scholarly journals Motor Function Outcome Assessment by Grip and Pinch Strength Following Carpal Tunnel Release

2016 ◽  
Vol 9 (4) ◽  
Author(s):  
Surendra U. Kamath ◽  
Nahar Vivek ◽  
K. R. Gowtham
Keyword(s):  
Outcome Assessment ◽  
Motor Function ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Pinch Strength

ENDOSCOPIC CARPAL TUNNEL RELEASE: SINGLE OR DOUBLE PORTAL?

Hand Surgery ◽  
1996 ◽  
Vol 01 (02) ◽  
pp. 89-94
Author(s):  
Malcolm H. Wicks
Keyword(s):  
Return To Work ◽  
Carpal Tunnel ◽  
Local Anaesthesia ◽  
Carpal Tunnel Release ◽  
The Other ◽  
Pinch Strength ◽  
Accelerated Rehabilitation ◽  
Light Sedation ◽  
Portal Technique ◽  
No Tourniquet

This report outlines my experience with 20 patients who underwent bilateral endoscopic carpal tunnel releases: one side by a uni-portal (Unit-Cut) release, the other by a two portal (modified Chow) technique at the same time. All patients were treated as out-patients, the operations being performed under local anaesthesia with light sedation, no tourniquet inflated, and with pressure bandage applied for twelve hours only. The patients underwent an accelerated rehabilitation programme beginning the same day, and were encouraged to use their hands as soon as possible. Grip and pinch strength return was similar for both techniques, the single portal being slightly quicker. Return to work averaged 8.5 days (range 3–25 days) and full activities returned by 14.3 days (range 1–40 days). When asked, the patient strongly preferred the single portal technique, i.e., 18 out of 20 patients.

The results of carpal tunnel release for carpal tunnel syndrome diagnosed on clinical grounds, with or without electrophysiological investigations: a randomized study

2012 ◽  
Vol 38 (1) ◽  
pp. 44-49 ◽  
Author(s):  
A. Żyluk ◽  
Z. Szlosser
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Carpal Tunnel Release ◽  
Randomized Study ◽  
Clinical Importance ◽  
Nerve Conduction Studies ◽  
Pinch Strength ◽  
Tunnel Syndrome ◽  
To Receive

We compared the results of carpal tunnel release in patients with the diagnosis of carpal tunnel syndrome based on only clinical grounds and those diagnosed on clinical and electrophysiological grounds. Ninety-three patients, 83 women (89%) and ten men (11%), meeting the criteria of ‘typical’ carpal tunnel syndrome, were randomly assigned to receive carpal tunnel release with ( n = 45, 48%) or without ( n = 48, 52%) nerve conduction studies. Patients were followed-up at 1 and 6 months, by assessments that included the Levine scores, filament tests, grip and pinch strength. No significant differences in Levine scores were found at the 1 and 6 months assessments. Statistically significant differences were noted in three-point pinch strength and sensation; however, they were not of clinical importance. The results of the study show that the results of carpal tunnel release in patients with typical symptoms are no better after nerve conduction studies and, therefore, nerve conduction studies can be omitted.

scholarly journals The management of failed cubital tunnel decompression

2021 ◽  
Vol 6 (9) ◽  
pp. 735-742
Author(s):  
Abdus S. Burahee ◽  
Andrew D. Sanders ◽  
Dominic M. Power
Keyword(s):  
Outcome Assessment ◽  
Diagnostic Criteria ◽  
Failure Rate ◽  
Carpal Tunnel ◽  
Revision Surgery ◽  
Carpal Tunnel Release ◽  
Nerve Transfer ◽  
Cubital Tunnel ◽  
Quality Research ◽  
Primary Procedure

Cubital tunnel decompression is a commonly performed operation with a much higher failure rate than carpal tunnel release. Failed cubital tunnel release generally occurs due to an inadequate decompression in the primary procedure, new symptoms due to an iatrogenic cause, or development of new areas of nerve irritation. Our preferred technique for failed release is revision circumferential neurolysis with medial epicondylectomy, as this eliminates strain, removes the risk of subluxation, and avoids the creation of secondary compression points. Adjuvant techniques including supercharging end-to-side nerve transfer and nerve wrapping show promise in improving the results of revision surgery. Limited quality research exists in this subject, compounded by the lack of consensus on diagnostic criteria, classification, and outcome assessment. Cite this article: EFORT Open Rev 2021;6:735-742. DOI: 10.1302/2058-5241.6.200135

Endoscopic Carpal Tunnel Decompression

1994 ◽  
Vol 19 (1) ◽  
pp. 5-13 ◽  
Author(s):  
M. W. H. ERDMANN
Keyword(s):  
Pilot Study ◽  
Carpal Tunnel ◽  
Endoscopic Surgery ◽  
Carpal Tunnel Release ◽  
Endoscopic Technique ◽  
Pinch Strength ◽  
Main Trial ◽  
Open Release ◽  
Prospective Pilot Study ◽  
Average Return

A study of endoscopic carpal tunnel release was carried out in three parts, consisting of initial cadaveric dissections, a prospective pilot study of 20 patients and a prospective, randomized trial of 71 patients comparing endoscopic with open decompression. In the main trial, 25 patients with bilateral symptoms underwent simultaneous endoscopic and open release, with the remainder randomized to one or other technique. Both techniques effectively decompressed the median nerve. A significant improvement in grip and pinch strength over 3 months was achieved in those undergoing endoscopic surgery. Average return to work was 14 days in the endoscopic series and 39 days in the open series. A complication rate of 35% was achieved with the transbursal endoscopic technique, 3.7% with the extrabursal endoscopic technique and 13.5% in the open series.

