tunnel release offers a minimally invasive alternative to other traditional techniques with similar outcomes. By placing the incision proximal to the transverse carpal ligament there is potential for decreased scar sensitivity and pillar pain. The technique is technically demanding. The superficial palmar arch and common digital nerve to the ring and middle fingers are at risk for injury during the procedure. With adherence to anatomical landmarks and the proper visualization, the surgery may be safely performed.

An Assessment of Sleep Disturbance in Patients before and after Carpal Tunnel Release

2019 ◽  
Vol 24 (02) ◽  
pp. 144-146 ◽  
Author(s):  
John Erickson ◽  
Daniel Polatsch ◽  
Steven Beldner ◽  
Eitan Melamed
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbance ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Continuous Variables ◽  
Night Time ◽  
Before And After ◽  
Tunnel Syndrome ◽  
English Speaking

Background: Night time numbness is a key characteristic of CTS and relief of night time symptoms is one of the outcomes most important to patients. This study tested the null hypothesis that there is no difference between sleep quality and night symptoms before and after carpal tunnel release (CTR). Methods: Forty-four, English-speaking adult patients requesting open CTR for electrodiagnostically confirmed carpal tunnel syndrome completed questionnaires before and after surgery. Average age was 59, 24 patients were men and 20 were women. Patient with a primary or secondary sleep disorder were excluded. Before surgery, patients completed the Pittsburg Sleep Quality index (PSQI). At an average of 3 months after surgery, participants completed PSQI questionnaires. Onset of sleep quality improvement was specifically addressed. Differences between preoperative and postoperative sleep quality were evaluated using the paired t-test. Spearman correlations were used to assess the relationship between continuous variables. Results: Of the 44 patients, 32 (72%) were classified as poor sleepers (PSQI > 5.5) prior to surgery. At 3 months follow up, there was a significant improvement PSQI global scores (7.8 ± 5.1 vs 4 ± 3.5, p < 0.001) as well as subdivisions. Daytime dysfunction (0.2 ± 0.4, p < 0.001) and medication use (1.0 ± 1.2 vs 0.9 ± 1.2, p < 0.045) secondary to sleep disturbance and was improved as well. In all patients, onset of improvement was within 24 hours of surgery. Conclusions: CTR is associated with improvement in sleep quality at 3 months follow-up. CTR improves daytime dysfunction related to the sleep disturbance. The onset of sleep improvement is 24 hours after surgery in most cases.

scholarly journals Comparison of Local-Only Anesthesia Versus Sedation in Patients Undergoing Staged Bilateral Carpal Tunnel Release: A Randomized Trial

Hand ◽  
2019 ◽  
Vol 15 (6) ◽  
pp. 785-792 ◽  
Author(s):  
Garrhett G. Via ◽  
Andrew R. Esterle ◽  
Hisham M. Awan ◽  
Sonu A. Jain ◽  
Kanu S. Goyal
Keyword(s):  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Common Disease ◽  
Hand Laterality ◽  
Included Patient ◽  
High Satisfaction ◽  
Tunnel Syndrome ◽  
Second Procedure ◽  
Wide Awake

Purpose: Carpal tunnel syndrome is a common disease treated operatively. During the operation, the patient may be wide-awake or sedated. The current literature has only compared separate cohorts. We sought to compare patient experience with both local-only anesthesia and sedation. Methods: Staged bilateral carpal tunnel release utilizing open or endoscopic technique was scheduled and followed through to completion of per-protocol analysis in 31 patients. Patients chose initial hand laterality and were randomized regarding initial anesthesia method: local-only or sedation. Data collection via questionnaires began at consent and continued to 6 weeks postoperatively from second procedure. Primary outcome measures included patient satisfaction and patient anesthesia preference. Results: At final follow-up, 6 weeks postoperatively, high satisfaction (30 of 31 patients per method) was reported with both types of anesthesia. Among these patients, 17 (54%) preferred local-only anesthesia, 10 (34%) preferred sedation, 2 had no preference, and 2 opted out of response. Although anesthesia fees were approximately $390 lower with local-only anesthesia, total costs for carpal tunnel release were not significantly different with respect to the anesthesia cohorts. Total time in surgical facility was approximately 26 minutes quicker with local-only anesthesia, largely due to shorter time in the post-anesthesia care unit. Scaled comparison of worst postoperative pain following the 2 procedures revealed no difference between local-only anesthesia and sedation. Conclusions: Patients reported equal satisfaction scores with carpal tunnel release whether performed under local-only anesthesia or with sedation. In addition, local-only anesthesia was indicated as the preference of patients in 59% of cases.

Sign in / Sign up

Export Citation Format

Share Document