Outcome of Carpal Tunnel Release: a prospective study

BACKGROUND: Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy and is manifested by characteristic signs and symptoms resulting from median nerve compression at the carpal tunnel. The diagnosis is essentially clinical, which is further confirmed by nerve conduction studies. Surgical release of the transverse carpal ligament is advised when conservative treatment fails. METHODS: This prospective study evaluates the outcome of standard open carpal tunnel release performed at our center* from June 2004 to July 2007. Thirty two patients with idiopathic carpal tunnel syndrome, with failed conservative treatments, either with NSAIDs and/or local infiltration with corticosteroid injections plus night splint, or recurrence after conservative treatment were subjected to open carpal tunnel release after getting approval from the local ethical committee and getting a written and informed consent from the patient. Clinical assessment was done preoperatively and at 6 weeks, 3 months and 6 months following the procedure and included the two-point discrimination test at the tip of the index finger and Boston questionnaires as an outcome measurement of symptoms severity. All the patients were followed up for a period of six months. RESULTS: All the patients presented improvement in the postoperative evaluations in all the analyzed parameters. CONCLUSION: Open carpal tunnel release is a safe and effective method for the treatment of CTS and can be carried out when the conservative means fail to relieve the symptoms. DOI: http://dx.doi.org/10.3126/noaj.v1i1.8129 Nepal Orthopaedic Association Journal Vol.1(1) 2010

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The Anatomical Site of Constriction of the Median Nerve in Patients with Severe Idiopathic Carpal Tunnel Syndrome

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhsb.2006.07.013 ◽

2006 ◽

Vol 31 (6) ◽

pp. 608-610 ◽

Cited By ~ 6

Author(s):

M. M AL-QATTAN

Keyword(s):

Carpal Tunnel Syndrome ◽

Median Nerve ◽

Carpal Tunnel ◽

Carpal Tunnel Release ◽

Anatomical Site ◽

Idiopathic Carpal Tunnel Syndrome ◽

Tunnel Syndrome ◽

A Prospective Study ◽

Open Carpal Tunnel Release ◽

Radiological Studies

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.

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A Prospective Study of Outcome Following Mini-open Carpal Tunnel Release

Hand Surgery ◽

10.1142/s0218810403001522 ◽

2003 ◽

Vol 08 (01) ◽

pp. 59-63 ◽

Cited By ~ 10

Author(s):

Michael P. Bradley ◽

Edward P. Hayes ◽

Arnold-Peter C. Weiss ◽

Edward Akelman

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Carpal Tunnel Release ◽

Historical Cohort ◽

Endoscopic Release ◽

Severity Scores ◽

Tunnel Syndrome ◽

A Prospective Study ◽

Open Carpal Tunnel Release ◽

Mini Open

Mini-open carpal tunnel release has been the focus of recent attention for surgical decompression of carpal tunnel syndrome. Other techniques such as standard open carpal tunnel release and endoscopic release have been well established, and outcomes, complications and results for these operations have been published widely. Our study uses the validated Levine Katz questionnaire for carpal tunnel syndrome to measure patient subjective outcomes at one year follow-up after mini-open carpal tunnel release. Thirty-four consecutive hands were enrolled prospectively with preoperative and postoperative questionnaires. Mean symptom severity scores per question improved from 2.8 to 1.3 and mean function severity scores per question improved from 2.6 to 1.3. Comparing our data to the historical cohort of Levine et al., there was a statistically significant improvement in postoperative outcomes in our population (p < 0.0001).

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Angiolipoma: A Unique Cause of Carpal Tunnel Syndrome

Case Reports in Orthopedic Research ◽

10.1159/000511968 ◽

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.

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Wrist immobilization after carpal tunnel release: a prospective study

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2006000400013 ◽

2006 ◽

Vol 64 (3a) ◽

pp. 596-599 ◽

Cited By ~ 21

Author(s):

Roberto S. Martins ◽

Mario G. Siqueira ◽

Hougelli Simplício

Keyword(s):

Prospective Study ◽

Carpal Tunnel ◽

Outcome Measurement ◽

Carpal Tunnel Release ◽

Neutral Position ◽

Significant Difference ◽

Group B ◽

A Prospective Study ◽

Open Carpal Tunnel Release

This prospective study evaluates the possible advantages of wrist imobilization after open carpal tunnel release comparing the results of two weeks immobilization and no immobilization. Fifty two patients with idiopathic carpal tunnel syndrome were randomly selected in two groups after open carpal tunnel release. In one group (A, n=26) the patients wore a neutral-position wrist splint continuosly for two weeks. In the other group (B, n=26) no wrist immobilization was used. Clinical assessment was done pre-operatively and at 2 weeks follow-up and included the two-point discrimination test at the second finger and two questionnaires as an outcome measurement of symptoms severity and intensity. All the patients presented improvement in the postoperative evaluations in the three analyzed parameters. There was no significant difference between the two groups for any of the outcome measurements at the final follow-up. We conclude that wrist immobilization in the immediate post-operative period have no advantages when compared with no immobilization in the end result of carpal tunnel release.

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