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Carpal Tunnel

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https://www.readbyqxmd.com/read/29150192/thirty-day-reoperation-and-or-admission-after-elective-hand-surgery-in-adults-a%C3%A2-10-year-review
#1
Avi D Goodman, Joseph A Gil, Adam M Starr, Edward Akelman, Arnold-Peter C Weiss
PURPOSE: Whereas acute complications following elective hand surgery have been assumed to be rare, the incidence of 30-day unplanned reoperation and/or admission for the most common elective procedures has not been well described. Our goal was to calculate the incidence and identify the risk factors associated with these complications in a busy academic practice. METHODS: Our institution's quality assurance database was examined retrospectively for unplanned reoperations and/or admissions within 30 days in adults undergoing elective procedures with 2 senior attending surgeons from February 2006 to January 2016...
November 15, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29141522/perceived-comfort-during-minor-hand-surgeries-with-wide-awake-local-anaesthesia-no-tourniquet-walant-versus-local-anaesthesia-la-tourniquet
#2
Jayaletchumi Gunasagaran, Ee Soon Sean, Sachin Shivdas, Shams Amir, Tunku Sara Ahmad
PURPOSE: Minor hand surgeries can be done under field sterility in procedure rooms. Surgeons are still sceptical about the usage of wide awake local anaesthesia no tourniquet (WALANT) technique. They perceive that patients can tolerate tourniquet for a brief period while they perform minor surgeries under local anaesthesia (LA). We compared the perceived comfort experienced by patients during minor hand surgeries with WALANT and LA/tourniquet. We investigated the difference in preoperative preparation time, operating time and blood loss between the two groups...
September 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/29140902/endoscopic-carpal-tunnel-release-with-and-without-sedation
#3
Jacob E Tulipan, Nayoung Kim, Asif M Ilyas, Jonas L Matzon
BACKGROUND: This study evaluates outcomes and complications with endoscopic carpal tunnel release (eCTR) performed with local anesthesia (LOCAL) only versus local anesthesia with sedation (SEDATION). We hypothesize that patient outcomes and satisfaction will be equivalent in both groups irrespective of anesthesia type. METHODS: One hundred fifty-four consecutive patients undergoing eCTR with either LOCAL or SEDATION protocols were prospectively enrolled in a study of satisfaction and outcomes...
November 11, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29137727/the-quantitative-evaluation-of-the-relationship-between-the-forces-applied-to-the-palm-and-carpal-tunnel-pressure
#4
Kazutoshi Kubo, Yu-Shiuan Cheng, Boran Zhou, Kai-Nan An, Steven L Moran, Peter C Amadio, Xiaoming Zhang, Chunfeng Zhao
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy occurring in upper limbs. The etiology, however, has not been fully understood yet. Median nerve could be compressed by either increase of carpal tunnel pressure (CTP) or direct impingement when it is forced toward to carpal ligament especially in wrist flexion leading to CTS development. Thus, the increase of carpal tunnel pressure is considered an important role in CTS development. It has been identified that forces applied to the palm would affect the CTP...
November 4, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/29127019/a-survey-on-recent-medical-school-graduate-comfort-with-the-level-1-milestones
#5
Michael E Petravick, J Lawrence Marsh, Matthew D Karam, Douglas R Dirschl
OBJECTIVE: The Next Accreditation System implemented 5 levels of milestones for orthopedic surgery residents in 2013. The Level 1 milestones were noted as those "expected of an incoming resident." While the milestones were intended for assessing resident progression and readiness for independent practice, this designation can also be used to assess how well prepared graduating medical students are for beginning an orthopedic surgery residency. The primary objective of this paper is to measure recent medical school graduate comfort with the Level 1 milestones...
November 7, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29125813/the-effect-of-metabolic-syndrome-on-recurrence-in-patients-who-had-undergone-surgery-for-carpal-tunnel-syndrome
#6
Ersin Kasım Ulusoy, Alper Çıraklı, Yakup Ekinci
OBJECTIVES: This study aims to investigate whether or not metabolic syndrome (MS) affects recurrence in patients who had undergone surgery for carpal tunnel syndrome (CTS). PATIENTS AND METHODS: The study included 86 hands of 78 patients (19 males, 59 females; mean age 52.0±8.2 years; range 36 to 78 years) who underwent CTS surgery. Patients were examined clinically and demographically for the presence of MS. Patients were also evaluated using a visual analog scale and the Boston Carpal Tunnel Syndrome Questionnaire...