A comparison of outcomes of carpal tunnel release for carpal tunnel syndrome in patients diagnosed with and without electrophysiological studies

2017 ◽  
Vol 49 (05) ◽  
pp. 304-308
Author(s):  
Piotr Puchalski ◽  
Andrzej Zyluk ◽  
Zbigniew Szlosser
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Clinical Findings ◽  
Pinch Strength ◽  
Electrophysiological Studies ◽  
Tunnel Syndrome

AbstractRecords were analysed from the institutional database, including 943 patients (1089 hands) with CTS who were operated on in the authors’ department over a period of four years (2012 to 2015). The diagnosis of CTS was made solely on the basis of clinical findings in 551 patients (58 %); 392 patients (42 %) also had electrodiagnostic tests performed, for various reasons. Patients were followed-up at 1 and 6 months with assessments that included the Levine scores, filament tests, grip and pinch strength. No significant differences in Levine scores were found at the 1 and 6 month assessments. Statistically significant differences were noted in 3-point pinch strength and sensation: however, these were not clinically meaningful. The results of the study show that the results of carpal tunnel release in patients with typical symptoms are no better after electrodiagnostic tests.

Thumb Function and Electromyography Result after Modified Camitz Tendon Transfer

2017 ◽  
Vol 22 (03) ◽  
pp. 275-280 ◽  
Author(s):  
Claire Marie Durban ◽  
Bernard Antolin ◽  
Chung Ying Sau ◽  
Sheung Wai Li ◽  
Wing Yuk Ip
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Pinch Strength ◽  
Muscle Recovery ◽  
Abductor Pollicis Brevis ◽  
Palmaris Longus ◽  
Contralateral Hand ◽  
Tunnel Syndrome ◽  
Open Carpal Tunnel Release

Background: Various techniques of opponensplasty have been developed with the aim of restoring the thumb function. The modified Camitz opponensplasty is a simple technique done together with an open carpal tunnel release. It restores thumb palmar abduction soon after the procedure, during such time that the abductor pollicis brevis (APB) is still recovering. The aim of this study was to assess the recovery and level of activity of the abductor pollicis brevis and palmaris longus (PL) muscles during thumb opposition and abduction after performing the modified Camitz opponensplasty. Methods: The records of 21 patients who underwent modified Camitz opponensplasty for severe carpal tunnel syndrome were reviewed. Thumb function was evaluated using the Van Wetter Apogee test, Kapandji index, tripod pinch strength, and power grip. Electromyography was utilized to evaluate APB recovery; ultrasonography was employed to evaluate PL activity. Results: Twenty patients reached 80% of the abduction height of the contralateral hand; the Kapandji index was good in thirteen. Palmaris longus activity was evaluated together with the APB muscle recovery. There was significant improvement in the average grip strength and average tripod pinch strength. However, this did not correlate with the degree of neurologic and muscular recovery of the APB. We surmise that the palmaris longus augmented the abductor pollicis brevis muscle even in those with full muscle recovery. Conclusions: The modified Camitz opponensplasty is a practical option for patients suffering from severe carpal tunnel syndrome with diminished thumb function.

Early Mobilization Following Carpal Tunnel Release

1995 ◽  
Vol 20 (2) ◽  
pp. 228-230 ◽  
Author(s):  
A. C. COOK ◽  
R. M. SZABO ◽  
S. W. BIRKHOLZ ◽  
E. F. KING
Keyword(s):  
Return To Work ◽  
Activities Of Daily Living ◽  
Carpal Tunnel ◽  
Daily Living ◽  
Carpal Tunnel Release ◽  
Randomized Study ◽  
Early Mobilization ◽  
Scar Tissue ◽  
Pinch Strength ◽  
Wrist Flexion

A prospective randomized study was undertaken of 50 consecutive patients undergoing surgery for idiopathic carpal tunnel syndrome to determine the value of splintage of the wrist following open carpal tunnel release. Patients were randomized to either be splinted for 2 weeks following surgery or to begin range-of-motion exercises on the first post-operative day. Subjects were evaluated at 2 weeks, 1 month, 3 months, and 6 months after surgery by motor and sensory testing, physical examination, and a questionnaire. Variables assessed included date of return to activities of daily living, dates of return to work at light duty and at full duty, pain level, grip strength, key pinch strength, and occurrence of complications. Patients who were splinted had significant delays in return to activities of daily living, return to work at light and full duty, and in recovery of grip and key pinch strength. Patients with splinted wrists experienced increased pain and scar tenderness in the first month after surgery; otherwise there was no difference between the groups in the incidence of complications. We conclude that splinting the wrist following open release of the flexor retinaculum is largely detrimental, although it may have a role in preventing the rare but significant complications of bowstringing of the tendons or entrapment of the median nerve in scar tissue. We recommend a home physiotherapy programme in which the wrist and fingers are exercised separately to avoid simultaneous finger and wrist flexion, which is the position most prone to cause bowstringing.