December 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/29123420/concurrent-musculoskeletal-and-soft-tissue-pain-in-the-upper-extremity-can-affect-the-treatment-and-prognosis-of-carpal-tunnel-syndrome-redefining-a-common-condition
#7
Reynaldo P Lazaro, Thomas S Eagan
Objective: To demonstrate the importance of recognizing and separating nonmedian nerve-related symptoms from those related to median nerve compression at the carpal tunnel. Methods: The records of 80 patients, aged 31-82 years (39 males and 41 females), who had undergone median nerve decompression using open and endoscopic release surgery, were reviewed. Peripheral electrodiagnostic studies were performed in all patients prior to surgery. Those whose nonmedian nerve-related symptoms, also known as musculoskeletal and soft tissue pain and tenderness, persisted postoperatively, were referred to another electrodiagnostic study to reassess the median nerve function at the carpal tunnel...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29122425/analgesic-consumption-following-outpatient-carpal-tunnel-release
#8
Blair Peters, Arash Izadpanah, Avinash Islur
PURPOSE: Few studies have examined the consumption of prescribed opioid medications after elective outpatient surgery. A better understanding of opioid consumption after elective upper-extremity surgery may lead to improved prescribing practices, decreased costs, and less leftover medication available for potential misuse. The goal of this study was to evaluate pain control and quantify the amount of leftover pain medication after outpatient carpal tunnel release. METHODS: We performed a prospective study of patients scheduled for outpatient carpal tunnel surgery...
November 7, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29117826/an-anatomic-variant-of-persistent-median-artery-in-association-with-carpal-tunnel-syndrome-case-report-and-review-of-the-literature
#9
Adam M Feintisch, Haripriya S Ayyala, Ramazi Datiashvili
The persistent median artery can be a rare cause of carpal tunnel syndrome. We present an anatomic variant of this artery. A 47-year-old female patient with bilateral carpal tunnel syndrome was found to have bilateral patent, functional persistent median arteries (PMA) upon operative exploration. Unlike previous reports, the PMAs were not located dorsal to the flexor retinaculum (FR). Rather, the PMAs were interposed between the palmar aponeurosis and the FR. Accompanied by two venae comitantes, the aberrant arteries were positioned directly in line with our carpal tunnel incisions on both hands...
December 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/29117820/carpal-tunnel-syndrome-and-trigger-wrist-caused-by-localized-amyloidosis-a-case-report
#10
Takuma Wakasugi, Ritsuro Shirasaka, Toshiyuki Kawauchi, Koji Fujita, Atsushi Okawa
We report a case of carpal tunnel syndrome and trigger wrist caused by localized amyloidosis. A 37-year-old man, who worked as a manufacturer, presented with a 5-month history of tingling sensation in the three radial fingers of the left hand and a painful click at the volar aspect of the wrist during digital motion. We divided the transverse carpal ligament and detected diffuse tenosynovitis that was especially severe around the flexor digitorum profundus tendons. Histological findings led to a diagnosis of amyloidosis...
December 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/29117740/regional-variations-of-medicare-physician-payments-for-hand-surgery-procedures-in-the-united-states
#11
David R Veltre, Mark Yakavonis, Emily J Curry, Antonio Cusano, Robert L Parisien, Josef K Eichinger, Scott F M Duncan, Andrew B Stein, Xinning Li
BACKGROUND: Medicare reimbursement is known to exhibit geographic variation for inpatient orthopedic procedures. This study determined whether US geographic variations also exist for commonly performed hand surgeries. METHODS: Using the Medicare Provider Utilization and Payment Data (2012-2013) from Centers for Medicare & Medicaid Services, we analyzed regional physician charges/payments for common outpatient hand surgeries. RESULTS: The most commonly performed procedures in the United States were open carpal tunnel release (n = 21 944), trigger finger release (n = 15 345), endoscopic carpal tunnel release (n = 7106), and basal joint arthroplasty/ligament reconstruction and tendon interposition (n = 2408)...
November 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29115959/increased-stiffness-of-median-nerve-in-systemic-sclerosis
#12
Ilker Yagci, Ozge Kenis-Coskun, Tugba Ozsoy, Gulsen Ozen, Haner Direskeneli
BACKGROUND: Systemic sclerosis can affect peripheral nerves, but the extent and the nature of this involvement are not well defined. The aim of this study is to compare the sonoelastrographic measurements of median nerves in systemic sclerosis (SSC), idiopathic carpal tunnel syndrome (CTS) and healthy individuals. METHODS: The clinical, electrophysiological and ultrasonographic assessments were done. Patients with SSC and CTS were assessed with nerve conduction studies...
November 7, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29114414/comparison-between-the-two-injection-technique-and-the-four-injection-technique-in-axillary-brachial-plexus-block-with-articaine
#13
Aysun Ertikin, Güldeniz Argun, Mesut Mısırlıoğlu, Murat Aydın, Murat Arıkan, Nihal Kadıoğulları
Objective: In this study, we aimed to compare axillary brachial plexus block using the two-injection and four-injection techniques assisted with ultrasonography (USG) and nerve stimulator in patients operated for carpal tunnel syndrome with articaine. To evaluate which technique is more effective, we compared the onset time, effectiveness, and duration of block procedures, patient satisfaction, adverse effect of the drug, and complication rates of the motor and sensory blocks. Methods: Sixty patients were randomly divided into two groups...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29114281/factors-correlated-with-unfavorable-outcome-after-carpal-tunnel-release-surgery
#14
Fakhr Fakhouri, Rana Alnasser Alsukhni, Bashar Altunbi, Zakaria Hawoot, Rasha Dabbagh
Objectives: Carpal tunnel release surgery has excellent results. The aim of this study was to identify which baseline clinical and demographic factors could predict a good outcome from surgery. Understanding the impact of prognostic factors will enable surgeons to indicate surgical intervention better, provide appropriate preoperative counseling, and manage expectations postoperatively. Materials and Methods: A prospective, observational study included 620 carpal tunnel syndrome patients (age 42...
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29108853/the-biomechanics-of-subsynovial-connective-tissue-in-health-and-its-role-in-carpal-tunnel-syndrome
#15
REVIEW
V J M M Festen-Schrier, P C Amadio
Carpal Tunnel Syndrome (CTS) is the most common surgically treated problem in the hand. Aside from the neuropathy itself, the most common findings are fibrosis of the subsynovial connective tissue (SSCT) and increased intra carpal tunnel pressure. Normally, the SSCT is a multilayer tissue interspersed among the carpal tendons and nerve. As the tendons move, successive SSCT layers are recruited, forming a gliding unit and providing a limit to differential movement. Exceeding this limit, damages the SSCT as has been shown in both cadavers and animal models...
October 24, 2017: Journal of Electromyography and Kinesiology
https://www.readbyqxmd.com/read/29102992/association-of-psychological-distress-quality-of-life-and-costs-with-carpal-tunnel-syndrome-severity-a-cross-sectional-analysis-of-the-palms-cohort
#16
Christina Jerosch-Herold, Julie Houghton, Julian Blake, Anum Shaikh, Edward Cf Wilson, Lee Shepstone
OBJECTIVES: The Prediciting factors for response to treatment in carpal tunnel syndrome (PALMS) study is designed to identify prognostic factors for outcome from corticosteroid injection and surgical decompression for carpal tunnel syndrome (CTS) and predictors of cost over 2 years. The aim of this paper is to explore the cross-sectional association of baseline patient-reported and clinical severity with anxiety, depression, health-related quality of life and costs of CTS in patients referred to secondary care...
November 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/29099415/analgesic-drug-prescription-after-carpal-tunnel-surgery-a-pharmacoepidemiological-study-investigating-postoperative-pain
#17
Régis Fuzier, Isabelle Serres, Robert Bourrel, Aurore Palmaro, Maryse Lapeyre-Mestre
BACKGROUND AND OBJECTIVES: Carpal tunnel syndrome is a frequent cause of neuropathic pain of the upper limb. Surgery is often proposed in second-line treatment, leading to an expected decrease in analgesic drug consumption. The main objective of this study was to investigate the variations in analgesic drug prescriptions, with a special focus on constant or increasing prescription patterns, before and after surgery for carpal tunnel syndrome. METHODS: We designed a retrospective cohort study of French beneficiaries from the health insurance system in Midi-Pyrénées area...
November 2, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29091494/abductor-digiti-minimi-flap-for-vascularized-coverage-in-the-surgical-management-of-complex-regional-pain-syndrome-following-carpal-tunnel-release
#18
Kevin Cheung, Melissa A Klausmeyer, Jesse B Jupiter
BACKGROUND: The development of Complex Regional Pain Syndrome (CRPS) represents a potentially devastating complication following carpal tunnel release. In the presence of a suspected incomplete release of the transverse carpal ligament or direct injury to the median nerve, neurolysis as well as nerve coverage to prevent recurrent scar has been shown to be effective. METHODS: Retrospective chart review and telephone interview was conducted for patients who underwent abductor digiti minimi flap coverage and neurolysis of the median nerve for CRPS following carpal tunnel release...
November 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29091490/prospective-evaluation-of-opioid-consumption-following-hand-surgery-performed-wide-awake-versus-with-sedation
#19
Andrew Miller, Nayoung Kim, Asif M Ilyas
BACKGROUND: We prospectively evaluated opioid consumption postoperatively following trigger finger release (TFR) and open carpal tunnel release (CTR), and hypothesized that cases performed wide awake with local anesthesia and no tourniquet (WALANT) would result in increased opioid consumption compared with cases performed under monitored anesthesia care (MAC). METHODS: Postoperative opioid consumption following CTR and TFR was prospectively collected over 6 months...
November 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29091486/postoperative-pain-management-following-carpal-tunnel-release-a-prospective-cohort-evaluation
#20
Andrew Miller, Nayoung Kim, Benjamin Zmistowski, Asif M Ilyas, Jonas L Matzon
BACKGROUND: Managing postoperative pain in hand surgery is important for both patients and surgeons. However, there is growing concern over prescription opioid abuse. We hypothesized: (1) that pain medications after carpal tunnel release (CTR) surgery are over-prescribed; and (2) that opioids are unnecessary in the majority of patients. METHODS: We prospectively studied 2 demographically similar patient cohorts receiving either opioid or tramadol for CTR performed by 2 hand surgery fellowship-trained orthopedic surgeons over a 1-year period...
November 2017: Hand: Official Journal of the American Association for Hand Surgery
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