The Relative Responsiveness and Construct Validity of the Spanish Version of the Dash Instrument for Outcomes Assessment in Open Carpal Tunnel Release

2008 ◽  
Vol 34 (1) ◽  
pp. 72-75 ◽  
Author(s):  
R. S. ROSALES ◽  
I. DIEZ DE LA LASTRA ◽  
S. MCCABE ◽  
J. I. ORTEGA MARTINEZ ◽  
Y. M. HIDALGO
Keyword(s):  
Construct Validity ◽  
Carpal Tunnel ◽  
Short Form ◽  
Carpal Tunnel Release ◽  
Physical Exam ◽  
Spanish Version ◽  
Pinch Strength ◽  
Sf 36 ◽  
Study Population ◽  
Open Carpal Tunnel Release

The objective of this study was to evaluate the responsiveness and construct validity of the Spanish version of the DASH as outcome measure for carpal tunnel surgery. The study population was 42 patients with the diagnosis of carpal tunnel syndrome (CTS) based on clinical and electrophysiological criteria. The clinical design was a classic Cohort study with measures the day before and 12 weeks after open carpal tunnel release. The Spanish version of the DASH was compared to the physical exam measures as dexterity time, grip and pinch strength, range of motion of the wrist (ROM) and two-point discrimination (2PPD). The responsiveness was evaluated based on the effect size (ES) and the standardised response means (SRM). The Spanish version of the CTS questionnaire (CTQ) and the Spanish version of the 36-item short-form health survey (SF-36) were self-administered to the same study population and followed the same clinical design. The hypothesis that the DASH instrument should present a responsiveness level higher than the SF-36 and lower than the CTQ was established to demonstrate the construct validity. The DASH instrument showed an ES of 0.68 and an SRM of 1.00. Responsiveness of traditional physical exam measures were lower, running from 0.35 (SRM) for dexterity time to 0.00 (ES) for key pinch strength. The SF-36 presented a responsiveness level (range from 0.07 to 0.14) lower that the DASH. The CTQ showed the highest level of responsiveness (ES = 1.41 and 0.7) (SRM = 1.75 and 0.51). In conclusion, The DASH instrument is more sensitive in detecting clinical change than the physical exam measures for use in clinical outcome studies of CTS done at 12 weeks after surgery. The Spanish DASH showed a responsiveness lower than the CTQ and higher than the SF-36 as a proof of a good construct validity.

scholarly journals A Prospective, Randomized Trial Comparing Open and Endoscopic Carpal Tunnel Release Within the Same Patient

Hand ◽  
2018 ◽  
Vol 15 (3) ◽  
pp. 322-326 ◽  
Author(s):  
Brett M. Michelotti ◽  
Kavita T. Vakharia ◽  
Diane Romanowsky ◽  
Randy M. Hauck
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Functional Status ◽  
Carpal Tunnel ◽  
Symptom Severity ◽  
Carpal Tunnel Release ◽  
Demographic Data ◽  
Pinch Strength ◽  
Postoperative Time ◽  
Tunnel Syndrome ◽  
A Prospective Study

Background: Surgical management of carpal tunnel syndrome includes performing an endoscopic (ECTR) or open (OCTR) carpal tunnel release. Several studies have shown less postoperative pain and improvement in grip and pinch strength with the endoscopic technique. The goal of this study was to prospectively examine outcomes, patient satisfaction, and complications after both ECTR and OCTR in the opposite hands of the same patient. Methods: This was a prospective study in which patients with bilateral carpal tunnel syndrome underwent surgical release with both techniques, with initial operative approach randomized in the more symptomatic hand. Demographic data and functional outcomes were recorded, including the pain score, 2-point discrimination, Semmes-Weinstein monofilament testing, thenar strength testing, grip strength, carpal tunnel syndrome functional status score, carpal tunnel syndrome symptom severity score, and overall satisfaction. Results: Thirty patients completed the study; there were no significant differences in any measure at any of the postoperative time points. Symptom severity and functional status scores were not significantly different between groups at any evaluation. Subjectively, 24 of 30 patients did state they preferred the ECTR, mostly citing less pain as their primary reason, although pain scores were not significantly different. Differences in overall satisfaction were also not significant. Conclusions: Both techniques are well tolerated with no differences in outcomes. With the added cost and equipment associated with ECTR, and no added benefit, the usefulness of ECTR is questionable.

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